Can Managed Care Manage Polypharmacy?

Stefanacci, Richard G.; Khan, Taha

doi:10.1016/j.cger.2017.01.005

Cited by 9 publications

(5 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some previous studies have established that the existence of the so‐called poly‐prescriber (multiple physicians who see the patient in different care settings) is a polymedication risk factor for older adults, a situation similar to that described in this work . It has also been determined that the fragmentation of care among different health service providers is a risk factor for excessive polypharmacy .…”

Section: Discussionsupporting

confidence: 57%

“…29 Some previous studies have established that the existence of the so-called poly-prescriber (multiple physicians who see the patient in different care settings) is a polymedication risk factor for older adults, a situation similar to that described in this work. 30 It has also been determined that the fragmentation of care among different health service providers is a risk factor for excessive polypharmacy. 9,14 A study that looked for the relationship between polypharmacy and the number of doctors in a population of the elderly found that when elderly patients were assessed by more than four prescribers in the last 4 months, the average number of medications used was 8.1, a figure similar to the findings of this series of patients.…”

Section: Multivariate Analysismentioning

confidence: 99%

See 1 more Smart Citation

Factors related to excessive polypharmacy (≥15 medications) in an outpatient population from Colombia

et al. 2018

View full text Add to dashboard Cite

Summary Aims To determine the frequency of excessive polypharmacy (≥15 medications) in an outpatient population from Colombia and the variables associated with this condition. Methods A cross‐sectional study using a systematised database of 6.2 million affiliates of the Colombian Health System. All patients treated uninterruptedly with 15 or more medications for 3 months (January‐March 2017) were included. Sociodemographic, pharmacological, potential drug interactions, and prescribers' variables were identified. Results A total of 264 patients with prescriptions of ≥15 medications were identified; with an estimated prevalence of excessive polypharmacy of 108.4 per 100 000 people. The mean age was 67.7 ± 17.8 years and 60.6% were females. The mean number of medications per patient was 20.1 ± 4.5 and 48.9% (n = 129) had 20 or more. The most used were antiulcer medications (89.0%; n = 235), antihypertensives (85.6%; n = 226), analgesic/antipyretic (80.3%; n = 212), psychiatric/neurologic medications (78.5%; n = 207), statins (67.4%; n = 178), acetylsalicylic acid (59.5%; n = 157), and vitamins (57.2%; n = 151). On average, each patient had 21.0 ± 11.4 drug‐drug interactions and were attended by 6.2 ± 3.1 physicians. Being treated by seven or more physicians (OR: 5.09; 95% CI: 1.64‐15.79) increased the probability of receiving more than 20 medications. Conclusions Drugs for treatment of chronic conditions prevailed, especially in elderly patients with multiple chronic conditions; however, some groups of medications without clear indications, such as antiulcer medications or vitamin supplements, also had extensive use. A main factor that increases the probability of polypharmacy greater than 20 drugs is care by seven or more physicians, which shows a fragmentation in patient care by the country's health system, without achieving co‐ordination and integration between the different agents involved in medical care, also influenced by different physicians′ practice patterns.

show abstract

Section: Discussionsupporting

confidence: 57%

Section: Multivariate Analysismentioning

confidence: 99%

Factors related to excessive polypharmacy (≥15 medications) in an outpatient population from Colombia

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Quantitative studies have been conducted in Africa on the effects of polypharmacy [ 10 , 14 ]. The assessment of older patients knowledge, attitude and belief on polyphamcy using qualitatitative methods has mostly been done outside Africa [ 15 , 16 ]. A South African a qualitatitative study [ 9 ], explored the knowledge, attitudes and beliefs of older persons about polypharmacy.…”

Section: Introductionmentioning

confidence: 99%

Knowledge, attitudes and beliefs toward polypharmacy among older people attending Family Medicine Clinic, Nairobi, Kenya

Kamau,

Nyanja,

Lusambili

et al. 2024

BMC Geriatr

View full text Add to dashboard Cite

Background Life expectancy has increased over the last century among older people, particularly those aged over 60 years. Aging is associated with increased disability, multiple chronic conditions, and increased use of health services managed with polypharmacy. There are few studies on polypharmacy and aging in sub-Saharan Africa, and it is unclear what older people know and their attitudes toward polypharmacy. This paper presents findings from a study that aimed to understand older people’s knowledge, attitudes and beliefs about polypharmacy. Methods A qualitative study using in-depth interviews of 15 patients aged 60 years and older who were taking more than five medications per day. The study was conducted at the Family Medicine Clinic (FMC), Aga Khan University Hospital, Nairobi. Data were analyzed using NVivo 12 software. Result Majority of participants had a good understanding of their underlying health conditions, but they did not know the specific names of the medications they were taking. Participants had diverse attitudes toward polypharmacy, with both positive and negative perceptions. Although adverse side effects were reported, participants remained positive because they believed these medicines were beneficial. Religion, faith and living healthy lifestyles were perceived to contribute to their positive attitude toward polypharmacy. Stigma and the cost of medication were reported as barriers. Conclusion This study provides valuable insights into the complexities of polypharmacy in older people. It highlights the importance of patient education, fostering strong patient-provider relationships, de-stigmatization, and improving medication affordability and accessibility. Further research could explore the polypharmacy of older people attending public institutions in rural Kenya.

show abstract

“…Several quantitative studies have been conducted in Africa on the effects of polypharmacy (10,11). While many of these studies investigate the prevalence of polypharmacy (12,13), there are even fewer qualitative studies exploring the knowledge, attitudes and beliefs of older persons about polypharmacy. Thus, a literature gap exists, particularly regarding a patient's lived experiences.…”

Section: Introductionmentioning

confidence: 99%

Knowledge, attitudes and beliefs toward polypharmacy among older people attending Family Medicine Clinic, Nairobi, Kenya

Kamau,

Mohamoud,

Lusambili

et al. 2023

Preprint

View full text Add to dashboard Cite

Background Life expectancy has increased over the last century among older individuals, particularly those 60 years and over. Aging is associated with increased disability, multiple chronic conditions, and increased use of health services managed with polypharmacy. There are few studies on polypharmacy and aging in sub-Saharan Africa, and it is unclear what older people know and their attitudes toward polypharmacy. This paper presents findings from a study that aimed to understand older people's knowledge, attitudes and beliefs toward polypharmacy. Methods A qualitative study using in-depth interviews of 15 patients aged 60 years and older taking more than five medications per day. The study was conducted at the Aga Khan University Hospital, Family Medicine Clinic (FMC). Data were analyzed using NVivo 12 software. Results Participants had a good understanding of their comorbidities. For many, healthcare professionals and the Internet remained credible sources of polypharmacy. Their beliefs influenced compliance with polypharmacy in order to live. Although adverse side effects were reported, participants remained positive because they believed these medicines were beneficial. Religious faith and living healthy lifestyles were perceived to contribute to their positive attitude toward polypharmacy. Stigma and the cost of the medication were reported as barriers. Conclusion Older patients need to be educated to reduce the negative attitudes and stigma associated with polypharmacy. Prescription review is encouraged at every clinical encounter to ensure that older patients do not use potentially inappropriate medications. Further research could explore polypharmacy in the geriatric population attending public institutions and in rural settings in Kenya.

show abstract

Can Managed Care Manage Polypharmacy?

Cited by 9 publications

References 17 publications

Factors related to excessive polypharmacy (≥15 medications) in an outpatient population from Colombia

Factors related to excessive polypharmacy (≥15 medications) in an outpatient population from Colombia

Knowledge, attitudes and beliefs toward polypharmacy among older people attending Family Medicine Clinic, Nairobi, Kenya

Knowledge, attitudes and beliefs toward polypharmacy among older people attending Family Medicine Clinic, Nairobi, Kenya

Contact Info

Product

Resources

About