Determinants of change in polypharmacy status in Switzerland: the population-based CoLaus study

Abstract

Objectives: To assess the prevalence, the change and the determinants of change in polypharmacy in a population-based sample.Methods: Baseline (2003-06) and follow-up (2009-12) data from 4679 participants aged between 35 and 75 years (53.5% women, mean age 52.6 ± 10.6 years) from the population of Lausanne, Switzerland.Polypharmacy was defined by the regular use of ≥5 drugs. Four categories of change were defined: never (no polypharmacy at baseline and follow-up), initiating (no polypharmacy at baseline but at follow-up), maintaining or quitting.Results: Polypharmacy increased from 7.7% at baseline to 15.3% at follow-up. Cardiovascular drugs were the most prescribed medicines at baseline and follow up. Gender, age, obesity, smoking, previously diagnosed hypertension or diabetes or dyslipidemia were significantly and independently associated with initiating and maintaining polypharmacy. Conclusion:In a population-based sample, prevalence of polypharmacy doubled over a 5.6 year period.The main determinants of initiating polypharmacy were age, overweight and obesity, smoking status and previous diagnosed cardiovascular risk factors. Abstract word count: 159

How Chronic Is Polypharmacy in Old Age? A Longitudinal Nationwide Cohort Study

“…The main strength of this study is that it includes the entire population of older adults aged 65 years or older with polypharmacy in Sweden, followed up for 3 years. The monthly assessments of polypharmacy exposure provide better time resolution of the fluctuations in polypharmacy status than earlier survey‐based studies with longer time periods between survey waves . There are some notable limitations to the study.…”

“…Yet, few studies have documented the longitudinal development of polypharmacy over time, and little is known about the proportion of older adults who are chronically exposed to polypharmacy. Prior studies suggest that older adults tend to persist with polypharmacy over time . Factors such as higher age, female sex, high body mass index, smoking, and chronic conditions are associated with higher odds of remaining on polypharmacy .…”

Polypharmacy in a semirural community in Chile: Results from Maule Cohort

“…Number of medications was coded as the number of active ingredients reported by each participant. Polypharmacy was defined as the concomitant use of five or more active ingredients, including herbal supplements and multivitamins …”

“…Polypharmacy is most commonly defined as the concomitant use of five or more medications . Polypharmacy has been associated with medication errors, drug‐drug interactions, drug‐disease interactions, increased health‐service utilization, and adverse drug reactions . Most studies analyzing polypharmacy and its risk factors are based on elderly populations .…”

“…[1][2][3] Polypharmacy has been associated with medication errors, drug-drug interactions, drug-disease interactions, increased health-service utilization, and adverse drug reactions. [2][3][4][5][6][7] Most studies analyzing polypharmacy and its risk factors are based on elderly populations. 1,8,9 However, polypharmacy in younger populations is a growing public health concern.…”