Global prevalence of polypharmacy among the COVID-19 patients: a comprehensive systematic review and meta-analysis of observational studies

Abstract

Background Polypharmacy has traditionally been defined in various texts as the use of 5 or more chronic drugs, the use of inappropriate drugs, or drugs that are not clinically authorized. The aim of this study was to evaluate the prevalence of polypharmacy among the COVID-19 patients, and the side effects, by systematic review and meta-analysis. Methods This study was performed by systematic review method and in accordance with PRISMA 2020 criteria. The protocol in this work is registered in PROSPERO (CRD42021281552). Particular databases and repositories have been searched to identify and select relevant studies. The quality of articles was assessed based on the Newcastle–Ottawa Scale checklist. Heterogeneity of the studies was measured using the I2 test. Results The results of meta-analysis showed that the prevalence of polypharmacy in 14 studies with a sample size of 189,870 patients with COVID-19 is 34.6% (95% CI: 29.6–40). Studies have shown that polypharmacy is associated with side effects, increased morbidity and mortality among patients with COVID-19. The results of meta-regression analysis reported that with increasing age of COVID-19 patients, the prevalence of polypharmacy increases (p < 0.05). Discussion The most important strength of this study is the updated search to June 2022 and the use of all databases to increase the accuracy and sensitivity of the study. The most important limitation of this study is the lack of proper definition of polypharmacy in some studies and not mentioning the number of drugs used for patients in these studies. Conclusion Polypharmacy is seen in many patients with COVID-19. Since there is no definitive cure for COVID-19, the multiplicity of drugs used to treat this disease can affect the severity of the disease and its side effects as a result of drug interactions. This highlights the importance of controlling and managing prescription drugs for patients with COVID-19.

Correlates of poor clinical outcomes related to COVID-19 among older people with psychiatric illness - a mixed methods study

“…21,26 Polypharmacy and high anticholinergic burden have been associated with increased risk of poor clinical outcomes related to COVID-19. 27,28 Our findings corroborate the association of high anti-cholinergic burden with COVID-19 related poor clinical outcomes, and add novel evidence for its association with COVID-19 related deaths. Biological mechanisms underlying these associations should be investigated further.…”

Prevalence of Potentially Inappropriate Prescriptions According to the New STOPP/START Criteria in Nursing Homes: A Systematic Review

“…The authors also showed that the older the COVID patients are, the higher the prevalence of polypharmacy. Therefore, it is possible that in recent years PIPs in NHs have increased even more due to the pandemic [15] PIPs have a negative impact on older people at multiple levels. A recent meta-analysis has shown a significant association with emergency room visits, adverse drug events, functional decline, health-related quality of life and hospitalizations [16].…”

Polypharmacy and potentially inappropriate medications among hospitalized older adults with COVID-19 in Malaysian tertiary hospitals

“…With a rapidly ageing population worldwide, studies regarding polypharmacy PIMs were extensively conducted in recent years among older adults. A metaanalysis of polypharmacy prevalence among 189,870 patients reported a pooled prevalence of 34.6%, in which most of the studies were conducted in developed European countries [12]. Comparatively, a study in India revealed that the prevalence of polypharmacy among adults admitted in COVID-19 ward was more than 80% [13].…”