Patterns of patients with polypharmacy in adult population from Korea

Abstract

Polypharmacy and its rising global prevalence is a growing public health burden. Using a large representative nationwide Korean cohort (N = 761,145), we conducted a retrospective cross-sectional study aiming to identify subpopulations of patients with polypharmacy and characterize their unique patterns through cluster analysis. Patients aged ≥ 30 years who were prescribed at least one medication between 2014 and 2018 were included in our study. Six clusters were identified: cluster 1 mostly included patients who were hospitalized for a long time (4.3 ± 5.3 days); cluster 2 consisted of patients with disabilities (100.0%) and had the highest mean number of prescription drugs (7.7 ± 2.8 medications); cluster 3 was a group of low-income patients (99.9%); cluster 4 was a group of high-income patients (80.2%) who frequently (46.4 ± 25.9 days) visited hospitals/clinics (7.3 ± 2.7 places); cluster 5 was mostly elderly (74.9 ± 9.8 years) females (80.3%); and cluster 6 comprised mostly middle-aged (56.4 ± 1.5 years) males (88.6%) (all P < 0.001). Patients in clusters 1–5 had more prescribed medications and outpatient visit days than those in cluster 6 (all P < 0.001). Given limited health care resources, individuals with any of the identified phenotypes may be preferential candidates for participation in intervention programs for optimal medication use.

Differences in healthcare service utilization in patients with polypharmacy according to their risk level by adjusted morbidity groups: a population-based cross-sectional study

“…Our lower numbers could point to a more appropriate and safe use of drugs by these patients and a more suitable prescription of medications by the healthcare professionals in the Community of Madrid [ 42 ]. In a similar way, the rates of hospitalizations were lower than those observed in many previous reviews [ 13 , 27 , 42 , 44 ], although similar [ 32 ] or lower [ 25 ] to others. In comparison with the total population of the Community of Madrid, patients with polypharmacy visited the emergency room and were hospitalized around two times more [ 29 ], coinciding with the results reported by Nascimento et al [ 13 ].…”

“…The most prevalent comorbidities within the polypharmacy population were hypertension, dyslipidaemia, diabetes, osteoporosis, dysrhythmias, arthrosis and obesity, in accordance with other populations with polypharmacy [ 13 , 19 , 27 ] and with the elderly population with polypharmacy [ 12 , 15 , 18 , 21 , 24 – 26 , 28 ]. Our results agree with earlier findings that cardiovascular diseases are more prevalent in men, while arthritis, osteoporosis and thyroid disorder are more prevalent in women [ 12 , 15 , 16 , 18 , 26 ].…”

“…Patients with polypharmacy made great use of PC services, accounting for a mean of 25.9 contacts annually, similar in number to that observed within other polypharmacy populations [ 32 , 33 ], but lower than that in other studies that defined polypharmacy as the use of 5 or more medications [ 21 , 27 ]. The frequency of contacts with PC described for polypharmacy patients tripled that registered by non-polypharmacy patients, and the group of polypharmacy high risk patients registered the highest mean of contacts with PC, pursuant to the fact that the use of PC increases with the number of medicines consumed [ 12 , 21 , 22 , 25 , 34 ].…”

Trends in commonly used and potentially inappropriate medications in older Korean patients with polypharmacy

“…Initiatives to reduce potentially inappropriate medication use, especially among frail older adults living in long-term care facilities, should be prioritized. Considering that patients with polypharmacy usually visit multiple medical institutions in Korea, it may be an option to implement a primary care physician system for older patients [ 26 ].…”

Prevalence, trends, and characteristics of polypharmacy among US pregnant women aged 15 to 44 years: NHANES 1999 to 2016

“…Previous studies primarily investigated polypharmacy issues in populations other than pregnant women. [11][12][13] Although some studies showed a trend of polypharmacy in pregnant women, they were either not nationally representative or focused on specific conditions such as psychiatric illnesses, epilepsy, and migraines. [14][15][16][17] Therefore, findings from previous studies cannot provide a comprehensive overview of polypharmacy in pregnant women from a US nationally representative perspective.…”