Prevalence and Risk of Polypharmacy among Community-Dwelling, Elderly Kuwaiti Patients

Abstract

Objectives: To estimate the prevalence of polypharmacy in community-dwelling, older Kuwaiti patients, describe the number and types of drugs used, and identify risk factors associated with polypharmacy. Subjects and Methods: This was a descriptive cross-sectional questionnaire-based survey in which we interviewed 500 community-dwelling Kuwaiti adults over 65 years of age. The data collection occurred during a 4-month period from March to July 2017. Results: Fifty-two percent (n = 260) of the patients were males, with a mean age of 71.73 ± 5.32 years. The prevalence of polypharmacy (5–8 drugs) and excessive polypharmacy (>8 drugs) was 58.4% (n = 292) and 10.2% (n = 51), respectively. The risk factors associated with an increased number of medicines used were: female gender (p = 0.019), a lower level of education (p = 0.003), a high number of hospital admissions (p = 0.000), clinics visited by the patient (p =0.000), and number of comorbidities (p = 0.000). The most commonly used medications (82.6% of the study population) were blood glucose-lowering agents, excluding insulin. Other commonly used medications were antihypertensive drugs and lipid-modifying agents. Conclusion: A significant sector of the older Kuwaiti patient population has a high prevalence of polypharmacy and is thus exposed to its potential hazards. The current study highlights the need to revise the drug-dispensing policy among community-dwelling, older Kuwaiti people, as well as to initiate educational programs among healthcare practitioners concerning prescribing issues in older individuals.

Prevalence of polypharmacy and the association with non-communicable diseases in Qatari elderly patients attending primary healthcare centers: A cross-sectional study

“…Three medications on this list (pantoprazole, rabeprazole, and esomeprazole) reduce gastric acid and are indicated for the treatment of conditions such as GERD and peptic ulcers. These are in line with other studies that have reported associations between polypharmacy and common comorbidities in the elderly [10,11,13,31,32].…”

“…A recent study conducted in Saudi Arabia among a sample of 3009 older adults found that 55% of them were exposed to polypharmacy [30]. Also, a study in Kuwait showed that more than 60% of the older adults had polypharmacy [31]. In addition, a study in Italy reported that the prevalence of polypharmacy among a national sample of elderly individuals was 40% [10], while a study in Sweden was 44.0% [17].…”

Economic implications of polypharmacy in Nepal: Multicenter community-based study

“…The studies conducted in different countries such as Saudi Arabia 22 ,Oman 23 , Brazil 24 , and England 25 also showed that gender had no significant impact on polypharmacy. However, research conducted in Kuwait showed significant relation of gender with polypharmacy 26 . Such discrepancy in the output with the demographic characteristics might be one of the beauties of epidemiologic research with a diverse population.…”

“…However, research conducted in Kuwait showed significant relation of gender with polypharmacy. 26 Such discrepancy in the output with the demographic characteristics might be one of the beauties of epidemiologic research with a diverse population. The study also reported that education beyond primary education significantly decreased polypharmacy as the case in the present study i.e, the lower the education, the higher was the incidence of polypharmacy.…”

“…The study also reported that education beyond primary education significantly decreased polypharmacy as the case in the present study i.e, the lower the education, the higher was the incidence of polypharmacy. 22,[26][27][28] Salih et al reported significant relationship of eight different diagnoses such as dyslipidemia, hypertension, diabetes mellitus, osteoarthritis, bronchial asthma, osteoporosis, heart failure and coronary artery disease with the polypharmacy. 22 Similarly, the study by Al-Hashar et al also reported that polypharmacy was significantly correlated with the number of comorbidities as well as with the cardiovascular disease as the admitting diagnosis.…”