An Increasing Trend in the Prevalence of Polypharmacy in Sweden: A Nationwide Register-Based Study

Abstract

Polypharmacy is becoming a global health problem. The aims of this study were to evaluate the temporal trends in the prevalence of polypharmacy in Sweden and to explore polypharmacy disparities by age, gender, education, and immigration status. Methods: Polypharmacy and excessive polypharmacy were evaluated using data extracted from the Swedish Prescribed Drug Register between 2006 and 2014. Polypharmacy was defined as being exposed to five or more drugs and excessive polypharmacy was defined as being exposed to 10 or more drugs during 1 month respectively. Average annual percent change (AAPC) was calculated using Joinpoint Statistical Software. Results: The prevalence of polypharmacy increased from 16.9% in 2006 to 19.0% in 2014 with an AAPC of 1.3; the prevalence of excess polypharmacy increased from 3.8% in 2006 to 5.1% in 2014 with an AAPC of 3.4. The prevalence of polypharmacy and excessive polypharmacy increased dramatically with age and peaked up to 79.6% and 36.4% in individuals aged 90 and above respectively. Females and individuals with lower education level were associated with a higher rate of polypharmacy and excessive polypharmacy. Immigrants from Middle-Eastern countries had the highest rate of polypharmacy and excessive polypharmacy, whereas individuals from Western Europe countries had the lowest rate. Conclusion: The prevalence of polypharmacy has increased gradually in Sweden during the past decade. Individuals with older age, female sex, or lower education have a higher rate of polypharmacy and excessive polypharmacy. Immigrants from Middle-Eastern countries showed a higher rate of polypharmacy.

Prevalence and Age Structure of Polypharmacy in Poland: Results of the Analysis of the National Real-World Database of 38 Million Citizens

“…In this case our results are again similar to those obtained in other countries, proving polypharmacy particularly prevalent in the elderly. In Sweden, polypharmacy rates for age groups <60, 60-69, 70-79, 80-89 and over 90 years were 8.5, 35.9, 54.8, 73.0 and 79.6%, respectively in 2014 (Zhang et al, 2020). In Italy, polypharmacy was observed in 39.4% of the elderly in 2007 (Slabaugh et al, 2010), in Switzerland in 41% in 2013 (Blozik et al, 2013), in Denmark in 51% of those aged over 75 years in 2016 (Kornholt and Christensen, 2020).…”

“…These findings correspond with results of studies performed in other countries, despite several differences in methodology (e.g., different time frame, or number of dispensed drugs defining polypharmacy). Out of studies using threshold of ≥5 drugs, two assessed polypharmacy in Sweden and found to involve 11.1%, and 19.0% of the total population in 2008 and 2014, respectively (Hovstadius et al, 2010;Zhang et al, 2020). A study analyzing data from pharmacy claims of 1.7 million citizens found polypharmacy in 17% of Swiss population in 2013 (Blozik et al, 2013).…”

“…This challenge is even growing due to the rapid rise in its global prevalence that has been observed recently, to a large extent being caused by two interlinked factors, aging and multimorbidity. (Hovstadius et al, 2010;Charlesworth et al, 2015;Craftman et al, 2016;Martin-Pérez et al, 2017;Zhang et al, 2020) (Carmona-Torres et al, 2018.…”

The Quest for System-Theoretical Medicine in the COVID-19 Era

“…In synergy with ACh, cortisol also suppresses macrophage activity. Several other examples can be worked out ( 96 ), e.g., multimorbitidy and the problem of polypharmacy that affects about 20% of the population ( 97 , 98 ). For instance, the comorbidity of diabetes mellitus and depression can be revisited by looking to molecular signaling cross-overs between the CNS (relative hypofunction of noradrenaline, dopamine and serotonin compared to acetylcholine, glutamate, and GABA in depression) and the physiological control of beta and alpha cells in pancreas physiology by these neurotransmitters and also the effects of insulin in the brain, etc.…”

Psychosocial job strain and polypharmacy: a national cohort study

“…In Sweden, the prevalence of polypharmacy increased from 17% in 2006 to 19% in 2014 in the general population. The rate of polypharmacy was 8.5% among those <60 years ( 6 ). With growing medication use among those of working age, the contribution of working life to polypharmacy warrants further investigation.…”