Drug-related problems in hospitalized patients on polypharmacy: the influence of age and gender

Abstract

Background: Drug-related problems (DRPs) have been shown to prevail in hospitalized patients, and polypharmacy and increasing age have been identified as two important risk factors. Objective: We investigated the occurrence of DRPs and adverse drug reactions (ADRs) amongst hospitalized patients prescribed polypharmacy, and the association of advanced age and female gender. Method: A retrospective cross-sectional study was performed in an acute-care hospital in Singapore. Only patients prescribed polypharmacy were included. Mann-Whitney test was used to test for significant difference between the age and gender of patients and their risk of acquiring DRPs. The relative risks of developing DRP and ADR for geriatric patients and female patients were estimated. Results: Of 347 patients prescribed polypharmacy (43% female and 58.2% geriatrics), no statistical correlations were observed between age and gender with developing DRPs. An increased number of medications was associated with higher risk for patients with DRPs on admission (p = 0.001), but not for inpatients with DRPs (p = 0.119). Results from patients with ADRs showed that the relative risk (RR) of geriatrics prescribed polypharmacy and major polypharmacy (10 and more drugs) were 1.01 and 1.23, respectively. Female patients had a RR of 0.79 compared with male patients in developing ADRs. Conclusion: Results showed that among patients with polypharmacy, age and gender may not be as important as number of drugs prescribed as predictors of experiencing a DRP. A similar trend was observed in the development of ADRs.

Pharmacist Involvement to Decrease Drug-Related Problems Among Geriatric Patients in Indonesian Primary Health Centers

“…The duration of treatment was positively correlated with undesirable drug reactions [24]. The patient's age before and after the recommendations were not correlated and had no effect on the occurrence of DRPs, almost in line with the research conducted by Koh et al [27], which proposed that age does not significantly affect DRPs but the number of the drugs was an important predictor. Increasing age in geriatric patients in this study probably caused physicians to give extra attention to prescribed medication.…”

To study the pattern of adverse drug reactions among patients hospitalized in the medical wards of a tertiary care hospital

“…Similar results were reported by Goyal et al (59.3%), Chen et al (68.5%) and Palanisamy et al (59%) in male and (41%) were female whereas Lobo et al and Koh et al concluded in their studies that gender was not a risk factor to develop ADRs. [13][14][15][16][17] In our study age group 41-60 years showed high incidence of ADRs (38.4%) in both the genders. Similar findings were shown by Palanisamy et al who observed the same age group (41-60 years) with 42.71% of ADRs.…”

Polypharmacy, length of hospital stay, and in-hospital mortality among elderly patients in internal medicine wards. The REPOSI study

“…Although polypharmacy has no generally accepted definition, most often it is defined by cut-offs, in terms of the number of medications taken, ranging from two to ten (9)(10)(11)(12). However, regardless of the definition, its prevalence has been reported to rise with age, and is associated with an increased risk of inappropriate drug prescription, under-use of effective treatment, medication errors, poor adherence to pharmacological therapies, drug/drug and drug/disease interactions, and adverse effects (3,(13)(14)(15)(16)(17)(18).…”

“…Many risk factors for polypharmacy have been identified, including demographic aspects such as age, white race, education, sex, poor health, number of chronic diseases, living arrangements, and the number and characteristics health providers (1)(2)(14)(15)(16). Elderly patients with multiple chronic conditions are common in general medicine specialties such as internal and geriatric medicine.…”

“…In many cases hospitalization is associated with an irreversible decline in functional status, cognitive performance, and quality of life (14,20,24,30). Although polypharmacy and the risk of inappropriate use of medications in community-living and institutionalized elderly patients have been amply described, few studies have analyzed the prevalence, the predictors and the in-hospital outcomes of polypharmacy in elderly.…”