Polypharmacy among community-dwelling elderly in Singapore: Prevalence, risk factors and association with medication non-adherence

Abstract

Background: Polypharmacy, given its link with drug interactions, potentially inappropriate medications and medication non-adherence, may pose a significant health risk, especially among the elderly. A comprehensive understanding of the epidemiology of polypharmacy is essential for countries facing population ageing and growing chronic disease burden, like Singapore. Objectives: We assessed the prevalence and risk factors of polypharmacy (⩾5 prescription medications) among community-dwelling elderly in Singapore and established the association of polypharmacy with medication non-adherence. Methods: We used data from a national sample of 1499 community-dwelling elderly aged ⩾66 years. Using logistic regression, we assessed the association of socio-demographic, health and healthcare use variables with polypharmacy, and polypharmacy with medication non-adherence. Results: The weighted prevalence of polypharmacy was 14.5%. In multivariable analysis, elderly who were men (versus women), with ⩾2 (versus 0–1) chronic diseases, aged ⩾85 (versus 66–69) years, and of Malay and Indian (versus Chinese) ethnicity were significantly more likely to have polypharmacy; healthcare use variables were not associated. Polypharmacy was significantly correlated with medication non-adherence. Conclusions: The prevalence of polypharmacy among community-dwelling elderly in Singapore is lower than that reported in other countries; however, polypharmacy is associated with medication non-adherence. Elderly subgroups, defined by gender, health status, age and ethnicity, who are at a higher risk of polypharmacy will benefit from medication review and de-prescribing services.

Conformity of prescription medication labels with label format and content recommendations

“…The UMS is particularly useful for patients with polypharmacy to consolidate their medications to be taken at specific intervals throughout the day. A previous study observed that 14.5% of older Singaporeans had polypharmacy, and those with polypharmacy are less likely to adhere to their medications 25 . Only 21.2% of the PMLs in our study used explicit dosing instructions.…”

The economic burden of mental disorders among adults in Singapore: evidence from the 2016 Singapore Mental Health Study

“…Moreover, even though they had higher rates of these conditions, they had the lowest rates of screening for chronic conditions, such as cancers, diabetes, hypertension, and high cholesterol (Ministry of Health, 2010). It has been postulated that when there are high rates of undetected or unaddressed chronic health problems, these could lead to greater disease severity and polypharmacy risks (Tan et al, 2019), which potentially increase the overall healthcare utilization. Our results showed several significant interaction effects of mental disorders with specific sociodemographic variables and chronic physical conditions on total costs.…”

Clinical indicators of the nursing diagnosis ineffective health management: Systematic review and meta‐analysis

“…The CI “difficulty with prescribed regimen” may result from several interrelated factors, such as multimorbidities (Maffoni et al, 2020), difficulties in accessing medications or health services, poor health literacy skills (Devine et al, 2018), economic disadvantages (Reiners et al, 2019), and complex treatment regimens (Ayele et al, 2019) characterized by the number of medications needed for daily use (Tan et al, 2019), among others. In studies conducted with people with alcohol use disorder (Silva et al, 2013), people with high blood pressure (Lima et al, 2017), and people with chronic kidney disease on hemodialysis (Paiva et al, 2018), this CI showed high specificity.…”