Polypharmacy and medication adherence

Murray, Michael D.; Kroenke, Kurt

doi:10.1007/s11606-001-0033-y

Cited by 44 publications

(20 citation statements)

References 18 publications

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“…First, since CAM therapies are commonly used along with prescription medications, research suggests that increasing the number of interventions may adversely affect adherence, and/or adherence to conventional treatment recommendations. 19–21 On the other hand, if families use CAM to mitigate side effects of conventional care, having fewer side effects may improve adherence to prescription medications. Another question is whether families turn to CAM instead of seeking professional mental/behavioral counseling due to financial barriers and/or other factors.…”

Section: Discussionmentioning

confidence: 99%

Use of Complementary and Alternative Medical Therapies Among Youth With Mental Health Concerns

Kemper

Gardiner

Birdee

2013

Academic Pediatrics

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Background Use of complementary and alternative medical (CAM) therapies is common among adults with mental health concerns, but little is known about CAM use among adolescents with mental health concerns. Methods Data from the 2007 National Health Interview Survey were analyzed for youth from 7–17 years old. The study focused on three common mental health conditions: attention deficit hyperactivity disorder (ADHD), anxiety, and depression. CAM use was identified by criteria from the National Institutes of Health National Center for Complementary and Alternative Medicine (NIH NCCAM). Results In a sample of 5651 individuals, representing seven million youth, with one or more mental health concerns in the past 12 months, 28.9% used one or more types of CAM excluding vitamins/minerals. In contrast, only 11.6% of those without mental health concerns reported CAM use (P<0.05). Among youth with one or more mental health conditions, the most commonly used CAM therapies were mind-body therapies (16.3%) and biologically-based therapies (11%); use was higher for therapies that could be directly accessed (18.6%), than for therapies delivered in groups (11.8%) or through a health professional (10.2%). In the multivariable regression model, demographic factors significantly associated with CAM use were higher household income, higher parental education, having other chronic health conditions, use of prescription medications, and difficulty affording mental health counseling. Conclusion Readily accessible CAM therapies are commonly used by youth with ADHD, depression, and anxiety, particularly those who have co-morbid chronic health conditions, take prescription medications, and difficulty affording counseling. Clinicians can use this data to guide inquiries and counseling. Researchers should explore the longitudinal relationship between access to coordinated care within a medical home and use of CAM therapies among youth with mental health concerns. What’s New Use of CAM is more than twice as common among youth with mental health concerns as those without. Among youth with mental health conditions, use is associated with presence of co-morbidities, prescription medication use, and difficulty affording counseling, perhaps reflecting higher health care utilization and inability to seek conventional care due to cost.

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Section: Discussionmentioning

confidence: 99%

Use of Complementary and Alternative Medical Therapies Among Youth With Mental Health Concerns

Kemper

Gardiner

Birdee

2013

Academic Pediatrics

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“…[7] Concerns with polypharmacy include the possibility of cumulative toxicity and increased vulnerability to adverse events as well as adherence issues which emerge with increasing regimen complexity. [16]…”

Section: Discussionmentioning

confidence: 99%

Pattern of psychotropic prescription in a tertiary care center: A critical analysis

et al. 2013

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Objectives:To study the prescription pattern of psychotropic drugs in a Tertiary Care Hospital in Eastern India with special reference to polypharmacy.Materials and Methods:A total of 411 patients were included in the study through systematic sampling. Patients were diagnosed by a Consultant Psychiatrist before inclusion in the study using a semi-structured interview schedule based on the International Classification of Disease (ICD), classification of mental and behavioral disorders, 10th version). The most recently prescribed psychopharmacological medication of those patients was studied. A checklist to assess the pattern of prescription and evaluate reasons of polypharmacy was filled up by the prescribing consultant.Results:About 76.6% of the patients received polypharmacy in the index study. Males were more exposed to polypharmacy compared to women (80.93% vs. 70.85%). Gender and diagnosis had a predictive value with regard to the polypharmacy. Polypharmacy was more common in organic mental disorders (F0), psychoactive substance abuse disorders (F1), psychotic disorders (F2), mood disorders (F3) and in childhood, and adolescent mental disorders (F9). Most frequently, antipsychotic drugs were prescribed followed by tranquilizers/hypnotics and anticholinergics. Antidepressants (35.13%) were more commonly prescribed as monotherapy. Anticholinergics (100%) and tranquilizers/hypnotics (96.7%) were the drugs more commonly used in combination with other psychotropics. The three most common reasons for prescribing polypharmacy were augmentation (43.8%) of primary drug followed by its use to prevent adverse effects of primary drug (39.6%) and to treat comorbidity (34.9%).Conclusions:Polypharmacy is a common practice despite the research based guidelines suggest otherwise. More vigorous research is needed to address this sensitive issue.

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“…Concerns with polypharmacy include not only possibilities of cumulative toxicity and increased vulnerability to adverse events (Stahl, 2008[50]) but also adherence issues which emerge with increasing regimen complexity (Murray and Kroenke, 2001[30]). Combinations of drugs may lead to various pharmaco-dynamic and pharmaco-kinetic interactions.…”

Section: Introductionmentioning

confidence: 99%

Polypharmacy in psychiatry: A review

et al. 2013

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Psychiatric polypharmacy refers to the prescription of two or more psychiatric medications concurrently to a patient. It can be categorised as same-class, multi-class, adjunctive, augmentation and total polypharmacy. Despite advances in psychopharmacology and a better understanding of the principles of therapeutics, its practice is increasing rapidly. The prevalence of polypharmacy in psychiatry varies between 13%-90%. There are various clinical and pharmaco-economic factors associated with it. Dealing with polypharmacy requires an understanding of its associated factors. Education, guidelines and algorithms for the appropriate management of various conditions are effective ways to avoid irrational polypharmacy.

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Polypharmacy and medication adherence

Cited by 44 publications

References 18 publications

Use of Complementary and Alternative Medical Therapies Among Youth With Mental Health Concerns

Use of Complementary and Alternative Medical Therapies Among Youth With Mental Health Concerns

Pattern of psychotropic prescription in a tertiary care center: A critical analysis

Polypharmacy in psychiatry: A review

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