Use of potentially inappropriate medication and polypharmacy in older adults: a repeated cross-sectional study

Abstract

Background: Potential inappropriate medications (PIM) have an increased risk for adverse drug reactions (ADR) in an older adult population. With increasing age, multimorbidity is growing along with the use of medications. For several years, polypharmacy has been found to increase in western societies. Polypharmacy is associated with an increased risk of ADR. In this study, we analysed the prevalence of PIM in an older adult population and in different strata of the variables age, gender, number of chronic conditions and polypharmacy and how that prevalence changed over time. Methods: This is a registry based repeated cross-sectional study including two cohorts. Individuals aged 75 or older listed at a primary care centre in Blekinge on the 31st March 2011 (cohort 1) or on the 31st December 2013 (cohort 2) were included in the respective cohorts. Using a chi2 test, the two cohorts were compared on the variables age, gender, number of chronic conditions and polypharmacy. Use of five or more medications at the same time was the definition for polypharmacy. Results: Use of PIM decreased from 10.60% to 7.04% (p-value 0.000) between 2011 and 2013, while prevalence of five to seven chronic conditions increased from 20.55% to 23.66% (p-value 0.000). Use of PIM decreased in all strata of the variables age, gender number of chronic conditions and polypharmacy. Except for age 80 to ≤ 85 and males, where it increased, prevalence of polypharmacy was stable in all strata of the variables. Conclusions: Use of potentially inappropriate medications had decreased in all variables between 2011 and 2013. Polypharmacy does not increase significantly compared to the rest of the population.

Polypharmacy and Lack of Joy Are Related to Physical Frailty among Northern Japanese Community-Dwellers from the ORANGE Cohort Study

“…A systematic review reported that, globally, there is large heterogeneity in the definition of polypharmacy ranging from numerical counts only, numerical counts for a given therapeutic setting or duration [15]. A cross-sectional study has investigated the prevalence of polypharmacy in Sweden, divided into 2 strata of no use to use of 4 medications (i.e., no polypharmacy) and use of 5 or more medications (i.e., polypharmacy) [16]. In Japan, the "Guidelines for Medical Treatment and Its Safety in the Elderly 2015" reported that an increase in occurrence of adverse drug events (ADE) is associated with the number of medications, such as 6 or more kinds of medication [17].…”