Background Polypharmacy poses a growing challenge to healthcare systems because of its association with adverse effects and the misuse of medication. This study aimed to identify the sociodemographic factors and comorbidities associated with polypharmacy.
Methods We selected patients aged ≥30 years registered in the National Health Information Database in 2018 who were prescribed at least one medication for ≥180 days. Multivariate logistic regression analyses were performed to evaluate the associations between polypharmacy, sociodemographic characteristics, and comorbidities.
Results Polypharmacy was significantly associated with increasing age, with the strongest association observed in adults aged ≥65 years. Compared with medical aid recipients, higher-income groups had a weaker association with polypharmacy. After adjusting for covariates, significant associations with polypharmacy were found for specific comorbidities, such as Parkinson disease (odds ratio [OR], 3.804; 95% confidence interval [CI], 3.733–3.876; P<0.001) and chronic ischemic heart disease (OR, 3.199; 95% CI, 3.178–3.221; P<0.001).
Conclusion These findings may help reduce the burden of polypharmacy by facilitating the development of targeted strategies tailored to patients.
Background Many studies have assessed the risk factors for adverse drug reactions (ADRs) in elderly patients. However, most of these studies have focused on risk factors for ADRs, not serious ADRs (s-ADRs). s-ADRs are commonly found in hospitalized patients. s-ADRs warrant imminent but thorough investigations, given their critical impact on patient health. Therefore, this retrospective study aimed to assess the associated risk factors for s-ADRs in elderly hospitalized patients.
Methods In-patients aged >65 years having ADRs during hospitalization at a university hospital in Korea between 2010 and 2012 were included. Medical professionals spontaneously reported ADRs using an electronic submission system at the study hospital. Further, all descriptions of ADRs were characterized and categorized through the screening of electronic medical records. We compared the characteristics of patients having s-ADRs with those of patients not having s-ADRs.
Results There were 353 cases of ADRs, 67 of which were s-ADRs. Patients taking more than eight concomitant drugs showed the highest odds ratio (OR, 11.99; 95% confidence interval [CI], 3.42–42.03). The ratio of aspartate aminotransferase (AST)/alanine aminotransferase (ALT) was also significantly related to s-ADRs (OR, 2.78; 95% CI, 1.33–5.81). The use of antibiotics (OR, 2.39; 95% CI, 1.13–5.02) and antineoplastics (OR, 4.17; 95% CI, 1.09–15.94) were significant risk factors.
Conclusion Our findings highlight the importance of polypharmacy. Liver function tests (AST/ALT ratio) must be monitored carefully within high-risk groups for ADRs.
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Background: Due to rapidly growing elderly population, there are increasing numbers of older persons with multiple chronic disorders and geriatric problems arising from polypharmacy. In this study we tried to find out the state of polypharmacy and inappropriate drug prescription and their related factors in community-dwelling elderly by review of drugs taken by older persons visiting a day health center. Methods: From April 2007 to July 2007, 80 subjects of 65 year-old or over with chronic illness who visited a elderly-wellness and health care center were randomly sampled. All of them were surveyed by structured questionnaires, medical records review, pill counts about all medications they are taking and experience of adverse drug reactions. And all the prescribed medications were reviewed or their drug prescription's appropriateness for each elderly according to Beers criteria. Data results were evaluated by frequency and correlation analyses. Results: The average counts of drugs taken by elderly with chronic disorders were 7.23, minimum 1 to maximum 27 drugs a day. Patients experienced more adverse effects significantly when more prescribed medications were taken (P=0.005), and patients with lack of information about their drugs had taken increased number of medications (P<0.001). Referred to Beers criteria, inappropriate cases of prescription were observed in 26 persons. Those drugs were NSAIDs including aspirin in 17 subjects (21%), amitrityline in 3 (4%), short-acting benzodiazepines in 3 (4%), long acting benzodiazepines in 2 (3%), and anticholinergic antihistamine in 1 (1%). Conclusion: Polypharmacy is very common in community-dwelling elderly with chronic disorders. More medications were related to more adverse drug reactions and lack of information about their drugs related to increased number of drug taking. High proportion of inappropriate drug prescriptions was observed in the elderly, which may have resulted from poor education concerning geriatric care of the medical personnels. (J Korean Acad Fam Med 2008;29:925-931)
Background This study was to verify the necessity of a control program developed to improve compliance, by conducting a research on the status of medication compliance in the elderly with chronic diseases in rural area and analyzing the related variables. Methods: The organized questionnaire and pill-count were used to collect information on personal details, physical status, drugs taken in the elderly over 65 years old suffering from more than two chronic diseases in one rural area. Results: The mean age of the subjects was 73.13±6.36 (65∼93), and the number of the subjects in compliance group was 60 (77.9%) and the accuracy of self-report which was identified by pill-count was 0.86. Polypharmacy and visiting several clinics were the main factors that decided a low- degree of compliance, with OR of 5.92 (95% CI 1.11∼31.44, P=0.037), and 4.25 (95% CI 1.03∼17.53, P=0.045), respectively. Conclusion: Systematic efforts are necessary and plans must be established without delay to increase compliance in the elderly in the rural, expansively to manage chronic diseases in stay-at-home elders. (J Korean Acad Fam Med 2008;29:604-611)
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