Epidemiology of Polypharmacy Among Family Medicine Patients at Hospital Discharge
Open Access
- 15 January 2013
- journal article
- Published by SAGE Publications in Journal of Primary Care & Community Health
- Vol. 4 (2), 101-105
- https://doi.org/10.1177/2150131912472905
Abstract
Background: Polypharmacy has been identified as a quality indicator, but no studies have been reported about the epidemiology of polypharmacy among hospital patients at discharge. Methods: Records of 142 family medicine patients aged ≥65 years who were discharged from the hospital during the period November 2008 to October 2009 were extracted. Forty-six of these patients were readmitted within 30 days and the remaining 96 not readmitted within 30 days. Polypharmacy was measured as >16 medications at dismissal. Independent variables related to person (use of medical care in the 12 months prior to hospitalization, number of high-risk diagnoses, and demographic characteristics), place (living situation at admission and disposition location), and time (month of admission). Chronic obstructive pulmonary disease, cancer, diabetes mellitus, congestive heart failure, and coronary artery disease were diagnoses determined to be high-risk. Results: Mean number of medications at dismissal was 13.5 and 23.2% of patients were prescribed more than 16 medications. No interactions were found between readmission status and any of the independent variables. Use of medical services in the previous year was not related to polypharmacy and no seasonal pattern was detected. Two or more high-risk diagnoses were independently related to polypharmacy (odds ratio [OR] = 4.75, confidence interval [CI] = 1.0-11.2, P = .00). Being discharged to a location with personal health services such as home care or a skilled nursing facility was also related to polypharmacy (OR = 3.07, CI = 1.3-7.2, P = .01). Conclusion: Drug reviews intended to reduce the rate of polypharmacy among discharged persons aged ≥65 years can be targeted at patients who have 2 or more high-risk diagnoses and at those discharged to receive personal health services either at home or in a convalescence facility.Keywords
This publication has 20 references indexed in Scilit:
- The impact of polypharmacy on the health of Canadian seniorsFamily Practice, 2012
- Prevalence of Unplanned Hospitalizations Caused by Adverse Drug Reactions in Older VeteransJournal of the American Geriatrics Society, 2011
- Variation Over Time in the Association between Polypharmacy and Mortality in the Older PopulationDrugs & Aging, 2011
- Potentially inappropriate medication use among older adults in the USA in 2007Age and Ageing, 2011
- Increasing polypharmacy - an individual-based study of the Swedish population 2005-2008BMC Clinical Pharmacology, 2010
- Predictors of falls and hospitalization outcomes in elderly patients admitted to an acute geriatric unitArchives of Gerontology and Geriatrics, 2009
- Polypharmacy in elderly patientsThe American Journal of Geriatric Pharmacotherapy, 2007
- The Relationship between Number of Drugs and Potential Drug-Drug Interactions in the ElderlyDrug Safety, 2007
- Polypharmacy and falls in the middle age and elderly populationBritish Journal of Clinical Pharmacology, 2005
- Factors predictive of outcome on admission to an acute geriatric wardAge and Ageing, 1999