nach oben

International Journal of Clinical Pharmacy

Erschienen in:

05.05.2024 | Short Research Report

Prevalence and trends in polypharmacy and excessive polypharmacy: a retrospective national database analysis (2012–2021)

verfasst von: Lorenz Van der Linden, Jos Tournoy

Erschienen in: International Journal of Clinical Pharmacy | Ausgabe 4/2024

Einloggen, um Zugang zu erhalten

Abstract

Background

Polypharmacy is a growing concern, impacting patient safety and healthcare costs. Monitoring its prevalence and temporal trends is essential for effective healthcare management.

Aim

This study aimed to determine prevalence and trends of polypharmacy and excessive polypharmacy in Belgium.

Method

Utilizing a federal claims database, medication data were analyzed from 2012 to 2021. Polypharmacy (≥ 5 medications) and excessive polypharmacy (≥ 10 medications) were evaluated, with prevalence calculated per 1000 inhabitants, and reported per year, age group and region. Linear regression estimated the impact of age and year on polypharmacy prevalence.

Results

In 2021, polypharmacy and excessive polypharmacy were reported in 135/1000 and 31/1000 Belgians respectively. Prevalence of both increased steadily from 2012 to 2021, with excessive polypharmacy rising more prominently. Among adults aged ≥ 65 years, prevalence rates were higher, with polypharmacy at 434/1000 and excessive polypharmacy at 106/1000. Regional variations were observed, with prevalence highest in the Walloons region. Patient age and year (2012–2021) were associated with both polypharmacy and excessive polypharmacy (p < 0.001).

Conclusion

We observed increases in polypharmacy and excessive polypharmacy over a decade in Belgium, particularly among older adults. Efforts to monitor, manage, and optimize medication use are imperative to ensure safe and effective healthcare delivery.

Hellemans L, Nuyts S, Hias J, et al. Polypharmacy and excessive polypharmacy in community-dwelling middle aged and aged adults between 2011 and 2015. Int J Clin Pract. 2021;75(4):e13942.CrossRefPubMed

Hias J, Hellemans L, Nuyts S, et al. Predictors for unplanned hospital admissions in community dwelling adults: a dynamic cohort study. Res Social Adm Pharm. 2023;19(11):1432–9.CrossRefPubMed

Wehling M. Guideline-driven polypharmacy in elderly, multimorbid patients is basically flawed: there are almost no guidelines for these patients. J Am Geriatr Soc. 2011;59(2):376–7.CrossRefPubMed

Wauters M, Elseviers M, Vaes B, et al. Too many, too few, or too unsafe? Impact of inappropriate prescribing on mortality, and hospitalization in a cohort of community-dwelling oldest old. Br J Clin Pharmacol. 2016;82(5):1382–92.CrossRefPubMedPubMedCentral

Petrovic M, Somers A, Onder G. Optimization of geriatric pharmacotherapy: role of multifaceted cooperation in the hospital setting. Drugs Aging. 2016;33(3):179–88.CrossRefPubMed

Onder G, van der Cammen TJ, Petrovic M, et al. Strategies to reduce the risk of iatrogenic illness in complex older adults. Age Ageing. 2013;42(3):284–91.CrossRefPubMed

Marcum ZA, Amuan ME, Hanlon JT, et al. Prevalence of unplanned hospitalizations caused by adverse drug reactions in older veterans. J Am Geriatr Soc. 2012;60(1):34–41.CrossRefPubMed

Leendertse AJ, Egberts AC, Stoker LJ, et al. Frequency of and risk factors for preventable medication-related hospital admissions in the Netherlands. Arch Intern Med. 2008;168(17):1890–6.PubMed

Van der Linden L, Hias J, Walgraeve K, et al. Guideline-directed medical therapies for heart failure with a reduced ejection fraction in older adults: a narrative review on efficacy. Saf Timeliness Drugs Aging. 2023;40(8):691–702.CrossRef

10.

Scott IA, Hilmer SN, Reeve E, et al. Reducing inappropriate polypharmacy: the process of deprescribing. JAMA Intern Med. 2015;175(5):827–34.CrossRefPubMed

11.

Hellemans L, Hias J, Walgraeve K, et al. Deprescribing in geriatric inpatients is associated with a lower readmission risk: a case control study. Int J Clin Pharm. 2020;42(5):1374–8.CrossRefPubMed

12.

Bulow C, Clausen SS, Lundh A, et al. Medication review in hospitalised patients to reduce morbidity and mortality. Cochrane Database Syst Rev. 2023;1(1):CD008986. https://doi.org/10.1002/14651858.CD008986.CrossRefPubMed

13.

Van der Linden L. Improving medication use in older adults: looking back to move forward. Lancet Healthy Longev. 2023;4(6):e246. https://doi.org/10.1016/S2666-7568(23)00082-X.CrossRefPubMed

14.

Thillainadesan J, Gnjidic D, Green S, et al. Impact of deprescribing interventions in older hospitalised patients on prescribing and clinical outcomes: a systematic review of randomised trials. Drugs Aging. 2018;35(4):303–19.CrossRefPubMed

15.

Belgian Intermutualistic Agency. ZorgAtlas 2023. https://atlas.ima-aim.be/databanken/?rw=1&lang=nl. Accessed 01 Aug 2023.

16.

STATBel - Belgium in Figures. Bevolkingsvooruitzichten. 2017. http://statbel.fgov.be/sites/default/files/files/documents/bevolking/5.8%20Bevolkingsvooruitzichten/bestanden/FOR_POP1660_11440_N%20print.pdf. Accessed 01 Aug 2023.

17.

Daunt R, Curtin D, O’Mahony D. Polypharmacy stewardship: a novel approach to tackle a major public health crisis. Lancet Healthy Longev. 2023;4(5):e228–35. https://doi.org/10.1016/S2666-7568(23)00036-3.CrossRefPubMed

18.

American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity. Guiding principles for the care of older adults with multimorbidity: an approach for clinicians: American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity. J Am Geriatr Soc. 2012;60(10):E1-E25. https://doi.org/10.1111/j.1532-5415.2012.04188.x.

19.

Morgan SG, Cunningham CM, Hanley GE. Individual and contextual determinants of regional variation in prescription drug use: an analysis of administrative data from British Columbia. PLoS ONE. 2010;5(12):e15883. https://doi.org/10.1371/journal.pone.0015883.CrossRefPubMedPubMedCentral

20.

Rankin A, Cadogan CA, Patterson SM, et al. Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database Syst Rev. 2018;9(9):CD008165. https://doi.org/10.1002/14651858.CD008165.CrossRefPubMed

21.

Capiau A, Foubert K, Van der Linden L, et al. Medication counselling in older patients prior to hospital discharge: a systematic review. Drugs Aging. 2020;37(9):635–55.CrossRefPubMed

22.

Van der Linden L, Hias J, Walgraeve K, et al. Clinical pharmacy services in older inpatients: an evidence-based review. Drugs Aging. 2020;37(3):161–74.CrossRefPubMed

23.

Tan ECK, Sluggett JK, Johnell K, et al. Research priorities for optimizing geriatric pharmacotherapy: an international consensus. J Am Med Dir Assoc. 2018;19(3):193–9.CrossRefPubMed

Titel: Prevalence and trends in polypharmacy and excessive polypharmacy: a retrospective national database analysis (2012–2021)
verfasst von: Lorenz Van der Linden
Jos Tournoy
Publikationsdatum: 05.05.2024
Verlag: Springer International Publishing
Erschienen in: International Journal of Clinical Pharmacy / Ausgabe 4/2024
Print ISSN: 2210-7703
Elektronische ISSN: 2210-7711
DOI: https://doi.org/10.1007/s11096-024-01735-9

Encouraging dissemination of research on the use of artificial intelligence and related innovative technologies in clinical pharmacy practice and education: call for papers

Editorial

Optimisation of medication reconciliation using queueing theory: a computer experiment

Research Article

Authors' response to comments on “The efficacy of zuranolone versus placebo in postpartum depression and major depressive disorder: a systematic review and meta-analysis”

Letter to the Editor

Novel opportunities for clinical pharmacy research: development of a machine learning model to identify medication related causes of delirium in different patient groups

Open Access
Commentary

Investigating practice integration of independent prescribing by community pharmacists using normalization process theory: a cross-sectional survey

Open Access
Research Article

Critical care pharmacy service provision and workforce in adult extracorporeal membrane oxygenation centres: a multicentre cross-sectional survey

Research Article

Kompaktes Leitlinien-Wissen Innere Medizin (Link öffnet in neuem Fenster)

Mit medbee Pocketcards schnell und sicher entscheiden.
Leitlinien-Wissen kostenlos und immer griffbereit auf ihrem Desktop, Handy oder Tablet.

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Verbände und Cremes gegen Dekubitus: „Wir wissen nicht, was sie bringen!“

17.01.2025
Dekubitus
Nachrichten

Die Datenlage zur Wirksamkeit von Verbänden oder topischen Mitteln zur Prävention von Druckgeschwüren sei schlecht, so die Verfasser einer aktuellen Cochrane-Studie. Letztlich bleibe es unsicher, ob solche Maßnahmen den Betroffenen nutzen oder schaden.

Schützt das tägliche Glas Milch vor Darmkrebs?

17.01.2025
Kolorektales Karzinom
Nachrichten

Die Milch machts – sie bietet Frauen nach Daten einer großen Ernährungsanalyse den besten Darmkrebsschutz aller Lebensmittel, was am hohen Kalziumgehalt liegen dürfte. Am anderen Ende des Spektrums steht der Alkoholkonsum: Das Glas Wein am Abend ist eher ungünstig.

Vorsicht mit Glukokortikoiden bei Glomerulopathie

16.01.2025
Primäre Glomerulonephritiden
Nachrichten

Auch niedrig dosierte Glukokortikoide zur Behandlung einer primären Glomerulopathie lassen offenbar die Infektionsgefahr steigen. In einer US-Studie hing das Risiko vor allem mit der kombinierten Anwendung von Immunsuppressiva zusammen.

KI-gestütztes Mammografiescreening überzeugt im Praxistest

16.01.2025
Künstliche Intelligenz im Gesundheitswesen
Nachrichten

Mit dem Einsatz künstlicher Intelligenz lässt sich die Detektionsrate im Mammografiescreening offenbar deutlich steigern. Mehr unnötige Zusatzuntersuchungen sind laut der Studie aus Deutschland nicht zu befürchten.

EKG Essentials: EKG befunden mit System (Link öffnet in neuem Fenster)

In diesem CME-Kurs können Sie Ihr Wissen zur EKG-Befundung anhand von zwölf Video-Tutorials auffrischen und 10 CME-Punkte sammeln.
Praxisnah, relevant und mit vielen Tipps & Tricks vom Profi.

Jetzt 10 CME-Punkte sammeln

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Prevalence and trends in polypharmacy and excessive polypharmacy: a retrospective national database analysis (2012–2021)

Abstract

Background

Aim

Method

Results

Conclusion

Weitere Artikel der Ausgabe 4/2024

Encouraging dissemination of research on the use of artificial intelligence and related innovative technologies in clinical pharmacy practice and education: call for papers

Optimisation of medication reconciliation using queueing theory: a computer experiment

Authors' response to comments on “The efficacy of zuranolone versus placebo in postpartum depression and major depressive disorder: a systematic review and meta-analysis”

Novel opportunities for clinical pharmacy research: development of a machine learning model to identify medication related causes of delirium in different patient groups

Investigating practice integration of independent prescribing by community pharmacists using normalization process theory: a cross-sectional survey

Critical care pharmacy service provision and workforce in adult extracorporeal membrane oxygenation centres: a multicentre cross-sectional survey

Kompaktes Leitlinien-Wissen Innere Medizin (Link öffnet in neuem Fenster)

Neu im Fachgebiet Innere Medizin

Verbände und Cremes gegen Dekubitus: „Wir wissen nicht, was sie bringen!“

Schützt das tägliche Glas Milch vor Darmkrebs?

Vorsicht mit Glukokortikoiden bei Glomerulopathie

KI-gestütztes Mammografiescreening überzeugt im Praxistest

EKG Essentials: EKG befunden mit System (Link öffnet in neuem Fenster)

Update Innere Medizin

Springer Medizin

Abstract

Background

Aim

Method

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten