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05-05-2024 | Short Research Report

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

Authors: Lorenz Van der Linden, Jos Tournoy

Published in: International Journal of Clinical Pharmacy | Issue 4/2024

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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.
Literature
1.
go back to reference 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 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
2.
go back to reference 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 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
3.
go back to reference 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 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
4.
go back to reference 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 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
5.
go back to reference 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 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
6.
go back to reference 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 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
7.
go back to reference 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 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
8.
go back to reference 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 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
9.
go back to reference 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 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.
go back to reference Scott IA, Hilmer SN, Reeve E, et al. Reducing inappropriate polypharmacy: the process of deprescribing. JAMA Intern Med. 2015;175(5):827–34.CrossRefPubMed 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.
go back to reference 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 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
14.
go back to reference 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 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
18.
go back to reference 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. 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.
21.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 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
Metadata
Title
Prevalence and trends in polypharmacy and excessive polypharmacy: a retrospective national database analysis (2012–2021)
Authors
Lorenz Van der Linden
Jos Tournoy
Publication date
05-05-2024
Publisher
Springer International Publishing
Published in
International Journal of Clinical Pharmacy / Issue 4/2024
Print ISSN: 2210-7703
Electronic ISSN: 2210-7711
DOI
https://doi.org/10.1007/s11096-024-01735-9

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