Long-term medication use and polypharmacy in older adults

Abstract

Introduction: In Turkey, long-term medication use reports help patients covered by universal health insurance to access drugs without having to make co-payments. Using these reports, the present study investigates the prevalence of polypharmacy and specifically, its relationship with age, gender, diagnosis, number of diseases, and various clinical branches. Materials and Methods: In this descriptive retrospective study, anonymous data obtained from long-term medication use reports were analyzed using SPSS and Microsoft Excel. Results: A total of 66,995 samples were examined, 60.7% of which were female patients. The average number of active substances was 2.78 ± 2.11, the rate of reports containing five or more active substances (polypharmacy) was 16.1% (10.757 samples), the distribution by gender was 62.7% female and 37.3% male. The distribution of polypharmacy by age groups was 60.1% in the 65-74 age group, 32.5% in the 74-85 age group, and 7.4% in the ?85 age group. The most common diagnoses were diabetes mellitus (37.8%), hypertension (12.9%), and hyperlipidemia (8.2%). The clinical branches accounting for the highest rate of polypharmacy were internal medicine (65.1%), cardiology (10%), and chest diseases (6.1%). Acetylsalicylic acid was the most prescribed substance (12.3%) among 657 active substances. Conclusion: The results of this study can be used by regulatory authorities and in clinical practice by physicians. Using a clinical decision system supported by guidelines can help clinicians to optimize drug therapy and reduce polypharmacy in older adults. To reduce inappropriate drug use, such as the Beers, STOPP-START, and TIME criteria were recommended to be used in decision support systems. © 2021, Geriatrics Society. All rights reserved.