Polypharmacy is associated with higher risk of mortality and hospitalizations among older adults

1. Polypharmacy was associated with a higher risk of mortality and hospitalization at one-year and five-years among older adults aged >75 years. 

Evidence Rating Level: 2 (Good)

Polypharmacy is commonly defined as the use of five or more medicines and is associated with medication non-adherence, cognitive impairment and adverse drug reactions (ADRs). Research findings on polypharmacy have been inconsistent or have had methodological limitations. This study thus investigated the association between polypharmacy with mortality, falls, ADRs and hospitalizations at one and five years. This retrospective cohort study included patients > 75 years old in the UK from the Clinical Practice Research Datalink (CPRD). The study period for the one-year analysis was January 2010-December 2010, and January 2010-December 2014 for the five-year analysis. Polypharmacy was defined as the use of five or more medicines. Out of the 977 patients analyzed (mean [SD] age = 83 +5.52, female [%] =624 [64.10]), the prevalence of polypharmacy was 47% (457/977). At one-year, polypharmacy was associated with a higher risk of mortality (hazard ratio [HR] 2.37; 95% CI, 1.40–3.90) and hospitalization (HR, 2.47; 95% CI, 1.40–4.30). At five-years, polypharmacy was associated with a higher risk of mortality (HR, 1.60; 95% CI, 1.30–2.00) and hospitalization (HR, 1.49; 95% CI, 1.30–1.70]). Falls and ADRs were not associated with polypharmacy, potentially due to inadequate recordings in the CPRD database. Overall, this study found that polypharmacy is a risk factor for mortality and hospitalizations in the short and long term among older adults aged >75 years. These findings highlight the importance of managing inappropriate polypharmacy.

Click here to read this study in PLOS One

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