Article metrics

  • citations in SCindeks: [2]
  • citations in CrossRef:[1]
  • citations in Google Scholar:[=>]
  • visits in previous 30 days:11
  • full-text downloads in 30 days:3
article: 1 from 1  
Opšta medicina
2015, vol. 21, iss. 3-4, pp. 81-90
article language: Serbian
document type: Original Paper
doi:10.5937/opmed1504081Z
Polypharmacy in patients who are using EMS Belgrade services
aGradski zavod za hitnu medicinsku pomoć, Beograd
bDom zdravlja 'Dr Boško Vrebalov', Zrenjanin

e-mail: slavoljubz3@mts.rs + slavoljubz3@open.telekom.rs

Abstract

Introduction: Polypharmacy represents a serious problem due to its many side effects. There is no single and clear definition for polypharmacy. Researchers mostly agree that it represents a number of drugs used at the same period of time. In this study, we have defined polypharmacy as simultaneous use of 6 or more drugs, either occasionally or continuously, during a period of 7 days. Objective: To identify the number of simultaneously used drugs and their correlation with gender and age of the study subjects. Method: In the period from 4 March 2008 until 29 March 2013, one emergency medicine doctor surveyed his patients regarding drugs they had used occasionally or continuously in the last 7 days. Vitamins and other supplements have also been accounted for, and complete results have been identified in the questionnaires. Collected data were entered into an excel database, and statistical analysis was performed using SPSS 11.0 for Windows. Results: 1516 subjects (649 male and 867 female) have completed the survey. Average age was 65.84±17.69. Average number of simultaneously used drugs was 6.82±3.79 (interval from 0 to 25). Age difference was not statistically significant. Six or more drugs used 847 subjects (349 male and 498 female). Average age of male subjects was 70.89±12.79 and of female subjects was 74.0±11.29. The largest number of subjects (60.10%) was 66-85 years old. Majority of subjects (70.60%) used 6-10 drugs. In both gender groups 39.79% of subjects used more then 10 drugs, and 80.18% of them were older than 65. On average, men used 9.55±3.06, and women 9.23±2.77 different drugs. Gender difference was not statistically significant (p=0.136). Average number of used drugs was increasing with subjects' age and it was the highest in 66-75 age groups. Age difference was statistically significant only between the younger subjects and subjects older than 65. Out of the total number of subjects with polypharmacy 74.97% were older than 65 years. They took more drugs compared to the younger subjects and there is a statistically significant difference between them (p=0.008). Conclusion: More than half of our study subjects have been exposed to polypharmacy and the same number of them has been exposed to excessive poly- pharmacy. Polypharmacy is significantly linked to ageing.

Keywords

polypharmacy; ageing; gender; Belgrade emergency medical service

References

*** (2012) The pursuit of responsible use of medicines: Sharing and learning from country experiences. in: Technical Report prepared for the Ministers Summit on The benefits of responsible use of medicines: Setting policies for better and cost-effective health care, WHO-EMPMAR.3, [Internet] [cited 2014 Jun]. Available from http:www.who.intmedicinesareasrational_useen
Beloosesky, Y., Nevo, R.F.G., Weiss, A., Nenaydenko, O., Adunsky, A. (2013) Rates, variability, and associated factors of polypharmacy in nursing home patients. Clinical Interventions in Aging, 8: 1585
Bushardt, R.L., Massey, E.B., Simpson, T.W., Ariail, J.C., Simpson, K.N. (2008) Polypharmacy: Misleading, but manageable. Clin Interv Aging, Jun; 3(2):383-389
Fick, D.M., Cooper, J.W., Wade, W.E., Waller, J.L., Maclean, J. R., Beers, M.H. (2003) Updating the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. Archives of Internal Medicine, 163(22): 2716
Haider, S.I., Ansari, Z., Vaughan, L., Matters, H., Emerson, E. (2014) Prevalence and factors associated with polypharmacy in Victorian adults with intellectual disability. Research in Developmental Disabilities, 35(11): 3071-3080
Hanlon, J.T., Schmader, K.E., Koronkowski, M.J., Weinberger, M., Landsman, P.B., Samsa, G.P., Lewis, I.K. (1997) Adverse drug events in high risk older outpatients. Journal of the American Geriatrics Society / J Am Geriatr Soc, 45(8): 945-8
Hovstadius, B. On drug use, multiple medication and polypharmacy in a national population. Linnaeus University, Dissertations No 152010
Hovstadius, B., Tågerud, S., Petersson, G., Åstrand, B. (2010) Prevalence and therapeutic intensity of dispensed drug groups for individuals with multiple medications: a register-based study of 2.2 million individuals. Journal of Pharmaceutical Health Services Research, 1(4): 145-155
Hovstadius, B., Petersson, G. (2013) The impact of increasing polypharmacy on prescribed drug expenditure—A register-based study in Sweden 2005–2009. Health Policy, 109(2): 166-174
Junius-Walker, U., Theile, G., Hummers-Pradier, E. (2006) Prevalence and predictors of polypharmacy among older primary care patients in Germany. Family Practice, 24(1): 14-19
Kim, H., Shin, J., Kim, M., Park, B. (2014) Prevalence and Predictors of Polypharmacy among Korean Elderly. PloS One, 9(6): e98043
Kojima, G., Bell, C., Tamura, B., Inaba, M., Lubimir, K., Blanchette, P.L., Iwasaki, W., Masaki, K. (2012) Reducing Cost by Reducing Polypharmacy: The Polypharmacy Outcomes Project. Journal of the American Medical Directors Association, 13(9): 818.e11-818.e15
Lizano-Diez, I., Modamio, P., Lopez-Calahorra, P., Lastra, C.F., Gilabert-Perramon, A., Segu, J.L., Marino, E.L. (2013) Profile, cost and pattern of prescriptions for polymedicated patients in Catalonia, Spain. BMJ Open, 3(12): e003963-e003963
Maher, R.L., Hanlon, J., Hajjar, E.R. (2014) Clinical consequences of polypharmacy in elderly. Expert Opinion on Drug Safety, 13(1): 57-65
Morgan, T.K., Williamson, M., Pirotta, M., Stewart, K., Myers, S.P., Barnes, J. (2011) A national census of medicines use: a 24-hour snapshot of Australians aged 50 years and older. Medical Journal of Australia, 196(1): 50-53
Nomura, K. (2011) Drug use patterns and predictors of polypharmacy among elderly, community-residing persons in Hiroshima, Japan from October to December 2009. Liverpool, UK: Laureate Online Education
Onder, G., Bonassi, S., Abbatecola, A.M., Folino-Gallo, P., Lapi, F., Marchionni, N., Pani, L., Pecorelli, S., Sancarlo, D., Scuteri, A., Trifiro, G., Vitale, C., Zuccaro, S.M., Bernabei, R., Fini, M. (2013) High Prevalence of Poor Quality Drug Prescribing in Older Individuals: A Nationwide Report From the Italian Medicines Agency (AIFA). Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 69(4): 430-437
Onder, G., Liperoti, R., Fialova, D., Topinkova, E., Tosato, M., Danese, P., Gallo, P.F., Carpenter, I., Finne-Soveri, H., Gindin, J., Bernabei, R., Landi, F., Project for the SHELTER (2012) Polypharmacy in Nursing Home in Europe: Results From the SHELTER Study. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 67A(6): 698-704
Papapetrou, I., et al. (2012) Investigation of polypharmacy and rational prescribing in elderly patients in a health centre of Nicosia, Cyprus. China-USA Business Review, 1587
Payne, R.A., Avery, A.J., Duerden, M., Saunders, C.L., Simpson, C.R., Abel, G.A. (2014) Prevalence of polypharmacy in a Scottish primary care population. European Journal of Clinical Pharmacology, 70(5): 575-581
Petrov-Kiurski, M., Trifunović-Balanović, D., Dimitrijević, Z., Akulov, D., Radosavljević, N., Kondić-Jovanović, N., Janković, S., Protić, M., Mihajlović, R., Đorđević, S., Cimbaljević, B., Aljeti, B. (2010) Studija o samolečenju pacijenata u ambulantama opšte medicine u Srbiji. Opšta medicina, vol. 16, br. 1-2, str. 9-20
Richardson, K., Moore, P., Peklar, J., Galvin, R., Bennett, K., Kenny, R.A. (2012) Polypharmacy in adults over 50 in Ireland: Opportunities for cost saving and improved healthcare. Irish Longitudinal Study on Ageing, [Internet]. 200 Apr [cited jun 20014] Available at: http:tilda.tcd.ieassetspdfPolypharmacyReport.pdf
Şayir, Ç.T. (2014) Aile Hekimliği Polikliniği'ne başvuran 65 yaş üstü hastalarda polifarmasi ve tamamlayıcı tedavi kullanımlarının değerlendirilmesi. Turkiye Aile Hekimligi Dergisi, 18(1): 35-41
Schaefer, K., Maerkedahl, H., Birk, H.O., Henriksen, L.O. (2010) Polypharmacy in general practice. Dan Med Bull, Jul; 57(7):A4165
Shalini, J., et al. (2012) Study of polypharmacy and associated problems among elderly patients. Internet Journal of Medical, Update January;7(1):35-3
Slabaugh, S. L., Maio, V., Templin, M., Abouzaid, S. (2010) Prevalence and Risk of Polypharmacy among the Elderly in an Outpatient Setting. Drugs & Aging, 27(12): 1019-1028
Šter, M.P., Gorup, E.C., Klančič, D. (2009) Polypharmacy and inappropriate drug prescribing in elderly nursing home residents. Zdravniški Vestnik, 78(5); 231-240
Taleb, M., Abed, A.A., Dahudi, A.R., Najim, A., Ahmed, A. (2014) Polypharmacy in Primary Care Practices among Chronic Elderly Patients in Gaza Strip. Pharmacology, 05(03): 291-297
Viktil, K.K., Salvesen, B.H., Reikvam, A. (2008) The Janus face of polypharmacy: Overuse versus underuse of medication. Norsk Epidemiology, 18(2): 147-152
WHO Rational use of medicines: Summary of activities. [Internet]. Mar 012 [cited jun 2014] http:ww.who.intmedicinesareasrational_useen
Wise, J. (2013) Polypharmacy: a necessary evil. BMJ, 347(nov28 1): f7033-f7033
Živanović, S. (2000) Polipragmazija kod starih. Beograd: Univerzitet u Beogradu-Medicinski fakultet, Rad uže specijalizacije iz gerontologije