Understanding Polypharmacy in Older Adults
The Risks of Polypharmacy
Polypharmacy refers to the concurrent use of multiple medications, which can elevate the risk of severe side effects. A recent study investigated the prevalence of polypharmacy among older adults in the United Kingdom, highlighting the potential dangers of medication interactions.
Study Overview
A team of researchers in the United Kingdom aimed to assess how prevalent polypharmacy is among older adults and whether its occurrence increases with age. Their findings were published in the journal BMC Geriatrics.
Participants and Methodology
The research utilized data from the MRC National Survey for Health and Development, which has tracked over 5,000 individuals born during the same week in 1946 across England, Scotland, and Wales. Currently, nearly 2,700 of these participants are alive and reside in mainland Britain. The researchers conducted home interviews with over 2,000 participants aged 69, gathering information about their current prescribed medications and comparing it to data collected five years earlier.
Findings on Medication Use
The results revealed that participants were, on average, taking two medications, with 80% reporting the use of at least one medication and 60% taking two or more. Notably, nearly 23% of participants were on five or more medications, primarily for cardiovascular disorders, which affected more than half of the participants. The study found that the average number of medications taken by participants had increased compared to five years prior. The percentage of drug-free individuals decreased by almost 9%, while those taking one to four medications rose by 6%.
Factors Influencing Polypharmacy
The study indicated that polypharmacy was more prevalent among individuals with a higher burden of diseases and lower education levels. Participants without secondary school graduation were nearly twice as likely to take at least nine medications compared to those who completed secondary education. Furthermore, they were five times more likely to take nine or more medications than those with post-secondary qualifications.
Gender Differences in Medication Use
While there were no significant overall gender differences in polypharmacy rates, a notable disparity emerged regarding cardiovascular medications. Men were twice as likely as women to be prescribed five or more drugs for heart disease.
Implications for Future Research
The researchers recognized certain limitations in their study, such as reliance on participants’ self-reported medication use and health conditions. They did not account for variations in prescribing practices among different healthcare providers, which could influence the number of medications prescribed.
There is a pressing need to explore why individuals with lower education levels are prescribed more medications, as this discrepancy cannot solely be explained by a higher disease burden. Additionally, the trend of men taking more cardiovascular medications warrants further investigation, as these groups may face an increased risk of adverse effects due to drug interactions.
Conclusion
The study underscores the necessity for ongoing research into polypharmacy, particularly among vulnerable populations. Understanding the factors contributing to medication use can help mitigate risks associated with polypharmacy and improve health outcomes for older adults.
Written by Bryan Hughes, PhD
Reference: Rawle, M. J., Richards, M., Davis, D., & Kuh, D. (2018). The prevalence and determinants of polypharmacy at age 69: a British birth cohort study. BMC Geriatrics, 18, 118.