Comparison of polypharmacy and pharmacotherapy among seniors in social institutions in 2001 and 2019
Authors:
Ivan Bartošovič 1; Ivana Ivánková Bartošovičová 2; Katarína Zrubáková 3,4; Peter Mikus 5; Róbert Ochaba 6; Irina Goljerová 7
Authors‘ workplace:
Vysoká škola zdravotníctva a sociálnej práce sv. Alžbety Bratislava, Ústav zdravotníckych disciplín
1; OZS Skalica, ambulancia všeobecného lekára pre dospelých
2; Vysoká škola zdravotníctva a sociálnej práce sv. Alžbety Bratislava, Ústav zdravotníckych disciplín
3; Katolícka univerzita Ružomberok, Fakulta zdravotníctva, katedra ošetrovateľstva
4; Slovenská zdravotnícka univerzita Bratislava, Lekárska fakulta, klinika geriatrie
5; Trnavská univerzita Trnava, Fakulta zdravotníctva a sociálnej práce, katedra verejného zdravotníctva
6; Univerzita Komenského Bratislava, Lekárska fakulta, Detská otorinolaryngologická klinika
7
Published in:
Vnitř Lék 2023; 69(E-2): 4-9
Category:
Original Contributions
doi:
https://doi.org/10.36290/vnl.2023.022
Overview
Introduction: Polypharmacy (polypharmacotherapy) is a serious problem among seniors. The aim of the work was to compare pharmacotherapy and polypharmacy among seniors in social facilities in 2001 and 2019.
Methodology: As of December 31, 2001, we collected data on the pharmacotherapy of 151 residents of two retirement homes (average age 75.1 years, 68.9% women). We compared the results with the pharmacotherapy of residents of two facilities for seniors as of October 31, 2019 (237 seniors, average age 80.5 years, 73.4% women). According to the medical records, we determined and compared the regularly used medicines of all residents, the use of medicines by age and sex, the use of 0-4 medicines, 5-9 medicines, 5 or more medicines, 10 or more medicines and the groups of medicines according to the ATC classification. For statistical processing, we used the t-test and chi-square test.
Results: In 2001, residents regularly used a total of 891 medicines, 18 years later, they used a total of 2099 medicines. We observed a significant increase in the average number of regularly used medications per resident by more than a half (from 5.90 medications to 8.86 medications), in women from 6.11 drugs to 9.24 drugs and in men from 5.45 drugs to 7.81 drugs. The number of residents with polypharmacy (regular use of ≥ 5 drugs) increased by almost a quarter (from 70.2% to 87.3%), and the number of seniors with excessive polypharmacy (regular use of ≥ 10 drugs) increased 4.6 times (from 9, 3% to 43.5%).
Conclusion: Our work confirmed that over the course of 18 years, the number of medications used by seniors in social-type institutions has increased. It also points to the trend of increasing polypharmacy and excessive polypharmacy among seniors, especially at the age of 75+ and among women.
Keywords:
pharmacotherapy – polypharmacy – seniors – polypharmacotherapy – social institutions
Sources
1. Šprocha B, Ďurček P. Starnutie populácie Slovenska v čase i priestore. 1 vyd. SAV: Bratislava 2019. 96 s. ISBN 978-80-89524-39-6.
2. Štatistický úrad SR. My v číslach – pohyb obyvateľstva 2021. Štatistický úrad SR: Bratislava 2022. 75 s. Dostupné z WWW: https://slovak.statistics.sk/
3. Ministerstvo práce, sociálnych vecí a rodiny SR. Správa o sociálnej situácii obyvateľstva SR za rok 2021. MPSVaR: Bratislava 2022. Dostupné z WWW: https://www.employment.gov.sk/ files/slovensky/ministerstvo/analyticke‑centrum/ 2022/spravasossr_2021_pub.pdf.
4. Kriška M. Zlyhanie farmakoterapie u starších ľudí. In: [Kriška M, Gajdošík J, Dukát A. et al. -eds.] Zlyhanie farmakoterapie. Možnosti prevencie. SAP: Bratislava 2015: 183-198. ISBN 978-80-8960733-4.
5. Payne RA. The epidemiology of polypharmacy. Clinical Medicine. 2016;16(5):465-469.
6. Fialová D. Specifické rysy racionální geriatrické farmakoterapie: role klinických farmaceutů v individualizované léčbe ve stáří. Vnitř Lék. 2019;64(11):51-60.
7. Topinková E. Redukce nevhodné a neúčelné farmakoterapie – deprescribing. Geri a Gero. 2020;9(1):9-14.
8. Weber P, Meluzínová H, Prudius, D. Polyfarmakoterapie nahlížená nejen prizmatem multimorbidity, ale jako další geriatrický syndróm. Vnitř Lék. 2016;62(9, Suppl 3):35135-35139.
9. Krajčík Š. Užívanie liekov a nežiaduce účinky liekov vo vyššom veku. [In: Krajčík Š, Dúbrava M, Bartošovič I et al. -eds.] Geriatria. 2 vyd. Herba: Bratislava 2022: 173-175. ISBN 978-80-8229-020-5.
10. Masnoon N, Skakib S, Kalisch‑Ellett L, et al. What si polypharmacy? A systematic review of definitions. BMC Geriatrics. 2017;17:230-40.
11. Mair A. Medication Safety in Polypharmacy. Technical Report. World Health Organization: Geneva 2019. 62 s. Available from: https://www.who.int/publications/i/item/WHO‑UHC‑SDS- 2019.11.
12. Hovstadius B, Petersson G. Factors leading to excessive polypharmacy. Clin Geriatr Med. 2012;(28):159-172.
13. Jokanovic N, Tan ECK, Dooley MJ, et al. Prevalence and factors associated with polypharmacy in long‑term facilities: a systematic review. JAMDA 2015; 535.e1-535.e12. Available from DOI: https://dx.doi.org/10.1016/j.jamda.2015. 03. 003.
14. Onder G, Liperoti R, Fialova D, et al. Polypharmacy in nursing home in Europe: results from the Shelter study. J Gerontol A Biol Sci Medi. 2012;67 A(6):698-704.
15. Státní ústav pro kontrolu léčiv. Farmakoterapie v domovech pro seniory. Farmakoterapeutické informace. 2018;7-8:1-4.
16. Herr M, Grondin H, Sanchez S, et al. Polypharmacy and potentially inappropriate medications: a cross –sectional analysis among 451 nursing homes in France. Eur J Clin Pharmacol. 2017;73:601-608.
17. Jyrkkä J, Vartiainen L, Hartikainen S, et al. Increasing use of medicines in elderly persons: a five‑year follow‑up of the Kuopio 75+ study. Eur J Clin Pharmacol. 2006;62:151-158.
18. Zhang N, Sundquist J, Sundquist K, et al. An increasing trend in the prevalence of polypharmacy in Sweden: a nationwide register‑based study. Front Pharmacol. 2020; 11:326.
19. Kantor ED, Rehm CD, Haas JS, et al. Trends in prescription drug use among adults in the United States 1999-2012. JAMA. 2016;314(17):1818-1831.
20. Barber ND, Alldred DP, Raynor DK, et al. Care homes use of medicines study: prevalence, causes and potential harm of medication errors in care homes for older people. Qual Saf Health Care. 2009;18:341-346.
21. Szczepura A, Wild D, Nelson S. Medication administration errors for older people in long‑term residential care. BMC Geriatrics. 2011;11:82. Available from: WWW: https://www.biomedcentral. com/1471-2318/11/82.
22. Duerden M, Avery AJ, Payne RA. Polypharmacy and medicines optimisation: making it safe and sound. London: The King’s Fund 2013. 56 s. ISBN 978-1-909029-18-7.
23. Ali MU, Sherifali D, Fitzpatrick‑Lewis D, et al. Interventions to adress polypharmacy in older adults living with multimorbidity. Canadian Family Physician. 2022;68:e215- e.226. Available from DOI: https://dx.doi.org/10.46747/cfp.6807e215.
24. Kriška M, Dukát A, Gajdošík J, et al. Polyfarmácia polypragmázia, hyperpreskripcia – sú aj na Slovensku! Aktuálna úloha – depreskripcia. Monitor medicíny SLS. 2020;10 (1-2):1-9.
25. Baqir W, Hughes J, Jones T, el al. Impact of medication review, within a shared decision‑making framework, on deprescribing in people living in care homes. Eur J Hosp Pharm. 2017;14:30-33.
26. Plechatá I, Halačová M. První zkušenosti z projektu Účelná a bezpečná farmakoterapie v zařízení sociálních služeb (realizovaný na Vysočine v letech 2016-2017). Geri a Gero. 2018;7(2):65-67.
Labels
Diabetology Endocrinology Internal medicineArticle was published in
Internal Medicine
2023 Issue E-2
Most read in this issue
- Severe autoimune thyreotoxicosis complicated by febrile neutropenia as a result of thyreostatic therapy
- Anemia of inflammatory: does eiderr knowledge mean better diagnosis and treatment?
- Diabetes mellitus urological complication
- Comparison of polypharmacy and pharmacotherapy among seniors in social institutions in 2001 and 2019