The following is a summary of “Effect of polypharmacy on healthcare services utilization in older adults with comorbidities: a retrospective cohort study,” published in the June 2023 issue of Primary Care by Doumat et al.
Increasing comorbidities and polypharmacy are more common in older people. Polypharmacy is linked to improper prescribing and an increased risk of adverse effects. This study examined the impact of polypharmacy on healthcare services utilization (HSU) in elderly individuals. In addition, the effect of various medication classes, including psychotropic, antihypertensive, and antidiabetic polypharmacy, on HSU was investigated. This is an observational cohort study. From the primary care patient cohort database of the ambulatory clinics of the Department of Family Medicine at the American University of Beirut Medical Center, community-dwelling senior adults aged 65 years were selected. The use of five or more prescription medications concurrently was considered polypharmacy.
Collecting demographics, the Charlson Comorbidity Index (CCI), and HSU outcomes, such as the rate of all-cause emergency department (ED) visits, the rate of all-cause hospitalization, the rate of all-cause ED visits for pneumonia, and the rate of all-cause hospitalization for pneumonia, as well as mortality. Utilizing binomial logistic regression models, the rates of HSU outcomes were predicted.
About 496 patients were analyzed in total. All patients had comorbidities, with 22.8% (113) having mild to moderate comorbidity and 77.2% (383) having severe comorbidity. Patients with polypharmacy were more likely than patients without polypharmacy to have severe comorbidity (72.3% vs. 27.7%, P = 0.001). Patients with polypharmacy were more likely to visit the ED for all causes than patients without polypharmacy (40.6% vs. 31.4%, P = 0.05). They had a substantially higher rate of hospitalization for all reasons (adjusted odds ratio aOR 1.66, 95% CI = 1.08–2.52, P= 0.022). Patients with psychotropic polypharmacy were more likely to be hospitalized for pneumonia (cOR 2.37, 95 CI = 1.03–5.46; P = 0.043) and to visit the emergency department for pneumonia (cOR 2.31, 95 CI = 1.00–5.36; P= 0.049).
Adjustment diminished the significance of the association. Increased HSU outcomes are associated with the rising prevalence of polypharmacy in the geriatric population with comorbidity. Consequently, a holistic, multidisciplinary approach is required for frequent medication revisions.
Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-023-02070-0