Risk factors for polypharmacy in older adults in a primary care setting: a cross-sectional study

• Published in: Clinical interventions in aging Vol. 13; pp. 2003 - 2011
• Main Authors: Ersoy, Suleyman, Engin, Velittin Selcuk
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2018; Taylor & Francis Ltd; Dove Medical Press
• Subjects: Activities of daily living; Aged; Aged, 80 and over; Balance; Cardiovascular disease; Chronic Disease - epidemiology; Chronic Disease - therapy; Chronic illnesses; Cross-Sectional Studies; Depression - diagnosis; Depression - epidemiology; Female; Geriatric Assessment - methods; Geriatric depression; Geriatric Depression Scale; Geriatrics; Health care policy; Hospitalization; Humans; Incontinence; Informed consent; Lymphocytes; Male; Medicine; Mental depression; Metabolic syndrome; neutrophil/lymphocyte ratio; Neutrophils; older adult; Older people; Original Research; Pain; Patients; Polypharmacy; Population; Prescription drugs; Primary care; Primary Health Care - methods; Regression analysis; Risk Factors; Turkey - epidemiology; Turkey; metabolic syndrome; older adult; primary care; Geriatric Depression Scale; neutrophil/lymphocyte ratio; polypharmacy
• ISSN: 1178-1998; 1176-9092; 1178-1998
• DOI: 10.2147/CIA.S176329

Polypharmacy (PP) is a clinical challenge in older adults. Therefore, assessment of daily drug consumption (DDC) and its relationships is important. First-line health services have a crucial role in monitoring and preventing PP. In this study, we aimed to assess DDC and investigate the risk factors for higher DDC among older adults in a primary care setting. A total of 1,000 patients aged ≥65 years who visited Melek Hatun Family Practice Center between December 1, 2014, and August 1, 2017, were enrolled in the study. All patients were seen either at the center or in their homes, and informed consent was obtained. Comprehensive geriatric assessment was performed for each subject. Data were analyzed using SPSS software (version 17). The daily number of medicines that each patient used (DDC) regardless of whether they were prescribed was the dependent variable. Relationships between DDC and other continuous variables were examined using Pearson's correlation. For between-group comparisons of DDC, Student's -tests were performed. Univariate tests showed relationships between DDC and various demographic and clinical parameters. The variables that remained significant at the last step of a stepwise linear regression analysis were metabolic syndrome, chronic pain, incontinence, increased serum creatinine level, increased Geriatric Depression Scale scores, reported gastric disturbances, and neutrophil/lymphocyte ratio. Along with certain chronic conditions, depressive symptoms and an inflammatory marker (neutrophil/lymphocyte ratio) were significantly and independently related to higher DDC. Longitudinal and larger studies are needed to further explore the multifaceted relationships of PP.