Prevalence, risk factors and health outcomes associated with polypharmacy among urban community-dwelling older adults in multi-ethnic Malaysia
Document Type
Article
Publication Date
1-1-2017
Abstract
Background Polypharmacy has been associated with increased morbidity and mortality in the older population. Objectives The aim of this study was to determine the prevalence, risk factors and health outcomes associated with polypharmacy in a cohort of urban community-dwelling older adults receiving chronic medications in Malaysia. Methods This was a baseline study in the Malaysian Elders Longitudinal Research cohort. The inclusion criteria were individuals aged ≥55years and taking at least one medication chronically (≥3 months). Participants were interviewed using a structured questionnaire during home visits where medications taken were reviewed. Health outcomes assessed were frequency of falls, functional disability, potential inappropriate medication use (PIMs), potential drugdrug interactions (PDDIs), healthcare utilisation and quality of life (QoL). Risk factors and health outcomes associated with polypharmacy (≥5 medications including dietary supplements) were determined using multivariate regression models. Results A total of 1256 participants were included with a median (interquartile range) age of 69(63± 74) years. The prevalence of polypharmacy was 45.9% while supplement users made up 56.9% of the cohort. The risk factors associated with increasing medication use were increasing age, Indian ethnicity, male, having a higher number of comorbidities specifically those diagnosed with cardiovascular, endocrine and gastrointestinal disorders, as well as supplement use. Health outcomes significantly associated with polypharmacy were PIMS, PDDIs and increased healthcare utilisation. Conclusion A significant proportion of older adults on chronic medications were exposed to polypharmacy and use of dietary supplements contributed significantly to this. Medication reviews are warranted to reduce significant polypharmacy related issues in the older population.
Keywords
Age Factors, Aged, Aged, 80 and over, Dietary Supplements, Drug Interactions, Ethnic Groups, Female, Geriatric Assessment, Humans, Malaysia, Male, Middle Aged, Morbidity, Mortality, Polypharmacy, Prevalence, Public Health Surveillance, Quality of Life, Risk Factors, Urban Population
Divisions
fac_med
Funders
University of Malaya (UM) High Impact Research (HIR) Grant from the Department of Higher Education, Ministry of Education, Malaysia [UM.C/625/1/HIR/MOHE/ASH/02],University Malaya Research Grant from UM [UMRG RP029-14HTM]
Publication Title
PLoS ONE
Volume
12
Issue
3
Publisher
Public Library of Science