[Polypharmacy in the ambulatory care of aged patients]

Abstract

The aim of this study was to assess the prevalence and possible predictors of polypharmacy in a sample of the general population. The sample consisted of 638 subjects (267 males, mean age 54.7, and 371 females, mean age 55) taken from the records of three general practitioners in the city of Turin, Italy. The prevalence of polypharmacy, for prescription drugs, was 12.5% (80 subjects). The prevalence of polypharmacy, for non prescription drugs, was 17.4% (111 subjects). The number of prescription drugs per patient rises progressively with age, averaging 2.28 and 2.5 respectively in males and in female aged older than 80 years. The number of non prescription drugs was observed to decrease with age: in women, subjects that used two or more non prescription drugs were 35% in those aged under 50 years, 20% in subjects aged from 65 to 80 years and 12.5% in those aged older than 80 years. Subjects aged older than 65 years, an IADL score < 10, more than 20 physical exams performed by practitioner in the last year, a recent hospitalisation, presence of cardiovascular disease, and presence of genito-urinary disease, were significantly and independently associated to polypharmacy for prescription drugs. Only female sex was significantly associated to polypharmacy for non prescription drugs. Our conclusion is that although age should not be involved in polypharmacy as a variable, several phenomena that influence medical treatment goals become more prevalent with increasing age and explain the high drugs consumption in the elderly. A rational, essential therapy, helped by guidelines could reduce potential problems associated with polypharmacy in the elderly.