Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2007 Feb;63(2):187-95.
doi: 10.1111/j.1365-2125.2006.02744.x. Epub 2006 Aug 30.

Polypharmacy as commonly defined is an indicator of limited value in the assessment of drug-related problems

Kirsten K Viktil  1 , Hege S Blix, Tron A Moger, Aasmund Reikvam
Affiliations

Polypharmacy as commonly defined is an indicator of limited value in the assessment of drug-related problems

Kirsten K Viktil et al. Br J Clin Pharmacol. 2007 Feb.

Abstract

Aim: To investigate whether polypharmacy defined as a definite number of drugs is a suitable indicator for describing the risk of occurrence of drug-related problems (DRPs) in a hospital setting.

Methods: Patients admitted to six internal medicine and two rheumatology departments in five hospitals were consecutively included and followed during the hospital stay, with particular attention to medication and DRPs. Comparisons were made between patients admitted with five or more drugs and with less than five drugs. Clinical pharmacists assessed DRPs by reviewing medical records and by participating in multidisciplinary team discussions.

Results: Of a total of 827 patients, 391 (47%) used five or more drugs on admission. Patients admitted with five or more and less than five drugs were prescribed the same number of drugs after admission: 4.1 vs. 3.9 drugs [P = 0.4, 95% confidence interval (CI) - 0.57, 0.23], respectively. The proportion of drugs used on admission which was associated with DRPs was similar in the patient group admitted with five or more drugs and in those admitted with less than five drugs. The number of DRPs per patient increased approximately linearly with the increase in number of drugs used; one unit increase in number of drugs yielded a 8.6% increase in the number of DRPs (95% CI 1.07, 1.10).

Conclusion: The number of DRPs per patient was linearly related to the number of drugs used on admission. To set a strict cut-off to identify polypharmacy and declare that using more than this number of drugs represents a potential risk for occurrence of DRPs, is of limited value when assessing DRPs in a clinical setting.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Distribution of drug use on admission among 827 hospitalized patients
Figure 2
Figure 2
Frequency of drug-related problems (DRPs) per patient in relation to number of drugs used on admission (among 827 patients). DRPs per patient include both DRPs related to drugs on admission and DRPs originating from drugs commenced in hospital
See this image and copyright information in PMC

References

    1. Buckley BM. Healthy ageing: ageing safely. Eur Heart J. 2001;3(Suppl. N):N6–10. - PubMed
    1. Geest SD, Steeman E, Leventhal ME, Mahrer-Imhof R, Hengartner-Kopp B, Conca A, Bernasconi AT, Petry H, Rocca HB-L. Complexity in caring for an ageing heart failure population: concomitant chronic conditions and age related impairments. Eur J Cardiovasc Nurs. 2004;3:263–70. - PubMed
    1. Fulton MM, Allen ER. Polypharmacy in the elderly: a literature review. J Am Acad Nurse Pract. 2005;17:123–32. - PubMed
    1. Frazier SC. Health outcomes and polypharmacy in elderly individuals: an integrated literature review. J Gerontol Nurs. 2005;31:4–11. - PubMed
    1. Bjerrum L, Rosholm JU, Hallas J, Kragstrup J. Methods for estimating the occurrence of polypharmacy by means of a prescription database. Eur J Clin Pharmacol. 1997;53:7–11. - PubMed

Publication types

LinkOut - more resources