Trends in polypharmacy and excessive polypharmacy: a retrospective national database analysis (2012-2021)

Abstract

Abstract Background Polypharmacy is a growing concern in healthcare systems worldwide, impacting patient safety and healthcare costs. Monitoring its prevalence and trends is essential for effective healthcare management. Aim This study aimed to assess the prevalence and trends of polypharmacy and excessive polypharmacy in Belgium over a decade. Methods Utilizing the Belgian Intermutualistic agency database, reimbursed medication data were analyzed from 2012 to 2021. Polypharmacy (≥ 5 medications) and excessive polypharmacy (≥ 10 medications) were evaluated, with prevalence calculated per 1000 inhabitants. Linear regression was employed to examine temporal trends. Results In 2021, polypharmacy affected 135/1000 and excessive polypharmacy 31/1000 Belgians. Both entities exhibited a notable increasing trend over the 10-year period, with excessive polypharmacy rising more prominently. Prevalence was significantly higher in older adults (≥ 65 years), reaching 434/1000 for polypharmacy and 106/1000 for excessive polypharmacy. Regional variations were observed, with prevalence highest in the Walloons region. Age and time were identified as independent predictors for both polypharmacy and excessive polypharmacy (p < 0.001). Conclusion This comprehensive analysis highlights concerning increases in polypharmacy and excessive polypharmacy over a decade in Belgium, particularly among older adults. Efforts to monitor, manage, and optimize medication use are imperative to ensure safe and effective healthcare delivery.