Affiliation:
1. Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Quebec
2. Department of Family Medicine, McGill University, Quebec, Canada
Abstract
Abstract
Background
Polypharmacy carries the risk of adverse events, especially in people with multimorbidity.
Objective
To investigate the prevalence of polypharmacy in community-dwelling adults, the association of multimorbidity with polypharmacy and the use of medications for primary prevention.
Methods
Cross-sectional analysis of the follow-up data from the Program of Research on the Evolution of a Cohort Investigating Health System Effects (PRECISE) in Quebec, Canada. Multimorbidity was defined as the presence of three or more chronic diseases and polypharmacy as self-reported concurrent use of five or more medications. Primary prevention was conceptualized as the use of statin or low-dose antiplatelets without a reported diagnostic of cardiovascular disease.
Results
Mean age 56.7 ± 11.6, 62.5% female, 30.3% had multimorbidity, 31.9% had polypharmacy (n = 971). The most common drugs used were statins, renin–angiotensin system inhibitors and psychotropics. Compared to participants without any chronic disease, the adjusted odds ratios (ORs) for having polypharmacy were 2.78 [95% confidence interval (CI): 1.23–6.28] in those with one chronic disease, 8.88 (95% CI: 4.06–19.20) in those with two chronic diseases and 25.31 (95% CI: 11.77–54.41) in those with three or more chronic diseases, P < 0.001. In participants without history of cardiovascular diseases, 16.2% were using antiplatelets and 28.5% were using statins. Multimorbidity was associated with increased likelihood of using antiplatelets (adjusted OR: 2.98, 95% CI: 1.98–4.48, P < 0.001) and statins (adjusted OR: 3.76, 95% CI: 2.63–5.37, P < 0.001) for primary prevention.
Conclusion
There was a high prevalence of polypharmacy in community-dwelling adults in Quebec and a strong association with multimorbidity. The use of medications for primary prevention may contribute to polypharmacy and raise questions about safety.
Funder
Canadian Institutes of Health Research
Université de Sherbrooke
Publisher
Oxford University Press (OUP)
Cited by
27 articles.
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