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The development of polypharmacy. A longitudinal study.

L Veehof1, R Stewart, F Haaijer-Ruskamp

  • 1Department of General Practice and Northern Centre of Health Care, University of Groningen, Groningen, The Netherlands.

Family Practice
|June 14, 2000
PubMed
Summary
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Polypharmacy, the use of multiple long-term medications, slowly increased in Dutch elderly over four years. This trend was linked to existing conditions like diabetes and cardiovascular disease, and the use of drugs without clear indications.

Area of Science:

  • Geriatric Medicine
  • Pharmacology
  • Public Health

Background:

  • Limited research exists on polypharmacy development and its link to morbidity in Dutch general practices.
  • Understanding polypharmacy trends is crucial for managing chronic diseases in the elderly.

Purpose of the Study:

  • To investigate the relationship between increased long-term drug use and the incidence/severity of chronic diseases in the elderly.
  • To identify predictors for the development of polypharmacy in this population.

Main Methods:

  • A longitudinal study of 1544 elderly individuals from 1994-1997 in three Dutch general practices.
  • Polypharmacy defined as long-term use (>240 days/year) of two or more drugs.
  • Regression analysis used to predict polypharmacy and analyze disease incidence.

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Main Results:

  • Polypharmacy affected 42% of elderly participants by 1997, with 4% experiencing major polypharmacy (>5 drugs).
  • The average number of long-term drugs increased from 1.3 to 1.8 over four years.
  • Predictors for polypharmacy included baseline drug use, age, diabetes, coronary ischemic diseases, and non-indicated medication use.

Conclusions:

  • Polypharmacy showed a gradual increase, with nearly 20% of elderly developing it over the study period.
  • Polypharmacy primarily affects elderly patients with pre-existing conditions (cardiovascular, diabetes), those using multiple drugs, and those with non-indicated prescriptions.
  • New onset hypertension and atrial fibrillation were associated with polypharmacy development.