Does Polypharmacy in Nursing Homes Affect Long-Term Mortality?

Area of Science:

• Gerontology
• Clinical Pharmacy
• Public Health

Background:

• Polypharmacy is common in nursing home residents, increasing the risk of adverse drug events and healthcare costs.
• Understanding the association between polypharmacy and mortality is crucial for optimizing medication management in this vulnerable population.

Purpose of the Study:

• To investigate the association between polypharmacy and mortality in nursing home residents.
• To identify factors associated with increased or decreased mortality in this population.

Main Methods:

• Prospective observational cohort study involving 764 nursing home residents in central Israel.
• Two-year mortality was assessed and correlated with the number of medications taken at baseline, controlling for confounders.
• Data included demographics, comorbidities, and medication use.

Main Results:

• Polypharmacy, defined by the number of drugs, was not significantly associated with a two-year increased risk of mortality.
• Factors independently associated with higher mortality included male sex, older age, higher comorbidity index, and use of anticoagulant or antihyperglycemic medications.
• Factors associated with lower mortality included higher body mass index and use of lipid-lowering or selective serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitor medications.

Conclusions:

• Quantitative polypharmacy was not associated with increased mortality in nursing home residents.
• Specific medications and patient characteristics, rather than the sheer number of drugs, appear to be more influential on mortality outcomes.