Polypharmacy Among the Elderly in a List-Patient System.

Area of Science:

• Geriatric Medicine
• Pharmacology
• Public Health

Background:

• Polypharmacy (simultaneous use of multiple drugs) is linked to compliance issues and adverse drug reactions.
• Norway's list-patient system assigns patients to a regular general practitioner (GP) to enhance primary care quality and treatment coordination.

Purpose of the Study:

• To investigate the role of regular GPs in managing polypharmacy among home-dwelling elderly individuals in Norway.
• To quantify the increased risk of polypharmacy associated with multiple prescribers.

Main Methods:

• A population registry study utilized data from the Norwegian Prescription Database and the Regular General Practitioner Database (2004-2007).
• Included 624,308 patients aged 70+ and 4520 GPs.
• Polypharmacy was defined as five or more, and excessive polypharmacy as ten or more, prescribed drug substances per quarter.

Main Results:

• Polypharmacy rates are high and increasing among the elderly, even within the list-patient system.
• General practitioners (GPs) are involved in 64% of polypharmacy incidents.
• The risk of polypharmacy significantly increases with the number of prescribers (OR 2.32).

Conclusions:

• GPs are central to the high and rising rates of polypharmacy in Norway's elderly population.
• Effective interventions to combat polypharmacy must actively involve general practitioners (GPs).