The association between polypharmacy and medication regimen complexity and antibiotic use in bronchiectasis

Area of Science:

• Pulmonary Medicine
• Clinical Pharmacy
• Pharmacoeconomics

Background:

• Polypharmacy increases risks of adverse drug events and medication errors.
• Bronchiectasis patients frequently experience pulmonary exacerbations requiring antibiotic treatment.

Purpose of the Study:

• To quantify polypharmacy and medication regimen complexity in bronchiectasis patients.
• To investigate associations between these factors and antibiotic use for exacerbations.

Main Methods:

• Utilized patient records to measure polypharmacy (≥4, ≥10, ≥15 medicines) and medication regimen complexity (MRCI).
• Analyzed associations between polypharmacy thresholds, MRCI, and oral/intravenous antibiotic prescriptions.

Main Results:

• Over 77% of patients used ≥4 medicines; 33% used ≥10 medicines.
• Patients on ≥10 medicines were >3 times more likely to have received IV antibiotics (aOR 3.44).
• MRCI positively correlated with both oral and IV antibiotic use.

Conclusions:

• Significant outcome differences observed across the ≥10 medicines polypharmacy threshold.
• Polypharmacy and regimen complexity are linked to increased antibiotic use in bronchiectasis.
• Findings suggest a connection between medication burden and poorer patient outcomes.