Polypharmacy in outpatients with relapsing-remitting multiple sclerosis: A single-center study

Area of Science:

• Neurology
• Clinical Pharmacy

Background:

• Multiple sclerosis (MS) is a chronic, heterogeneous, immune-mediated central nervous system disease.
• Polypharmacy, the use of multiple medications, poses significant health challenges for patients with chronic conditions like MS.
• Managing complex medication regimens is a frequent clinical scenario in MS care.

Purpose of the Study:

• To determine the frequency of polypharmacy (≥5 medications) in relapsing-remitting MS (RRMS) patients.
• To identify sociodemographic and clinical factors associated with polypharmacy in RRMS.
• To compare medication use between MS patients with and without secondary illnesses and polypharmacy.

Main Methods:

• Prospective data collection from 145 RRMS outpatients using anamnesis, patient records, clinical examination, and structured interviews.
• Comparative analyses were performed on subgroups: patients with polypharmacy (PwP) vs. without (Pw/oP), patients with secondary illnesses (PwSI) vs. without (Pw/oSI), and men vs. women.
• Statistical analysis included odds ratios (OR) to assess the association of factors with polypharmacy.

Main Results:

• Polypharmacy was present in 30.3% of RRMS patients.
• Patients with polypharmacy were older (45.9 vs. 41.7 years), had lower education, and higher median EDSS scores (3.0 vs. 2.0).
• Comorbidities (OR=6.293) and higher EDSS scores (OR=1.440) significantly increased the risk of polypharmacy. Polypharmacy was four times higher in PwSI (46.8%) than Pw/oSI (11.8%).

Conclusions:

• A high burden of polypharmacy exists in RRMS patients.
• Polypharmacy is particularly prevalent in more disabled MS patients who also have comorbidities.
• Differences in the use of antihypertensives, gastrointestinal drugs, and supplements were noted between patients with and without polypharmacy.