Polypharmacy among elderly patients in Poland: prevalence, predisposing factors, and management strategies

The world's elderly population is growing dramatically. Pharmacotherapy in seniors is particularly challenging due to changes in metabolism, multimorbidity, and a great interest in nonprescription drugs.

We aimed to provide up‑to‑datedata on pharmacotherapy in the geriatric population of Poland, to determine factors predisposing to polypharmacy and excessive polypharmacy, and to identify seniors who are most likely to require multidisciplinary interventions in the field of pharmacotherapy.

We analyzed the use of all prescription and nonprescription drugs taken within 2 weeks preceding the study in a representative national sample of 3014 home‑dwelling seniors aged over 65 years. The variables of age, sex, place of residence, level of education, and multimorbidity were considered. Poststratification was used to balance the sample structure to match the Polish population of 2017.

Consumption of at least 1 drug was reported by 90.7% of the participants, and the mean number of drugs used was 5.01 (95% CI, 4.87-5.15). At least 1 nonprescription drug was used by 44.2% of the respondents, with a mean number of 0.52 (95% CI, 0.49-0.55). More than 5 drugs were taken by 53.5% of the entire population, while the use of more than 10 drugs was reported by 8.7% of the respondents, with multimorbidity as the most predisposing factor. Single‑pill combinations accounted for 27.2% of medications.

The high prevalence of polypharmacy resulting from multimorbidity confirms the need for the implementation of combined medical and pharmaceutical care of the geriatric patients.