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Exploring Polypharmacy in the BC Correctional Health Setting.

Lillian Lo¹, Sarah Masson², Matthew Brons³

¹PharmD, ACPR, RPh, is a Clinical Pharmacist with Royal Columbian Hospital, Lower Mainland Pharmacy Services (Fraser Health Authority), New Westminster, British Columbia.

The Canadian Journal of Hospital Pharmacy

|May 15, 2025

Summary

Polypharmacy is common in British Columbia correctional facilities, affecting over 25% of clients at some sites. Opioid agonist therapy and psychotropics were the most prescribed medications, highlighting a need for medication management optimization.

Keywords:

correctional health incarceration polypharmacy

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Area of Science:

Pharmacology
Public Health
Criminology

Background:

Incarcerated individuals face higher comorbidity and unique environmental factors, increasing polypharmacy risk.
Limited research exists on polypharmacy within correctional health settings.

Purpose of the Study:

Determine median medication count per client in British Columbia correctional facilities.
Calculate polypharmacy prevalence and identify top prescribed medication categories.
Screen for potential drug therapy problems in polypharmacy cases.

Main Methods:

Observational point prevalence study conducted at 5 correctional health facilities.
Included adult clients with active medications on census date.
Excluded clients with one-time or no medication orders.

Main Results:

420 clients analyzed; median medications ranged from 3-5 per client.
Polypharmacy rates varied from 23% to 41% across facilities.
Opioid agonist therapy and psychotropics were leading scheduled medications; drug interactions causing sedation were a key issue.

Conclusions:

Polypharmacy was prevalent across all studied facilities.
Prescribed medications align with existing literature, but optimization opportunities exist.