Polypharmacy in Patients With COPD: A Scoping Review

Area of Science:

• Pulmonology
• Clinical Pharmacy
• Geriatrics

Background:

• Chronic Obstructive Pulmonary Disease (COPD) is a significant global health issue.
• Patients with COPD often require multiple medications for both their condition and comorbidities.
• This increases the risk of polypharmacy and associated patient harm.

Purpose of the Study:

• To determine the prevalence of polypharmacy in COPD patients.
• To highlight the varied definitions of polypharmacy in existing literature.
• To report medication-related harms associated with polypharmacy in COPD.

Main Methods:

• A systematic review of 28 studies reporting polypharmacy rates in COPD populations.
• Analysis of studies from diverse geographical and clinical settings.
• Examination of different definitions of polypharmacy (≥3 to ≥20 medications).

Main Results:

• Polypharmacy rates in COPD ranged from 3.9% to 81.4%, with hyper polypharmacy (≥10 medications) from 6.6% to 74.6%.
• A lack of consistent definition for polypharmacy (≥5 medications used in 46.3% of studies) hinders direct comparison.
• Significant variability in polypharmacy prevalence across different countries and healthcare settings was observed.

Conclusions:

• Polypharmacy is prevalent in COPD patients but poorly understood due to definitional and methodological inconsistencies.
• The multimorbid nature of COPD increases vulnerability to polypharmacy's adverse effects like poor adherence and drug interactions.
• Clinicians must consider patient age, comorbidities, and drug interactions when prescribing for COPD patients to mitigate harm.