Polypharmacy prevalence, associated factors, and changes over time in Australians with multiple sclerosis

People with multiple sclerosis (PwMS) face a high risk of polypharmacy due to symptom management and comorbidities, yet research remains limited.

To examine polypharmacy prevalence, associated factors, and temporal trends among Australians with MS.

Data were drawn from the Australian Multiple Sclerosis Longitudinal Study. Prescription records were obtained from Pharmaceutical Benefits Scheme (PBS) datasets (2017-2022). Polypharmacy was defined as the use of ≥5 medications prescribed at least four times a year. Prevalence of overall, low-to-moderate (5-9 medications) and hyper-polypharmacy (≥10 medications) was calculated for 2022. Log-binomial regression was used to identify factors associated with polypharmacy. Among those having PBS data for every year of 2017-2022, the average annual percentage change in polypharmacy prevalence was estimated using Poisson regression.

In 2022, 24 % of PwMS experienced polypharmacy (22 % low-to-moderate; 3 % hyper-polypharmacy). Higher age, disability, number of comorbidities, and lower education were associated with higher likelihood of polypharmacy. Common self-reported comorbidities associated with higher polypharmacy prevalence included type 2 diabetes (prevalence ratio [95 % confidence interval]: 2.03 [1.61-2.56]), hypertension (1.49 [1.19-1.85]), high cholesterol (1.41 [1.14-1.75]), and depression (1.35 [1.07-1.71]). Polypharmacy prevalence increased consistently, with an average annual rate of 4.51 %.

Polypharmacy is common and increasing among PwMS. Older PwMS with higher disability levels, more comorbidities and lower levels of education are more likely to benefit from a formal review of their medications.