Prevalence of Polypharmacy and Factors Affecting Medication Non-Adherence among Non-Communicable Disease Patients in Nakhon Nayok Hospital: An Aspect of General Hospital
Keywords:
polypharmacy, geriatric patient, non-communicable disease, non-adherence drugAbstract
Introduction: Incidence of non-communicable diseases (NCDs) increases in Thailand leading to the use the multidrug agent. The parallel use of multidrug increased the risks of adverse drug reactions. In addition, concomitant administration of multiple drugs may lead to drug adherence and patient compliance. Objectives: This study is aimed to identify the prevalence of polypharmacy and factors related to non-adherence in NCD patients, particularly in a general hospital. Methods: The Cross-sectional analytic study was conducted from August 2019 to December 2019 at the NCDs clinic, Nakhon Nayok hospital. Data included underlying diseases, drug use in the past 6 months, and blood results. All participants have interviewed about the status and reason for non-adherence drugs. Polypharmacy was defined as receiving 5 or more medications while receiving 10 or more medications was defined as extremely polypharmacy. Older patients were defined as aged over 65 years. Results: Of 471 patients included in our study. Female was predominant (308, 65.39%). The mean age of patients was 57 years. Seventeen percent of participants were age older than 65 years. Pre-existing diseases of all patients were hypertension (74.7%), dyslipidemia (65.8%), and diabetic Mellitus (57.5%). Half of the patients were identified as polypharmacy (n= 251). Extremely polypharmacy was found in 20 patients (4.25%). In a subgroup analysis of older patients, there were 51 from 80 adults defined as polypharmacy (63.8%). But extremely polypharmacy was found in 6 of 80 patients (7.5%). Factors related to polypharmacy was diabetic Mellitus (p <0.001), hypertension (p=0.001), dyslipidemia (p=0.003), and high waist circumference (p=0.017), respectively. Conclusions: The high prevalence of polypharmacy was found in our study. Diabetic Mellitus, hypertension, and dyslipidemia were factors associated with polypharmacy.
References
Friend DG. Polypharmacy; multiple-ingredient and shotgun prescriptions. N Engl J Med 1959;260(20):1015-8.
De las Cuevas C, Sanz EJ. Polypharmacy in psychiatric practice in the Canary Islands. BMC Psychiatry 2004;4:18.
Riker GI, Setter SM. Polypharmacy in older adults at home: what it is and what to do about it--implications for home healthcare and hospice. Home Healthc Nurse 2012;30(8):474-85.
Hovstadius B, Hovstadius K, Astrand B, Petersson G. Increasing polypharmacy - an individual-based study of the Swedish population 2005-2008. BMC Clin Pharmacol 2010;10:16.
Kaufman DW, Kelly JP, Rosenberg L, Anderson TE, Mitchell AA. Recent patterns of medication use in the ambulatory adult population of the United States: the Slone survey. JAMA 2002;287(3):337-44.
Golchin N, Frank SH, Vince A, Isham L, Meropol SB. Polypharmacy in the elderly. J Res Pharm Pract 2015;4(2):85-8.
Makboona K, Pongpaew W, Mit-tangkulra P. Polypharmacy situation in Thambol Tubteelek of Muang District, Suphanburi Province. Health and the Environment Journal 2014;5:1-8.
Pasitpon Vatcharavongvan, Viwat Puttawanchai. Polypharmacy, medication adherence and medication management at home in elderly patients with multiple non-communicable diseases in Thai primary care. Family Medicine and Primary Care Review 2017;19(4):412-6.
Gomez C, Vega-Quiroga S, Bermejo-Pareja F, Medrano MJ, Louis ED, Benito-Leon J. Polypharmacy in the elderly: a marker of increased risk of mortality in a population-based prospective study (NEDICES). Gerontology 2015;61(4):301-9.
World Health Organization. Adherence to long-term therapies: evidence for action. Geneva, Switzerland: World Health Organization; 2003.
Weerasak Muangpaisan, Dujpratana Pisalsalakij, Somboon Intalapaporn, Wichai Chatthanawaree. Medication nonadherence in elderly patients in a Thai geriatric clinic. Asian Biomedicine 2014;8(4):541-45.
Williams A, Manias E, Walker R. Interventions to improve medication adherence in people with multiple chronic conditions: a systematic review. J Adv Nurs 2008;63(2):132-43.
Schenker Y, Park SY, Jeong K, Pruskowski J, Kavalieratos D, Resick J, et al. Associations between polypharmacy, symptom burden, and quality of life in patients with advanced, life-limiting illness. J Gen Intern Med 2019;34(4):559-66.
Kim HA, Shin JY, Kim MH, Park BJ. Prevalence and predictors of polypharmacy among Korean elderly. PLoS One 2014;9(6):e98043.
Alsuwaidan A, Almedlej N, Alsabti S, Daftardar O, Al Deaji F, Al Amri A, et al. A comprehensive overview of polypharmacy in elderly patients in Saudi Arabia. Geriatrics (Basel) 2019;4(2):36.
Slabaugh SL, Maio V, Templin M, Abouzaid S. Prevalence and risk of polypharmacy among the elderly in an outpatient setting: a retrospective cohort study in the Emilia-Romagna region, Italy. Drugs Aging 2010;27(12):1019-28.
Charlesworth CJ, Smit E, Lee DS, Alramadhan F, Odden MC. Polypharmacy among adults aged 65 years and older in the United States: 1988-2010. J Gerontol A Biol Sci Med Sci 2015;70(8):989-95.
Al-Dahshan A, Al-Kubiasi N, Al-Zaidan M, Saeed W, Kehyayan V, Bougmiza I. Prevalence of polypharmacy and the association with non-communicable diseases in qatari elderly patients attending primary healthcare centers: a cross-sectional study. PloS One 2020;15(6):e0234386.
Silveira EA, Dalastra L, Pagotto V. Polypharmacy, chronic diseases and nutritional markers in community-dwelling older. Rev Bras Epidemiol 2014; 17(4):818-29.
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