Journal Article

Polypharmacy in primary care: A population-based retrospective cohort study of electronic health records

Ihenetu, Gloria, Majeed, Azeem, Woodcock, Thomas, Armani, Keivan, Quilley, Angela, Aylin, Paul, Beaney, Thomas, Lovett, Derryn, Novov, Vesselin

2024

Overview

Polypharmacy, prescription of multiple medications to a patient, is a major challenge for health systems. There have been no peer-reviewed studies of polypharmacy prevalence and medication cost at a population level in England. To determine prevalence and medication cost of polypharmacy, by patient characteristics. Design and setting: Retrospective cohort study of North West London electronic health records. We quantified prevalence and direct cost of polypharmacy (five or more regular medications), stratified by demographics and frailty. We fitted a mixed-effects logistic regression for polypharmacy. Of 1.7 million adults, 167,665 (9.4%) were on polypharmacy. Age and socio-economic deprivation were associated with polypharmacy (OR 9.24 95% CI 8.99 to 9.50, age 65-74 compared with 18-44; OR 0.68 95% CI 0.65 to 0.71, least deprived compared with most). Polypharmacy prevalence increased with frailty (OR 1.53 95% CI 1.53 to 1.54 per frailty component, for White women). Men had higher odds of polypharmacy than women at average frailty (OR 1.26 95% CI 1.24 to 1.28) and with additional frailty components (OR 1.10 95% CI 1.09 to 1.10). Black people had lower odds of polypharmacy at average frailty (OR 0.82 95% CI 0.79 to 0.85, compared with White), but along with other ethnicities, saw greater odds increases with increasing frailty (OR 1.02 95% CI 1.01 to 1.03). Annual medication cost 8.2 times more for those on polypharmacy compared with not (£370.89 and £45.31). Demographic characteristics are associated with polypharmacy, after adjusting for frailty. Further research should explore why, to reduce health inequities and optimise cost associated with polypharmacy.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Access to information / Adolescent / Adult / Age / Aged / Aged, 80 and over / Analysis / Black people / Cardiovascular disease / Cohort analysis / Comorbidity / Computer and Information Sciences / Demographics / Demography / Diabetes / Drug Costs / Drug interactions / Electronic health records / Electronic Health Records - statistics & numerical data / Electronic medical records / Electronic records / Ethnicity / Expenditures / Female / Frailty / Gender / Humans / Ingredients / London - epidemiology / Male / Medical records / Medicine and Health Sciences / Methods / Middle Aged / Patient compliance / People and Places / Polypharmacy / Population / Population studies / Prevalence / Primary care / Primary health care / Primary Health Care - statistics & numerical data / Retrospective Studies / Women / Young Adult