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ORIGINAL RESEARCH article

Front. Pharmacol.
Sec. Pharmacoepidemiology
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1382990

The association between continuous polypharmacy and hospitalization, emergency department visits, and death in older adults: a nationwide large cohort study

Provisionally accepted
Jungmi Chae Jungmi Chae 1Jin Ho Jin Ho 1Sang-heon Yoon Sang-heon Yoon 1Dong-Sook Kim Dong-Sook Kim 2*
  • 1 Health Insurance Review and Assessment Service, Chuncheon, Gangwon, Republic of Korea
  • 2 Kongju National University, Gong, Republic of Korea

The final, formatted version of the article will be published soon.

    Background: This study aimed to investigate the association between continuous polypharmacy and hospitalization, emergency department (ED) visits, and death.Methods: This retrospective study utilized 6,443,896 patients aged between 65 and 84 years of National Health Insurance claims data from 2016 to 2018. Polypharmacy and excessive polypharmacy were defined as the concurrent use of 5 or more and 10 or more medications, respectively, for durations of both 90 days or more and 180 days or more within a 1-year observation period. The primary outcome measures included all-cause hospitalization, ED visits, and mortality. Multiple logistic regression models were used adjusting for patients' general characteristics, comorbidities, and history of hospitalization or ED visits.Results: Among 2,693,897 patients aged 65-84 years who had used medicines for 180 days or more (2,955,755 patients taking medicines for 90 days or more), the adverse outcomes were as follows: 20.5% (20.3%) experienced hospitalization, 10.9% (10.8%) visited the ED, and 1% (1%) died, respectively. In patients who exhibited polypharmacy for more than 180 days, the adjusted odds ratio of adverse outcomes was 1.32 (95% confidence interval [CI], 1.31-1.33) for hospitalization, 1.32 (95% CI, 1.31-1.33) for ED visits, 1.63 (95% CI, 1.59-1.67) for death, and that in excessive polypharmacy patients for more than 180 days was 1.85 for hospitalization, 1.92 for ED visits, and 2.57 for death, compared to non-polypharmacy patients.Our results suggest that polypharmacy in older adults might lead to negative health consequences. Thus, interventions to optimize polypharmacy may need to be implemented.

    Keywords: Polypharmacy, Elderly, Outpatients, hospitalization, emergency department visit, death

    Received: 06 Feb 2024; Accepted: 04 Jul 2024.

    Copyright: © 2024 Chae, Ho, Yoon and Kim. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Dong-Sook Kim, Kongju National University, Gong, Republic of Korea

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.