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Polypharmacy in an Australian teaching hospital: Preliminary analysis of prevalence, types of drugs and associations
Author(s) -
McMillan Derek A.,
Harrison Paul M.,
Rogers Lesley J.,
Tong Nicholas,
McLean Allan J.
Publication year - 1986
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1986.tb113844.x
Subject(s) - polypharmacy , medicine , intensive care medicine
A computer‐based prescription retrieval system was used to study 21 521 prescriptions that had been provided to hospital patients who were receiving predominantly outpatient care. Over a three‐month period 338 patients were found to be receiving 10 or more different drugs concomitantly. A further 338 patients were drawn at random from the same outpatient population for comparison. Age was linked significantly to polypharmacy (polypharmacy group: mean age, 63.7 years, SEM = 1.09; comparison group: mean age, 53.8 years, SEM = 1.00, P <0.05; χ 2 = 62.8, P <0.001). The relative risk of polypharmacy was related linearly to age. Admission to hospital was associated with increased prescribing rates in the polypharmacy sample ( P <0.05), as was attendance at multiple clinics and multiple attendance at outpatient clinics ( P <0.05 and P <0.05, respectively). Benzodiazepine agents were included in 63.7% of prescriptions in the polypharmacy group and in 37.3% of prescriptions in the comparison group. Non‐prescription drugs were noted in 97.2% of prescriptions in the polypharmacy group and 58.0% of prescriptions in the comparison group, representing 34.7% and 27.3% of all items, respectively. In patients of less than 30 years of age agents for allergy/asthma/atopy contributed most to polypharmacy; agents that were associated with renal failure most in patients aged 31‐50 years; and agents for cardiovascular disease contributed most in patients aged over 50 years. Our results suggest that a reduction in the use of non‐prescription and psychotropic agents, heightened awareness of the dangers of polypharmacy and coordination and integration of over‐all care and prescribing habits should reduce polypharmacy materially.