THE prevalence of polypharmacy among older Australians is relatively high and increasing as the population ages, with almost one million people using at least five prescribed medicines, according to the authors of research published by the Medical Journal of Australia.
Using several medicines concurrently — polypharmacy — places older people at risk of harm, including from adverse drug reactions, and is associated with poor clinical outcomes, including nutritional deficiencies, falls, frailty, impaired cognition, more frequent hospitalisation, and premature mortality, wrote the authors.
Led by Dr Amy Page, the NHMRC Early Career Fellow at the Centre for Optimisation of Medicines at the University of Western Australia and the lead pharmacist rehabilitation aged and community care at the Pharmacy Department at Alfred Health in Melbourne, the researchers analysed a random 10% sample of Pharmaceutical Benefits Scheme (PBS) data for people aged 70 years of age or more, who were dispensed PBS-listed medicines between 1 January 2006 and 31 December 2017.
“In 2017, 36.1% of older Australians were experiencing polypharmacy, or an estimated 935 240 people,” they found.
“Rates of polypharmacy were higher among women than men (36.6% v 35.4%) and were highest among those aged 80–84 years (43.9%) or 85–89 years (46.0%). The prevalence of polypharmacy among older people increased by 9% from 2006 to 2017 (from 33.2% to 36.2%). However, the total number of people experiencing polypharmacy increased by 52% (from 543 950 to 828 950).”
In their conclusion, Page and colleagues wrote: “Polypharmacy can be appropriate, but this needs to be balanced against the risk that it may contribute to adverse health outcomes in older people.
“We need strategies to reduce medicine use and complexity that target both health professionals and the public. These strategies need to be effective and sustainable. They should include both multidisciplinary approaches and system-level interventions,” they concluded.
- Cate Swannell