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Risk factors for polypharmacy in older adults in a primary care setting: a cross-sectional study

Authors Ersoy S, Engin VS

Received 5 June 2018

Accepted for publication 5 September 2018

Published 15 October 2018 Volume 2018:13 Pages 2003—2011

DOI https://doi.org/10.2147/CIA.S176329

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Cristina Weinberg

Peer reviewer comments 3

Editor who approved publication: Dr Richard Walker


Suleyman Ersoy,1 Velittin Selcuk Engin2

1Department of Family Medicine, Faculty of Medicine, Karabuk University, Karabuk, Turkey; 2Melekhatun Family Practice Center, Ministry of Health, Istanbul 34340, Turkey

Purpose: Polypharmacy (PP) is a clinical challenge in older adults. Therefore, assessment of daily drug consumption (DDC) and its relationships is important. First-line health services have a crucial role in monitoring and preventing PP. In this study, we aimed to assess DDC and investigate the risk factors for higher DDC among older adults in a primary care setting.
Patients and methods: A total of 1,000 patients aged ≥65 years who visited Melek Hatun Family Practice Center between December 1, 2014, and August 1, 2017, were enrolled in the study. All patients were seen either at the center or in their homes, and informed consent was obtained. Comprehensive geriatric assessment was performed for each subject. Data were analyzed using SPSS software (version 17). The daily number of medicines that each patient used (DDC) regardless of whether they were prescribed was the dependent variable. Relationships between DDC and other continuous variables were examined using Pearson’s correlation. For between-group comparisons of DDC, Student’s t-tests were performed.
Results: Univariate tests showed relationships between DDC and various demographic and clinical parameters. The variables that remained significant at the last step of a stepwise linear regression analysis were metabolic syndrome, chronic pain, incontinence, increased serum creatinine level, increased Geriatric Depression Scale scores, reported gastric disturbances, and neutrophil/lymphocyte ratio.
Conclusion: Along with certain chronic conditions, depressive symptoms and an inflammatory marker (neutrophil/lymphocyte ratio) were significantly and independently related to higher DDC. Longitudinal and larger studies are needed to further explore the multifaceted relationships of PP.

Keywords: polypharmacy, older adult, primary care, Geriatric Depression Scale, metabolic syndrome, neutrophil/lymphocyte ratio

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