Epidemiology of Polypharmacy, Drug-drug Interaction, and Potentially Inappropriate Medication Among Metabolic Syndrome Patients in Iran: A National, Cross-sectional, Multi-level Study

Purpose The prevalence of metabolic syndrome is 4.8% in adults worldwide. In the treatment process, Polypharmacy which is defined as concomitant use of ≥ 5 medications in a prescription is common and it may lead to untoward Drug-drug interactions. Methods A population-based, cross sectional study was conducted following joining the data from Iranians Health Insurance Service prescriptions in 2015 and 2016 with patients data from STEPwise approach to risk factor Surveillance 2016 survey in Iran. Epidemiology of polypharmacy was evaluated among Metabolic syndrome patients, and association between polypharmacy and individual and sociodemographic factors was assessed with polypharmacy being the dependent variable. Potentially Inappropriate Medication was evaluated among the ≥ 60 year-olds and, as the dependent variable, its association with individual and sociodemographic factors as well as polypharmacy was evaluated. Drug-drug interactions were assessed using LexiComp® software. Logistic regression analysis was used to analyze the associations. Results Out of 2075 patients, 10.3% had polypharmacy. There was significant association between polypharmacy with age and area of living ( p < 0.001). Potentially Inappropriate Medication was 13.2% and its association with area of living was significant ( p < 0.001). Among patients with polypharmacy, 91.4% in 2015, and 90.1% in 2016 had drug-drug interactions. Prevalence of C, D, and X risk category and prescriptions with 3 kinds of risk categories (C + D + X) was more among patients with polypharmacy.