Key result
Among 400 patients in Nepalese communities, 95.5% experienced moderate polypharmacy, which was significantly associated with education and occupation but not with total medication costs.
Why the study?
Improper management of polypharmacy can cause adverse effects and drug interactions across age groups, prompting an assessment of polypharmacy and associated costs in multiple Nepalese communities.
Cross-Sectional (n=400)
Yes
Polypharmacy is highly prevalent in Nepalese communities, with moderate polypharmacy affecting 95.5% of patients, highlighting the need for medication utilization reviews to minimize adverse drug reactions and costs.
Observed polypharmacy associations with education and occupation in Nepal are hypothesis-generating; prospective studies needed before practice implications.
Objective Improper management of polypharmacy in community and hospital pharmacies may lead to adverse effects and drug interactions in patients of all age groups, especially children and the elderly. This study aimed to determine the scenario of polypharmacy in multiple communities in Nepal and the costs associated with them. Design Cross-sectional study Setting Local communities of nine districts in Nepal Participants Total 400 patients of all age groups, who were consuming medicines and who fulfilled inclusion criteria from May 2017 to August 2018 Primary and secondary outcome measures A semi-structured questionnaire, based on the prescription optimization method, was used for data collection. Multinomial logistic regression was performed to analyze the statistical significance of polypharmacy with the predictor variables (e.g., age, education level, occupation, diagnosis, total cost of medicines). The p-value < 0.05 was considered statistically significant at 95% confidence interval. Polypharmacy cases and their economic implications were reported. Results Eighty-one patients (20.3%) with an age group of 22-31 years with female patients (219, 54.8%) reported more polypharmacy events. There were 216 patients (54%) with prescriptions of five medicines i.e., moderate polypharmacy. Total number of medicines consumed by all 400 patients was 2269, with a mean±SD 5.67 ±1.08. Total expenditure by all 400 patients was USD 3409.54 during the study period, with a mean±SD8.66±6.04. Both moderate and severe polypharmacy cases were non-significantly related with age, gender and total cost of medications. They had significant relationship in almost all levels of education and occupation and showed mixed type of significance and non-significance with the diagnosis of the respondents. Conclusion Polypharmacy cases can be minimized, considering adverse drug reactions and drug interactions. Further studies are warranted in medication utilization and avoidable polypharmacy along with detailed pharmacoeconomic evaluation.
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Sapkota et al. (2020) conducted a cross-sectional in Polypharmacy (n=400). Polypharmacy vs. Mild polypharmacy (1-4 medications) was evaluated on Prevalence and predictors of moderate and severe polypharmacy. Among 400 patients in Nepalese communities, 95.5% experienced moderate polypharmacy, which was significantly associated with education and occupation but not with total medication costs.
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