A high prevalence of polypharmacy (57.9% taking ≥6 medications) and multiple consultations was observed among late-stage elderly patients in a community hospital outpatient setting.
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High polypharmacy prevalence in elderly outpatients warrants review; hypothesis-generating for outcome effects and deprescribing trials.
UNLABELLED: background & aim: Elderly patients often suffer comorbidity, which leads to polypharmacy (≥ 6 concurrent medications). The extent of polypharmacy in very elderly patients in university hospitals has been reported, but not in community hospital outpatient units. We investigated polypharmacy in late-stage elderly patients at an outpatient unit of a community hospital. METHODS: The study group comprised 159 patients who visited a community hospital during 6 consecutive days. We analyzed the number of consultations and the changeless prescriptions for the past three months or more in the medical records of these patients. RESULTS: Patients took up to 15 types of medication (average 6.5 ± 3.5) and up to 36 tablets (average 12.4 ± 7.8 tablets/day) at the time of survey. Over 9 months, 76.1% of patients had multiple consultations. A total of 57.9% of patients received polypharmacy. Antihypertensive drugs were prescribed to 20.3% of patients. Inappropriate prescription accounted for 4.8% of a total of 1,031 prescriptions. CONCLUSION: A larger number of very elderly patients was receiving polypharmacy and multiple consultations in outpatient units of a community hospital than has been previously reported in university hospitals. It is important to prescribe appropriately for very elderly patients in teams which include pharmacists and nurses as well as doctors.
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Nomoto et al. (2011) studied this question.
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