Prevalence, risk factors and health outcomes associated with polypharmacy among urban community-dwelling older adults in multiethnic Malaysia

Li Min Lim, Megan McStea, Wen Wei Chung, Nuruljannah Nor Azmi, Siti Azdiah Abdul Aziz, Syireen Alwi, Adeeba Kamarulzaman, Shahrul Bahyah Kamaruzzaman, Siew Siang Chua, Reena Rajasuriar

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background Polypharmacy has been associated with increased morbidity and mortality in the older population. Objectives The aim of this study was to determine the prevalence, risk factors and health outcomes associated with polypharmacy in a cohort of urban community-dwelling older adults receiving chronic medications in Malaysia. Methods This was a baseline study in the Malaysian Elders Longitudinal Research cohort. The inclusion criteria were individuals aged ≥55years and taking at least one medication chronically (≥3 months). Participants were interviewed using a structured questionnaire during home visits where medications taken were reviewed. Health outcomes assessed were frequency of falls, functional disability, potential inappropriate medication use (PIMs), potential drugdrug interactions (PDDIs), healthcare utilisation and quality of life (QoL). Risk factors and health outcomes associated with polypharmacy (≥5 medications including dietary supplements) were determined using multivariate regression models. Results A total of 1256 participants were included with a median (interquartile range) age of 69(63± 74) years. The prevalence of polypharmacy was 45.9% while supplement users made up 56.9% of the cohort. The risk factors associated with increasing medication use were increasing age, Indian ethnicity, male, having a higher number of comorbidities specifically those diagnosed with cardiovascular, endocrine and gastrointestinal disorders, as well as supplement use. Health outcomes significantly associated with polypharmacy were PIMS, PDDIs and increased healthcare utilisation. Conclusion A significant proportion of older adults on chronic medications were exposed to polypharmacy and use of dietary supplements contributed significantly to this. Medication reviews are warranted to reduce significant polypharmacy related issues in the older population.

Original languageEnglish
Article numbere0173466
JournalPLoS One
Volume12
Issue number3
DOIs
Publication statusPublished - 1 Mar 2017

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Independent Living
Polypharmacy
Malaysia
drug therapy
risk factors
Dietary supplements
Health
Dietary Supplements
health services
dietary supplements
Delivery of Health Care
House Calls
endocrine diseases
Population
nationalities and ethnic groups
digestive system diseases
Comorbidity
quality of life
cardiovascular diseases
morbidity

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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Prevalence, risk factors and health outcomes associated with polypharmacy among urban community-dwelling older adults in multiethnic Malaysia. / Lim, Li Min; McStea, Megan; Chung, Wen Wei; Azmi, Nuruljannah Nor; Abdul Aziz, Siti Azdiah; Alwi, Syireen; Kamarulzaman, Adeeba; Kamaruzzaman, Shahrul Bahyah; Chua, Siew Siang; Rajasuriar, Reena.

In: PLoS One, Vol. 12, No. 3, e0173466, 01.03.2017.

Research output: Contribution to journalArticle

Lim, LM, McStea, M, Chung, WW, Azmi, NN, Abdul Aziz, SA, Alwi, S, Kamarulzaman, A, Kamaruzzaman, SB, Chua, SS & Rajasuriar, R 2017, 'Prevalence, risk factors and health outcomes associated with polypharmacy among urban community-dwelling older adults in multiethnic Malaysia', PLoS One, vol. 12, no. 3, e0173466. https://doi.org/10.1371/journal.pone.0173466
Lim, Li Min ; McStea, Megan ; Chung, Wen Wei ; Azmi, Nuruljannah Nor ; Abdul Aziz, Siti Azdiah ; Alwi, Syireen ; Kamarulzaman, Adeeba ; Kamaruzzaman, Shahrul Bahyah ; Chua, Siew Siang ; Rajasuriar, Reena. / Prevalence, risk factors and health outcomes associated with polypharmacy among urban community-dwelling older adults in multiethnic Malaysia. In: PLoS One. 2017 ; Vol. 12, No. 3.
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AU - Abdul Aziz, Siti Azdiah

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N2 - Background Polypharmacy has been associated with increased morbidity and mortality in the older population. Objectives The aim of this study was to determine the prevalence, risk factors and health outcomes associated with polypharmacy in a cohort of urban community-dwelling older adults receiving chronic medications in Malaysia. Methods This was a baseline study in the Malaysian Elders Longitudinal Research cohort. The inclusion criteria were individuals aged ≥55years and taking at least one medication chronically (≥3 months). Participants were interviewed using a structured questionnaire during home visits where medications taken were reviewed. Health outcomes assessed were frequency of falls, functional disability, potential inappropriate medication use (PIMs), potential drugdrug interactions (PDDIs), healthcare utilisation and quality of life (QoL). Risk factors and health outcomes associated with polypharmacy (≥5 medications including dietary supplements) were determined using multivariate regression models. Results A total of 1256 participants were included with a median (interquartile range) age of 69(63± 74) years. The prevalence of polypharmacy was 45.9% while supplement users made up 56.9% of the cohort. The risk factors associated with increasing medication use were increasing age, Indian ethnicity, male, having a higher number of comorbidities specifically those diagnosed with cardiovascular, endocrine and gastrointestinal disorders, as well as supplement use. Health outcomes significantly associated with polypharmacy were PIMS, PDDIs and increased healthcare utilisation. Conclusion A significant proportion of older adults on chronic medications were exposed to polypharmacy and use of dietary supplements contributed significantly to this. Medication reviews are warranted to reduce significant polypharmacy related issues in the older population.

AB - Background Polypharmacy has been associated with increased morbidity and mortality in the older population. Objectives The aim of this study was to determine the prevalence, risk factors and health outcomes associated with polypharmacy in a cohort of urban community-dwelling older adults receiving chronic medications in Malaysia. Methods This was a baseline study in the Malaysian Elders Longitudinal Research cohort. The inclusion criteria were individuals aged ≥55years and taking at least one medication chronically (≥3 months). Participants were interviewed using a structured questionnaire during home visits where medications taken were reviewed. Health outcomes assessed were frequency of falls, functional disability, potential inappropriate medication use (PIMs), potential drugdrug interactions (PDDIs), healthcare utilisation and quality of life (QoL). Risk factors and health outcomes associated with polypharmacy (≥5 medications including dietary supplements) were determined using multivariate regression models. Results A total of 1256 participants were included with a median (interquartile range) age of 69(63± 74) years. The prevalence of polypharmacy was 45.9% while supplement users made up 56.9% of the cohort. The risk factors associated with increasing medication use were increasing age, Indian ethnicity, male, having a higher number of comorbidities specifically those diagnosed with cardiovascular, endocrine and gastrointestinal disorders, as well as supplement use. Health outcomes significantly associated with polypharmacy were PIMS, PDDIs and increased healthcare utilisation. Conclusion A significant proportion of older adults on chronic medications were exposed to polypharmacy and use of dietary supplements contributed significantly to this. Medication reviews are warranted to reduce significant polypharmacy related issues in the older population.

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