Payne, R. A., Abel, G. A., Avery, A. J., Mercer, S. W. and Roland, M. O. (2014) Is polypharmacy always hazardous? A retrospective cohort analysis using linked electronic health records from primary and secondary care. British Journal of Clinical Pharmacology, 77(6), pp. 1073-1082. (doi: 10.1111/bcp.12292)
Full text not currently available from Enlighten.
Publisher's URL: http://dx.doi.org/10.1111/bcp.12292
Abstract
<b>Aim</b> Prescribing multiple medications is associated with various adverse outcomes, and polypharmacy is commonly considered suggestive of poor prescribing. Polypharmacy might thus be associated with unplanned hospitalisation. We sought to test this assumption.<p></p> <b>Methods</b> Scottish primary care data for 180,815 adults on long-term clinical conditions and numbers of regular medications were linked to national hospital admissions data for the following year. Using logistic regression (age, gender and deprivation adjusted), we modelled the association of prescribing with unplanned admission for patients with different numbers of long-term conditions.<p></p> <b>Results</b> Admissions were commoner in patients on multiple medications, but admission risk varied with number of conditions. For patients with one condition, the odds ratio for unplanned admission for 4-6 medications was 1.25 (95% CI 1.11-1.42) vs. 1-3 medications, and 3.42 (95% CI, 2.72-4.28) for ≥10 medications vs. 1-3 medications. However, this effect was greatly reduced for patients with multiple conditions; amongst patients with ≥6 conditions, those on 4-6 medications were no more likely to have unplanned admissions than those taking 1-3 medications (OR 1.00 (95% CI 0.88-1.14)), and those taking ≥10 medications had a modestly increased risk of admission (OR 1.50 (95% CI 1.31-1.71)).<p></p> <b>Conclusions</b> Unplanned hospitalisation is strongly associated with number of regular medications. However, the effect is reduced in patients with multiple conditions, with only the most extreme levels of polypharmacy associated with increased admissions. Assumptions that polypharmacy is always hazardous and represents poor care should be tempered by clinical assessment of the conditions for which those drugs are being prescribed.
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Mercer, Professor Stewart |
| Authors: | Payne, R. A., Abel, G. A., Avery, A. J., Mercer, S. W., and Roland, M. O. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care |
| Journal Name: | British Journal of Clinical Pharmacology |
| Journal Abbr.: | Br. J. Clin. Pharmacol. |
| Publisher: | Wiley |
| ISSN: | 0306-5251 |
| ISSN (Online): | 1365-2125 |
| Related URLs: |
University Staff: Request a correction | Enlighten Editors: Update this record
Altmetric
Altmetric