Prevalence and association of continuous polypharmacy and frailty among older women: A longitudinal analysis over 15 years

Thiruchelvam K 1 , Byles J 2 , Hasan SS 3 , Egan N 4 , Kairuz T 5

Affiliations 

  • 1 University of Newcastle, University Drive, Callaghan, New South Wales 2308, Australia; International Medical University, 126 Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia. Electronic address: kaeshaelyathiruchelvam@uon.edu.au
  • 2 University of Newcastle, University Drive, Callaghan, New South Wales 2308, Australia; Priority Research Centre for Generational Health and Ageing, Hunter Medical Research Institute, New Lambton Heights, New South Wales 2305, Australia. Electronic address: julie.byles@newcastle.edu.au
  • 3 University of Newcastle, University Drive, Callaghan, New South Wales 2308, Australia; University of Huddersfield, Queensgate, Huddersfield HD1 3DH, United Kingdom. Electronic address: S.hasan@hud.ac.uk
  • 4 University of Newcastle, University Drive, Callaghan, New South Wales 2308, Australia; Priority Research Centre for Generational Health and Ageing, Hunter Medical Research Institute, New Lambton Heights, New South Wales 2305, Australia. Electronic address: Nick.Egan@newcastle.edu.au
  • 5 University of Newcastle, University Drive, Callaghan, New South Wales 2308, Australia; International Medical University, 126 Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia. Electronic address: Therese.Kairuz@newcastle.edu.au
Maturitas, 2021 Apr;146:18-25.
PMID: 33722360 DOI: 10.1016/j.maturitas.2021.01.005

Abstract

OBJECTIVES: This study aimed to determine the prevalence of continuous polypharmacy and hyperpolypharmacy, determine medications that contribute to continuous polypharmacy, and examine the association between frailty and continuous polypharmacy.

STUDY DESIGN: A prospective study using data from the Australian Longitudinal Study on Women's Health. Women aged 77-82 years in 2003, and 91-96 years in 2017 were analysed, linking the Pharmaceutical Benefits Scheme data to participants' survey data.

MAIN OUTCOME MEASURES: The association between frailty and continuous polypharmacy was determined using generalised estimating equations for log binomial regressions, controlling for confounding variables. Descriptive statistics were used to determine the proportion of women with polypharmacy, and medications that contributed to polypharmacy.

RESULTS: The proportion of women with continuous polypharmacy increased over time as they aged. Among participants who were frail (n = 833) in 2017, 35.9 % had continuous polypharmacy and 1.32 % had hyperpolypharmacy. Among those who were non-frail (n = 1966), 28.2 % had continuous polypharmacy, and 1.42 % had hyperpolypharmacy. Analgesics (e.g. paracetamol) and cardiovascular medications (e.g. furosemide and statins) commonly contributed to continuous polypharmacy among frail and non-frail women. Accounting for time and other characteristics, frail women had an 8% increased risk of continuous polypharmacy (RR 1.08; 95 % CI 1.05, 1.11) compared to non-frail women.

CONCLUSIONS: Combined, polypharmacy and frailty are key clinical and public health challenges. Given that one-third of women had continuous polypharmacy, monitoring and review of medication use among older women are important, and particularly among women who are frail.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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