Factors Associated with Polypharmacy in Older Adults from 12 High-Andean Communities in Peru, 2013-2017
DOI:
https://doi.org/10.17533/udea.iatreia.305Keywords:
Aged, Polypharmacy, Risk factorsAbstract
Introduction: Polypharmacy, defined as the simultaneous consumption of 3 or more medications, is a significant concern in older adults, particularly in communities with limited access to healthcare services and adverse living
conditions. This study focuses on vulnerable populations in high-Andean communities of Peru.
Objectives: To determine the factors associated with polypharmacy in older adults from 12 high-Andean communities in Peru.
Methods: This observational, descriptive, and cross-sectional study included a sample of 399 elderly individuals selected through census sampling with a minimum response rate of 95%. The "Frailty in Older Adults from the Peruvian Andes" questionnaire was utilized. Multivariate analysis was conducted using Chi-square test, Student's t-test, Mann-Whitney U test, and
regression analysis for independent groups.
Results: Of the participants, 58.7% (n=234) were women, and 32.8% exhibited polypharmacy. The variables most strongly associated with polypharmacy were retirement (CI 2.07 - 8.13), previous hospitalizations (CI 0.09 - 0.31), alcohol consumption (CI 2.04 - 6.28), tobacco use (CI 2.78 - 10.12), and hypertension (CI 1.14 - 4.68).
Conclusions: Polypharmacy in older adults is influenced by sociocultural and demographic factors such as retirement, alcohol and tobacco consumption, and hypertension. Altitude did not show a significant association with polypharmacy.
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References
(1) Masnoon N, Shakib S, Kalisch-Ellett L, Caughey GE. What is polypharmacy? A systematic review of definitions. BMC Geriatr [Internet]. 2017;17(1):230. https://doi.org/10.1186/s12877-017-0621-2
(2) Taghy N, Cambon L, Cohen J-M, Dussart C. Failure to reach a consensus in polypharmacy definition: An obstacle to measuring risks and impacts—results of a literature review. Ther Clin Risk Manag [Internet]. 2020;16:57–73. https://doi.org/10.2147/tcrm.s214187
(3) Molina-Vilca PDC, Flores-Choque PH. Pluripatología, polifarmacia y prescripción potencialmente inadecuada en pacientes geriátricos en un servicio de hospitalización de agudos en el Hospital Geriátrico San José durante los meses de junio a septiembre del 2017 [Tesis] Lima; Universidad Nacional Mayor de San Marcos. 2018. Disponible en: https://cybertesis.unmsm.edu.pe/item/ee41a6de-3905-416a-8eeb-516d3cecb4de
(4) Carvajal-Botero LA, Estrada-Restrepo A, Giraldo-Giraldo NA. Estado nutricional de los adultos mayores de Antioquia y su relación con enfermedades y consumo de medicamentos. Iatreia [Internet]. 2022;36(4):481-494. https://doi.org/10.17533/udea.iatreia.205
(5) Poblano-Verástegui O, Bautista-Morales AC, Acosta-Ruíz O, Gómez-Cortez PM, Saturno-Hernández PJ. Polifarmacia en México: un reto para la calidad en la prescripción. Salud pública Méx [Internet]. 2020;62(6):859–867. https://doi.org/10.21149/11919
(6) Vallejos-Narváez ÁG, Bello-Benavides A, Caro-Uribe P, Hernández-Díaz W. Carga anticolinérgica en pacientes mayores de 65 años con tratamiento farmacológico ambulatorio en una población colombiana. Iatreia [Internet]. 2019;32(1):25–32. https://doi.org/10.17533/udea.iatreia.v32n1a03
(7) Vela-Ruiz JM, Medina-Rojas K, Machón-Cosme A, Turpo D, Saenz-Vasquez LA, Quiñones-Laveriano DM. Characteristics related to lifestyle in elderly patients in a Health Center of the Andes in Peru. Rev Fac Medic Hum [Internet]. 2021;22(1):95–102. https://doi.org/10.25176/RFMH.v22i1.4081
(8) Miranda JJ, Bernabe-Ortiz A, Gilman RH, Smeeth L, Malaga G, Wise RA, et al. Multimorbidity at sea level and high-altitude urban and rural settings: The CRONICAS Cohort Study. J Comorb [Internet]. 2019;9:2235042X19875297. https://doi.org/10.1177/2235042X19875297
(9) Urrunaga-Pastor D, Chambergo-Michilot D, Runzer-Colmenares FM, Pacheco-Mendoza J, Benites-Zapata VA. Prevalence of Cognitive Impairment and Dementia in Older Adults Living at High Altitude: A Systematic Review and Meta-Analysis. Dement Geriatr Cogn Disord [Internet]. 2021;50(2):124–34. https://doi.org/10.1159/000514471
(10) Pereira KG, Peres MA, Iop D, Boing AC, Boing AF, Aziz M, et al. Polifarmácia em idosos: um estudo de base populacional. Rev Bras Epidemiol [Internet]. 2017;20(2):335–44. https://doi.org/10.1590/1980-5497201700020013
(11) Bojuwoye AO, Suleman F, Perumal-Pillay VA. Polypharmacy and the occurrence of potential drug–drug interactions among geriatric patients at the outpatient pharmacy department of a regional hospital in Durban, South Africa. J Pharm Policy Pract [Internet]. 2022;15(1). https://doi.org/10.1186/s40545-021-00401-z
(12) Nwadiugwu MC. Frailty and the risk of polypharmacy in the older person: Enabling and preventative approaches. J Aging Res [Internet]. 2020;2020:1–6. https://doi.org/10.1155/2020/6759521
(13) Sanchez-Rodriguez JR, Escare-Oviedo CA, Castro-Olivares VE, Robles-Molina CR, Vergara-Martínez MI, Jara-Castillo CT. Polifarmacia en adulto mayor, impacto en su calidad de vida. Revisión de literatura. Rev Sal Púb [Internet]. 2019;21(2):271–7. https://doi.org/10.15446/rsap.v21n2.76678
(14) Klotz U. Pharmacokinetics and drug metabolism in the elderly. Drug Metab Rev [Internet]. 2009;41(2):67–76. https://doi.org/10.1080/03602530902722679
(15) Thürmann PA. Pharmacodynamics and pharmacokinetics in older adults. Curr Opin Anaesthesiol [Internet]. 2020;33(1):109–13. https://doi.org/10.1097/aco.0000000000000814
(16) Mangoni AA, Jackson SHD. Age-related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications. Br J Clin Pharmacol [Internet]. 2004;57(1):6–14. https://doi.org/10.1046/j.1365-2125.2003.02007.x
(17) Guillot J, Maumus-Robert S, Bezin J. Polypharmacy: A general review of definitions, descriptions and determinants. Therapie [Internet]. 2020;75(5):407–16. https://doi.org/10.1016/j.therap.2019.10.001
(18) Xue L, Boudreau RM, Donohue JM, Zgibor JC, Marcum ZA, Costacou T, et al. Persistent polypharmacy and fall injury risk: the Health, Aging and Body Composition Study. BMC Geriatr [Internet]. 2021;21(1). https://doi.org/10.1186/s12877-021-02695-9
(19) Li Y, Zhang X, Yang L, Yang Y, Qiao G, Lu C, et al. Association between polypharmacy and mortality in the older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr [Internet]. 2022;100. https://doi.org/10.1016/j.archger.2022.104630
(20) Plasencia-Castillo CI, Salvatierra-Hoyos BK, Velázquez-Guillén JM, Runzer-Colmenares FM, Parodi-García JF. Polifarmacia y mortalidad en adultos mayores: El rol del sexo y la comorbilidad. Rev haban cienc méd [Internet]. 2022;21(1):e4147. Disponible en: https://revhabanera.sld.cu/index.php/rhab/article/view/4147/3036
(21) Ye L, Yang-Huang J, Franse CB, Rukavina T, Vasiljev V, Mattace-Raso F, et al. Factors associated with polypharmacy and the high risk of medication-related problems among older community-dwelling adults in European countries: a longitudinal study. BMC Geriatr [Internet]. 2022;22(1). https://doi.org/10.1186/s12877-022-03536-z
(22) Basnet S, Paudel KR, Sah AK, Jha RK, Sah P, Adhikari S, et al. Prescribing pattern, polypharmacy and potentially inappropriate prescribing in hospitalized elderly patients: a retrospective study in a teaching hospital in Nepal. Int J Sci Rep [Internet]. 2016;2(1):7-12. https://doi.org/10.18203/issn.2454-2156.intjscirep20160087
(23) de Godoi Rezende-Costa Molino C, Chocano-Bedoya PO, Sadlon A, Theiler R, Orav JE, Vellas B, et al. Prevalence of polypharmacy in community-dwelling older adults from seven centres in five European countries: a cross-sectional study of DO-HEALTH. BMJ Open [Internet]. 2022;12(4):e051881. https://doi.org/10.1136/bmjopen-2021-051881
(24) Vandebroek I, Thomas E, Sanca S, Van-Damme P, Van-Puyvelde L, De-Kimpe N. Comparison of health conditions treated with traditional and biomedical health care in a Quechua community in rural Bolivia. J Ethnobiol Ethnomed [Internet]. 2008;4(1). https://doi.org/10.1186/1746-4269-4-1
(25) Bilo G, Caravita S, Torlasco C, Parati G. Blood pressure at high altitude: physiology and clinical implications. Kardiol Pol [Internet]. 2019;77(6):596-603. Available from: https://pubmed.ncbi.nlm.nih.gov/31099758/
(26) Brakema EA, Tabyshova A, Kasteleyn MJ, Molendijk E, van der Kleij RMJJ, van Boven JFM, et al. High COPD prevalence at high altitude: does household air pollution play a role? ERJ Open Res [Internet]. 2019;53(2):1801193. https://doi.org/10.1183/13993003.01193-2018
(27) Gupta A, Belwal R, Ramakrishnan L, Khenduja P, Kapil U. Association of tobacco and alcohol consumption with cardiovascular risk factors among elderly population in India. J Family Med Prim Care [Internet]. 2020;9(10):5242-48. https://doi.org/10.4103/jfmpc.jfmpc_628_20
(28) Roca-García IC, Ramos-Guevara K, Martínez-Ginarte GJ, Pérez-Marín D, González-Rodríguez MdR. Caracterización de la polifarmacia en adultos mayores de un consultorio médico urbano. Multimed [Internet]. 2021;25(2):e2052. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1028-48182021000200006&lng=es
(29) Wastesson JW, Morin L, Tan ECK, Johnell K. An update on the clinical consequences of polypharmacy in older adults: a narrative review. Expert Opin Drug Saf [Internet]. 2018;17(12):1185–96. https://doi.org/10.1080/14740338.2018.1546841
(30) Rojas-Gómez R, Rojas-Gómez E. Polifarmacia y adherencia terapéutica en el adulto mayor con Diabetes Mellitus. Rev méd (Col. Méd. Cir. Guatem. En línea) [Internet]. 2018;157(2):77–80. https://doi.org/10.36109/rmg.v157i2.101
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