Behavior of polypharmacy in older adults
Keywords:
ANCIANO; ENFERMEDAD CRÓNICA; POLIFARMACIA; SALUD DEL ANCIANO., AGED; CHRONIC DISEASE; POLYPHARMACY; HEALTH OF THE ELDERLY., IDOSO; DOENÇA CRÔNICA; POLIMEDICAÇÃO; SAÚDE DO IDOSO.Abstract
Introduction: polypharmacy, defined as the concurrent use of five or more medications, represents a growing challenge in the clinical management of older adults, particularly in primary care settings.
Objective: to describe the behavior of polypharmacy in older adults and its associated variables.
Methods: an observational, descriptive, cross-sectional study was conducted in a sample of 215 patients aged over 60 years from the “Dr. Modesto Gómez Rubio” Polyclinic in San Juan y Martínez during 2023. Document review and the application of instruments allowed the collection of information for the analyzed variables.
Results: adults aged ≥80 years (39,6 %) and females (56,6 %) predominated in the sample, both showing significant associations with polypharmacy (p<0,030). Although 58,0 % lived with others, those living alone presented a higher frequency of polypharmacy (50,6 %). Hypertension (66,0 %) and osteoarthritis (37,7 %) were the most common chronic diseases, while antihypertensives (66,0 %), analgesics (48,1 %), and anxiolytics (32,1 %) were the most frequently used drugs. Individuals with low medication-related knowledge predominated (42,0 %), showing a significant association with polypharmacy (p=0,044).
Conclusions: polypharmacy in older adults is associated with advanced age, female sex, chronic diseases, and low pharmacological knowledge, underscoring the need for educational strategies to promote safer medication use.
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1. Sánchez-Rodríguez JR, Escare-Oviedo CA, Castro-Olivares VE, Robles-Molina CR, Vergara-Martínez MI, Jara-Castillo CI. Polifarmacia en adulto mayor, impacto en su calidad de vida. Revisión de literatura. Revista de Salud Pública [Internet]. 2019 [Citado 04/11/2025]; 21(2): 271-277. Disponible en: https://www.scielosp.org/article/rsap/2019.v21n2/271-277/
2. World Health Organization. Medication safety in polypharmacy: technical report [Internet]. OMS; 2019 [Citado 04/11/2025]. Disponible en: https://www.who.int/publications/i/item/WHO-UHC-SDS-2019.11
3. Ramírez PAR, Ramírez PJF. Prevalencia de polifarmacia y problemas de medicación en ancianos de comunidades en Cienfuegos. Rev Cubana Farm [Internet]. 2021 [Citado 04/11/2025]; 54(1): e513. Disponible en: https://www.medigraphic.com/pdfs/revcubfar/rcf-2021/rcf211e.pdf
4. Maher RL, Hanlon J, Hajjar ER. Clinical consequences of polypharmacy in elderly. Expert Opin Drug Saf [Internet]. 2014 Jan [Citado 04/11/2025]; 13(1): 57-65. Disponible en: https://doi.org/10.1517/14740338.2013.827660
5. Sánchez-Pérez H, Ramírez-Rosillo FJ, Carrillo-Esper R. Polifarmacia en el adulto mayor. Consideraciones en el perioperatorio. Rev. mex. anestesiol. [Internet]. 2022 [citado 03/11/2025]; 45(1): 40-47. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0484-79032022000100040&lng=es
6. Archila Puac JL, Mota Chavarría AC, González Dardón WR. Consecuencias neurocognitivas y neuropsicológicas de la polifarmacia en el adulto mayor. Revista Académica CUNZAC [Internet]. 2024 [citado 03/11/2025]; 7(1): 24–36. Disponible en: https://doi.org/10.46780/cunzac.v7i1.114
7. Didone TVN, García-Delgado P, Melo DO, Romano-Lieber NS, Martínez FM, Ribeiro E. Validação do questionário “Conocimiento del Paciente sobre sus Medicamentos” (CPM-ES-ES). Cien Saude Colet [Internet]. 2019 Sep 9 [citado 03/11/2025]; 24(9): 3539-3550. Disponible en: https://doi.org/10.1590/1413-81232018249.26112017
8. Matovelle P, Oliván-Blázquez B, Fraile-Peñaranda I, Turón-Lanuza A, Gallego-Royo A, Casado-Vicente V, et al. Polypharmacy in Older Patients: A Three-Year Longitudinal Analysis in Primary Care Settings of Aragón, Spain. Ann Geriatr Med Res [Internet]. 2024 Mar [citado 03/11/2025]; 28(1):36-45. Disponible en: https://doi.org/10.4235/agmr.23.0137
9. Kim S, Lee H, Park J, Kang J, Rahmati M, Rhee SY, et al. Global and regional prevalence of polypharmacy and related factors, 1997-2022: An umbrella review. Arch Gerontol Geriatr [Internet]. 2024 Sep [citado 03/11/2025]; 124: 105465. Disponible en: https://doi.org/10.1016/j.archger.2024.105465
10. Thompson W, McDonald EG. Polypharmacy and deprescribing in older adults. Annu. Rev. Med [Internet]. 2024 [citado 2025 Nov 003/11/20253]; 75(1): 113-127. Disponible en: https://doi.org/10.1146/annurev-med-070822-101947
11. Cebrino J, Portero de la Cruz S. Polypharmacy and associated factors: a gender perspective in the elderly Spanish population (2011-2020). Front Pharmacol [Internet]. 2023 Apr 21 [citado 03/11/2025]; 14: 1189644. Disponible en: https://doi.org/10.3389/fphar.2023.1189644
12. Santalucia P, Franchi C, Djade CD, Tettamanti M, Pasina L, Corrao S, et al. Gender difference in drug use in hospitalized elderly patients. Eur J Intern Med [Internet]. 2015 Sep [citado 03/11/2025]; 26(7): 483-90. Disponible en: https://doi.org/10.1016/j.ejim.2015.07.006
13. Pollak C, Pham Y, Ehrlich A, Verghese J, Blumen HM. Loneliness and social isolation risk factors in community-dwelling older adults receiving home health services. BMC Geriatr [Internet]. 2025 Apr 28 [citado 03/11/2025]; 25(290). Disponible en: https://doi.org/10.1186/s12877-025-05947-0
14. Piao Z, Oh KS, Han E. Healthcare burden and clinical outcomes of polypharmacy in older adults: a population-based cohort study in South Korea. Arch Public Health [Internet]. 2025 Aug 25 [citado 03/11/2025]; 83(217). Disponible en: https://doi.org/10.1186/s13690-025-01703-3
15. Cho HJ, Chae J, Yoon SH, Kim DS. Factors related to polypharmacy and hyper-polypharmacy for the elderly: A nationwide cohort study using National Health Insurance data in South Korea. Clin Transl Sci [Internet]. 2023 Feb [citado 03/11/2025]; 16(2):193-205. Disponible en: https://doi.org/10.1111/cts.13438
16. Cho HJ, Chae J, Yoon SH, Kim DS. Aging and the Prevalence of Polypharmacy and Hyper-Polypharmacy Among Older Adults in South Korea: A National Retrospective Study During 2010-2019. Front Pharmacol [Internet]. 2022 May 9 [citado 03/11/2025]; 13: 866318. Disponible en: https://doi.org/10.3389/fphar.2022.866318
17. Pérez-Jover V, Mira JJ, Carratala-Munuera C, Gil-Guillen VF, Basora J, López-Pineda A, et al. Inappropriate Use of Medication by Elderly, Polymedicated, or Multipathological Patients with Chronic Diseases. Int J Environ Res Public Health [Internet]. 2018 Feb 10 [citado 03/11/2025]; 15(2):310. Disponible en: https://doi.org/10.3390/ijerph15020310
18. Eriksen CU, Kyriakidis S, Christensen LD, Jacobsen R, Laursen J, Christensen MB, et al. Medication-related experiences of patients with polypharmacy: a systematic review of qualitative studies. BMJ Open [Internet]. 2020 Sep 6 [citado 03/11/2025]; 10(9): e036158. Disponible en: https://doi.org/10.1136/bmjopen-2019-036158
19. Summer Meranius M, Engstrom G. Experience of self-management of medications among older people with multimorbidity. J Clin Nurs [Internet]. 2015 Oct [citado 03/11/2025]; 24(19-20): 2757-64. Disponible en: https://doi.org/10.1111/jocn.12868
20. Wang W, Luan W, Zhang Z, Mei Y. Association between medication literacy and medication adherence and the mediating effect of self-efficacy in older people with multimorbidity. BMC Geriatr [Internet]. 2023 Jun 19 [citado 03/11/2025]; 23(378). Disponible en: https://doi.org/10.1186/s12877-023-04072-0
21. İlhan N, Savci C, Yildirim S. The Association Between Medication Adherence and Rational Drug Use Knowledge and Health Literacy in Older Adults Residing in Nursing Homes. J Eval Clin Pract [Internet]. 2025 Feb [citado 03/11/2025]; 31(1): e14303. Disponible en: https://doi.org/10.1111/jep.14303
22. Gillespie R, Mullan J, Harrison L. Exploring Older Adult Health Literacy in the Day-to-Day Management of Polypharmacy and Making Decisions About Deprescribing: A Mixed Methods Study. Health Lit Res Pract [Internet]. 2023 Jan [citado 03/11/2025]; 7(1): e14-e25. Disponible en: https://doi.org/10.3928/24748307-20221216-01
23. Mortelmans L, Gentizon J, Dilles T. Medication Literacy and Medication Self-Management: A Cross-Sectional Study in Hospitalised Patients (65+) With Polypharmacy. J Nurs Manag [Internet]. 2024 Dec 31 [citado 03/11/2025]; 2024: 5430265. Disponible en: https://doi.org/10.1155/jonm/5430265
24. Stanly EAR, Vilakkathala R, George J. Medication Non-adherence in Older Adults: Underlying Factors, Potential Interventions and Outcomes. 03/11/2025]; 42(11):991-1000. Disponible en: https://doi.org/10.1007/s40266-025-01249-7
25. Doumat G, Daher D, Itani M, Abdouni L, El Asmar K, Assaf G. The effect of polypharmacy on healthcare services utilization in older adults with comorbidities: a retrospective cohort study. BMC Prim Care [Internet]. 2023 May 26 [citado 03/11/2025]; 24(120). Disponible en: https://doi.org/10.1186/s12875-023-02070-0
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