Prevalence and predictors of polypharmacy among Korean elderly

Polypharmacy is widespread in the elderly because of their multiple chronic health problems. The objective of this study was to investigate the prevalence and predictors associated with polypharmacy in a nationally representative sample of Korean elderly individuals. We used the Korea Health Insuran...

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Bibliographic Details
Published in:PloS one 2014-06, Vol.9 (6), p.e98043-e98043
Main Authors: Kim, Hong-Ah, Shin, Ju-Young, Kim, Mi-Hee, Park, Byung-Joo
Format: Article
Language:English
Subjects:
Age
Age Factors
Aged
Aged, 80 and over
Aging
Ambulatory care
Chronic illnesses
Confidence intervals
Drug Prescriptions - statistics & numerical data
Female
Gender
Geographic information systems
Geriatrics
Health care policy
Health insurance
Health problems
Humans
Insurance
Male
Medicine and Health Sciences
National health insurance
Nursing homes
Older people
Patients
Pharmaceutical Preparations
Polypharmacy
Population
Prescription drugs
Prevalence
Prevalence studies (Epidemiology)
Preventive medicine
Product safety
Public health
Remote sensing
Republic of Korea
Risk analysis
Risk factors
Statistical analysis
Studies
Substance abuse treatment
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Summary:Polypharmacy is widespread in the elderly because of their multiple chronic health problems. The objective of this study was to investigate the prevalence and predictors associated with polypharmacy in a nationally representative sample of Korean elderly individuals. We used the Korea Health Insurance Review and Assessment Service - National Patient Sample (HIRA-NPS) data from 2010 and 2011. We used information on 319,185 elderly patients (aged 65 years or older) between January 1, 2010 and December 31, 2011 from the HIRA-NPS database. We defined 'polypharmacy' as the concurrent use of 6 medications or more per person, 'major polypharmacy' as 11 medications or more, and 'excessive polypharmacy' as 21 medications or more. The frequency and proportion (%) and their 95% confidence intervals were presented according to the polypharmacy definition. Polypharmacy was visualized by the Quantum Geographic Information Systems (QGIS) program to describe regional differences in patterns of drug use. Multivariate ordinal logistic regression was performed to estimate odds ratios (ORs) and their 95% confidence intervals (CI) to investigate the risk factors for polypharmacy. Of the Korean elderly studied, 86.4% had polypharmacy, 44.9% had major polypharmacy and 3.0% had excessive polypharmacy. Polypharmacy was found to be primarily concentrated in the Southwest region of the country. Significant associations between polypharmacy and the lower-income Medical Aid population (OR = 1.52, 95% CI 1.47, 1.56) compared with National Health Insurance patients was observed. Nationwide efforts are needed for managing polypharmacy among Korean elderly patients. In particular, a national campaign and education to promote appropriate use of medicines for the Medical Aid population is needed.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0098043