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25 Jul 2019

The prevalence of polypharmacy among older Australians is relatively high and increasing as the population ages, with almost one million people using at least five prescribed medicines, according to the authors of research published by the Medical Journal of Australia.

Using several medicines concurrently — polypharmacy — places older people at risk of harm, including from adverse drug reactions, and is associated with poor clinical outcomes, including nutritional deficiencies, falls, frailty, impaired cognition, more frequent hospitalisation, and premature mortality, wrote the authors.

Led by Dr Amy Page, the NHMRC Early Career Fellow at the Centre for Optimisation of Medicines at the University of Western Australia and the lead pharmacist rehabilitation aged and community care at the Pharmacy Department at Alfred Health in Melbourne, the researchers analysed a random 10 per cent sample of Pharmaceutical Benefits Scheme (PBS) data for people aged 70 years of age or more, who were dispensed PBS-listed medicines between January 1, 2006 and December 31, 2017.

In 2017, 36.1 per cent of older Australians were experiencing polypharmacy, or an estimated 935,240 people, the researchers found. Rates of polypharmacy were higher among women than men (36.6 per cent v 35.4 per cent) and were highest among those aged 80–84 years (43.9 per cent) or 85–89 years (46.0 per cent).

The prevalence of polypharmacy among older people increased by 9 per cent from 2006 to 2017 (from 33.2 per cent to 36.2 per cent). However, the total number of people experiencing polypharmacy increased by 52 per cent (from 543,950 to 828,950).

In their conclusion, Dr Page and colleagues wrote: “Polypharmacy can be appropriate, but this needs to be balanced against the risk that it may contribute to adverse health outcomes in older people.

“We need strategies to reduce medicine use and complexity that target both health professionals and the public. These strategies need to be effective and sustainable. They should include both multidisciplinary approaches and system-level interventions.”


Published: 25 Jul 2019