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Determinants of change in polypharmacy status in Switzerland: the population-based CoLaus study

  • Pharmacoepidemiology and Prescription
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Abstract

Objectives

This study aimed to assess the prevalence, the change, and the determinants of change in polypharmacy in a population-based sample.

Methods

Baseline (2003–2006) and follow-up (2009–2012) data are from 4679 participants aged between 35 and 75 years (53.5% women, mean age 52.6 ± 10.6 years) from the population of Lausanne, Switzerland. Polypharmacy was defined by the regular use of ≥5 drugs. Four categories of change were defined: never (no polypharmacy at baseline and follow-up), initiating (no polypharmacy at baseline but at follow-up), maintaining, or quitting.

Results

Polypharmacy increased from 7.7% at baseline to 15.3% at follow-up. Cardiovascular drugs were the most prescribed medicines at baseline and follow-up. Gender, age, obesity, smoking, previously diagnosed hypertension, or diabetes or dyslipidemia were significantly and independently associated with initiating and maintaining polypharmacy.

Conclusion

In a population-based sample, prevalence of polypharmacy doubled over a 5.6-year period. The main determinants of initiating polypharmacy were age, overweight and obesity, smoking status, and previously diagnosed cardiovascular risk factors.

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References

  1. Moriarty F, Hardy C, Bennett K, Smith SM, Fahey T (2015) Trends and interaction of polypharmacy and potentially inappropriate prescribing in primary care over 15 years in Ireland: a repeated cross-sectional study. BMJ Open 5(9):e008656

    Article  PubMed  PubMed Central  Google Scholar 

  2. Gnjidic D, Hilmer SN, Blyth FM, Naganathan V, Waite L, Seibel MJ, McLachlan AJ, Cumming RG, Handelsman DJ, Le Couteur DG (2012) Polypharmacy cutoff and outcomes: five or more medicines were used to identify community-dwelling older men at risk of different adverse outcomes. J Clin Epidemiol 65(9):989–995

    Article  PubMed  Google Scholar 

  3. Arnoldo L, Cattani G, Cojutti P, Pea F, Brusaferro S (2016) Monitoring polypharmacy in healthcare systems through a multi-setting survey: should we put more attention on long term care facilities? J Public Health Res 5(3)

  4. Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B (2012) Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet 380(9836):37–43

    Article  PubMed  Google Scholar 

  5. Hughes CM, Cooper JA, Ryan C (2014) Going beyond the numbers—a call to redefine polypharmacy. Br J Clin Pharmacol 77(6):915–916

    Article  PubMed  PubMed Central  Google Scholar 

  6. Payne RA, Abel GA, Avery AJ, Mercer SW, Roland MO (2014) Is polypharmacy always hazardous? A retrospective cohort analysis using linked electronic health records from primary and secondary care. Br J Clin Pharmacol 77(6):1073–1082

    Article  PubMed  PubMed Central  Google Scholar 

  7. Lindblad CI, Hanlon JT, Gross CR, Sloane RJ, Pieper CF, Hajjar ER, Ruby CM, Schmader KE, Panel MC (2006) Clinically important drug-disease interactions and their prevalence in older adults. Clin Ther 28(8):1133–1143

    Article  CAS  PubMed  Google Scholar 

  8. Firmann M, Mayor V, Vidal PM, Bochud M, Pecoud A, Hayoz D, Paccaud F, Preisig M, Song KS, Yuan X, Danoff TM, Stirnadel HA, Waterworth D, Mooser V, Waeber G, Vollenweider P (2008) The CoLaus study: a population-based study to investigate the epidemiology and genetic determinants of cardiovascular risk factors and metabolic syndrome. BMC Cardiovasc Disord 8:6. doi:10.1186/1471-2261-8-6

    Article  PubMed  PubMed Central  Google Scholar 

  9. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M, Christiaens T, Cifkova R, De Backer G, Dominiczak A, Galderisi M, Grobbee DE, Jaarsma T, Kirchhof P, Kjeldsen SE, Laurent S, Manolis AJ, Nilsson PM, Ruilope LM, Schmieder RE, Sirnes PA, Sleight P, Viigimaa M, Waeber B, Zannad F, Redon J, Dominiczak A, Narkiewicz K, Nilsson PM, Burnier M, Viigimaa M, Ambrosioni E, Caufield M, Coca A, Olsen MH, Schmieder RE, Tsioufis C, van de Borne P, Zamorano JL, Achenbach S, Baumgartner H, Bax JJ, Bueno H, Dean V, Deaton C, Erol C, Fagard R, Ferrari R, Hasdai D, Hoes AW, Kirchhof P, Knuuti J, Kolh P, Lancellotti P, Linhart A, Nihoyannopoulos P, Piepoli MF, Ponikowski P, Sirnes PA, Tamargo JL, Tendera M, Torbicki A, Wijns W, Windecker S, Clement DL, Coca A, Gillebert TC, Tendera M, Rosei EA, Ambrosioni E, Anker SD, Bauersachs J, Hitij JB, Caulfield M, De Buyzere M, De Geest S, Derumeaux GA, Erdine S, Farsang C, Funck-Brentano C, Gerc V, Germano G, Gielen S, Haller H, Hoes AW, Jordan J, Kahan T, Komajda M, Lovic D, Mahrholdt H, Olsen MH, Ostergren J, Parati G, Perk J, Polonia J, Popescu BA, Reiner Z, Ryden L, Sirenko Y, Stanton A, Struijker-Boudier H, Tsioufis C, van de Borne P, Vlachopoulos C, Volpe M, Wood DA (2013) 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 34(28):2159–2219. doi:10.1093/eurheartj/eht151

    Article  PubMed  Google Scholar 

  10. Moser M, Gencer B, Rodondi N (2014) Recommendations for management of dyslipidemia in 2014. Rev Med Suisse 10 (420):518, 520-514

  11. Association AD (2014) Diagnosis and classification of diabetes mellitus. Diabetes care 37 (Supplement 1):S81-S90

  12. Viktil KK, Blix HS, Moger TA, Reikvam A (2007) Polypharmacy as commonly defined is an indicator of limited value in the assessment of drug-related problems. Br J Clin Pharmacol 63(2):187–195. doi:10.1111/j.1365-2125.2006.02744.x

    Article  PubMed  Google Scholar 

  13. Payne RA, Avery AJ, Duerden M, Saunders CL, Simpson CR, Abel GA (2014) Prevalence of polypharmacy in a Scottish primary care population. Eur J Clin Pharmacol 70(5):575–581. doi:10.1007/s00228-013-1639-9

    Article  CAS  PubMed  Google Scholar 

  14. Volpe M, Chin D, Paneni F (2010) The challenge of polypharmacy in cardiovascular medicine. Fundam Clin Pharmacol 24(1):9–17. doi:10.1111/j.1472-8206.2009.00757.x

    Article  CAS  PubMed  Google Scholar 

  15. Antiochos P, Marques-Vidal P, Waeber G, Vollenweider P (2015) Five year trends in dyslipidaemia prevalence and management in Switzerland: the CoLaus study. Nut Metab Cardiovasc Dis: NMCD 25(11):1007–1015. doi:10.1016/j.numecd.2015.07.011

    Article  CAS  Google Scholar 

  16. Goldacre B, Smeeth L (2014) Mass treatment with statins. BMJ (Clinical research ed) 349:g4745

    Google Scholar 

  17. Stewart J, Manmathan G, Wilkinson P (2017) Primary prevention of cardiovascular disease: a review of contemporary guidance and literature. JRSM Cardiovasc Dis 6:2048004016687211. doi:10.1177/2048004016687211

    PubMed  PubMed Central  Google Scholar 

  18. Kantor ED, Rehm CD, Haas JS, Chan AT, Giovannucci EL (2015) Trends in prescription drug use among adults in the United States from 1999-2012. JAMA 314(17):1818–1831. doi:10.1001/jama.2015.13766

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Vaidya V, Partha G, Karmakar M (2012) Gender differences in utilization of preventive care services in the United States. J Women's Health (Larchmt) 21(2):140–145. doi:10.1089/jwh.2011.2876

    Article  Google Scholar 

  20. Jokanovic N, Tan EC, Dooley MJ, Kirkpatrick CM, Bell JS (2015) Prevalence and factors associated with polypharmacy in long-term care facilities: a systematic review. J Am Med Dir Assoc 16 (6):535. e531-535. e512

  21. Degli Esposti E, Sturani A, Valpiani G, Di Martino M, Ziccardi F, Rita Cassani A, Baraccani C, Gentile M, Puglia MG, Degli Esposti L (2006) The relationship between body weight and drug costs: an Italian population-based study. Clin Ther 28(9):1472–1481. doi:10.1016/j.clinthera.2006.09.016

    Article  PubMed  Google Scholar 

  22. Pappa E, Kontodimopoulos N, Papadopoulos AA, Tountas Y, Niakas D (2011) Prescribed-drug utilization and polypharmacy in a general population in Greece: association with sociodemographic, health needs, health-services utilization, and lifestyle factors. Eur J Clin Pharmacol 67(2):185–192. doi:10.1007/s00228-010-0940-0

    Article  CAS  PubMed  Google Scholar 

  23. Davin C, Vollenweider P, Waeber G, Paccaud F, Marques-Vidal P (2012) Cardiovascular risk factors attributable to obesity and overweight in Switzerland. Nutr Metab Cardiovasc Dis 22(11):952–958. doi:10.1016/j.numecd.2011.01.004

    Article  CAS  PubMed  Google Scholar 

  24. Calderon-Larranaga A, Gimeno-Feliu LA, Gonzalez-Rubio F, Poblador-Plou B, Lairla-San Jose M, Abad-Diez JM, Poncel-Falco A, Prados-Torres A (2013) Polypharmacy patterns: unravelling systematic associations between prescribed medications. PLoS One 8(12):e84967. doi:10.1371/journal.pone.0084967

    Article  PubMed  PubMed Central  Google Scholar 

  25. Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, Cooney MT, Corra U, Cosyns B, Deaton C, Graham I, Hall MS, Hobbs FD, Lochen ML, Lollgen H, Marques-Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders Y, Tiberi M, van der Worp HB, van Dis I, Verschuren WM (2016) 2016 European guidelines on cardiovascular disease prevention in clinical practice: the Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 37(29):2315–2381. doi:10.1093/eurheartj/ehw106

    Article  PubMed  PubMed Central  Google Scholar 

  26. Veehof L, Stewart R, Haaijer-Ruskamp F, Jong BM (2000) The development of polypharmacy. A longitudinal study. Fam Pract 17(3):261–267

    Article  CAS  PubMed  Google Scholar 

  27. Husson N, Watfa G, Laurain MC, Perret-Guillaume C, Niemier JY, Miget P, Benetos A (2014) Characteristics of polymedicated (>/= 4) elderly: a survey in a community-dwelling population aged 60 years and over. J Nutr Health Aging 18(1):87–91. doi:10.1007/s12603-013-0337-8

    Article  CAS  PubMed  Google Scholar 

  28. Galea S, Tracy M (2007) Participation rates in epidemiologic studies. Ann Epidemiol 17(9):643–653. doi:10.1016/j.annepidem.2007.03.013

    Article  PubMed  Google Scholar 

  29. Drieling RL, LaCroix AZ, Beresford SA, Boudreau DM, Kooperberg C, Heckbert SR (2016) Validity of self-reported medication use compared with pharmacy records in a cohort of older women: findings from the Women's Health Initiative. Am J Epidemiol 184(3):233–238. doi:10.1093/aje/kwv446

    Article  PubMed  PubMed Central  Google Scholar 

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Author notes

  1. Nazanin Abolhassani and Julien Castioni contributed equally

Authors and Affiliations

  1. Department of Medicine, Internal Medicine, Lausanne University Hospital, Office BH10-642, Rue du Bugnon 46, 1011, Lausanne, Switzerland

    Nazanin Abolhassani, Julien Castioni, Pedro Marques-Vidal, Peter Vollenweider & Gérard Waeber

Authors
  1. Nazanin Abolhassani
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  2. Julien Castioni
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  3. Pedro Marques-Vidal
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  4. Peter Vollenweider
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  5. Gérard Waeber
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Contributions

NA wrote most of the manuscript. PMV collected data, made the statistical analysis, and reviewed the manuscript for important intellectual content. JC designed the study and reviewed the manuscript for important intellectual content. PV and GW revised the manuscript for important intellectual content. PMV had full access to the data and is the guarantor of the study. All authors have read and approved the final version of the manuscript.

Corresponding author

Correspondence to Pedro Marques-Vidal.

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Conflict of interest

The authors declare that they have no conflict of interest.

Funding

The CoLaus study was and is supported by research grants from GlaxoSmithKline, the Faculty of Biology and Medicine of Lausanne, and the Swiss National Science Foundation (grants 33CSCO-122661, 33CS30-139468, and 33CS30-148401). Nazanin Abolhassani is supported by an excellence scholarship from the Swiss Federal Government (Reference No. 2016.1098). The funding sources had no contribution to the study design, analysis, and interpretation, as well as writing the report and decision to submit the article for publication.

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Abolhassani, N., Castioni, J., Marques-Vidal, P. et al. Determinants of change in polypharmacy status in Switzerland: the population-based CoLaus study. Eur J Clin Pharmacol 73, 1187–1194 (2017). https://doi.org/10.1007/s00228-017-2288-1

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  • DOI: https://doi.org/10.1007/s00228-017-2288-1

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