Prevalence of polypharmacy in patients of the emergency hospital in East Kazakhstan

Aigul Z. Mussina, L Zhamalieyva, Gaziza Smagulova, A M Grjibovski

2015

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DOI 10.1093/eurpub/ckv171.007
Data confidence 70 medium
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Abstract

Background Polypharmacy i.e. administration of more medications than are clinically indicated is common among the elderly in many countries and is associated with negative health outcomes. European studies have reported the prevalence of polypharmacy ranging from 30.4% and 84.5%, but the evidence from Central Asian countries of the European WHO region is almost non-existent. The aim of this pilot study is to assess the prevalence of polypharmacy in a typical emergency hospital in a Kazakhstani urban setting. Methods A cross-sectional hospital-based study. Data were obtained from medical records of 358 randomly selected patients aged 16 years or more hospitalized to the emergency hospital in Aktobe (regional center of West Kazakhstan, population 385 thousand). Polypharmacy was defined as administration of more than 5 medicines. Potentially inappropriate medicines (PIM) were identified using the Beers criteria. The prevalence of polypharmacy is presented with 95% confidence intervals (CI) by gender and age and compared using Pearson’s chi-squared tests. Results The age ranged from 16 to 93 years. The number of prescribed medicines varied from 1 to 21 with the mean of 8.1 (95% CI: 7.8-8.5). The prevalence of polypharmacy was 78.4% (95% CI: 72.0-84.6) among women and 79.9% (95% CI: 73.1-85.3) among men (p = 0.723). Polypharmacy was observed in 76.3% of patients below 65 years of age (95% CI: 71.1-80.8) vs. 92.1% (95% CI: 82.7-96.6) among those who were 65 years and older (p = 0.005). By department, the prevalence of polypharmacy ranged from 34.3% in thoracic surgery department to 100% in cardiology department and intensive care unit. The most common PIM administered to elderly patients were ketorolac (29.8%), clopidogrel (17.5%) and diphenhydramine (10.5%). Conclusions We observed alarmingly high prevalence of polypharmacy particularly among elderly patients in the emergency hospital in Aktobe, Kazakhstan. The reasons behind our findings will be discussed. A larger study involving several hospitals from different parts of the country is needed to assess the nation-wide prevalence of polypharmacy and its correlates in Kazakhstan. Key message We observed alarmingly high prevalence of polypharmacy particularly among elderly patients in the emergency hospital in Aktobe, Kazakhstan