What is polypharmacy? A systematic review of definitions

BMC Geriatrics

Research Article

Sepehr Shakib¹  Lisa Kalisch-Ellett²  Gillian E. Caughey³  Nashwa Masnoon⁴ 

[1] Department of Clinical Pharmacology, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia, Australia;Discipline of Pharmacology, School of Medicine, University of Adelaide, North Terrace, Adelaide, South Australia, Australia;Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, University of South Australia, Frome Road, Adelaide, South Australia, Australia;Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, University of South Australia, Frome Road, Adelaide, South Australia, Australia;Department of Clinical Pharmacology, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia, Australia;Discipline of Pharmacology, School of Medicine, University of Adelaide, North Terrace, Adelaide, South Australia, Australia;Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, University of South Australia, Frome Road, Adelaide, South Australia, Australia;Department of Pharmacy, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia, Australia;

关键词: Polypharmacy;    Multimorbidity;    Comorbidity;    Inappropriate prescribing;    Aged;    Systematic review;   

DOI  :  10.1186/s12877-017-0621-2

 received in 2017-05-15, accepted in 2017-10-02,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundMultimorbidity and the associated use of multiple medicines (polypharmacy), is common in the older population. Despite this, there is no consensus definition for polypharmacy. A systematic review was conducted to identify and summarise polypharmacy definitions in existing literature.MethodsThe reporting of this systematic review conforms to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) checklist. MEDLINE (Ovid), EMBASE and Cochrane were systematically searched, as well as grey literature, to identify articles which defined the term polypharmacy (without any limits on the types of definitions) and were in English, published between 1st January 2000 and 30th May 2016. Definitions were categorised as i. numerical only (using the number of medications to define polypharmacy), ii. numerical with an associated duration of therapy or healthcare setting (such as during hospital stay) or iii. Descriptive (using a brief description to define polypharmacy).ResultsA total of 1156 articles were identified and 110 articles met the inclusion criteria. Articles not only defined polypharmacy but associated terms such as minor and major polypharmacy. As a result, a total of 138 definitions of polypharmacy and associated terms were obtained. There were 111 numerical only definitions (80.4% of all definitions), 15 numerical definitions which incorporated a duration of therapy or healthcare setting (10.9%) and 12 descriptive definitions (8.7%). The most commonly reported definition of polypharmacy was the numerical definition of five or more medications daily (n = 51, 46.4% of articles), with definitions ranging from two or more to 11 or more medicines. Only 6.4% of articles classified the distinction between appropriate and inappropriate polypharmacy, using descriptive definitions to make this distinction.ConclusionsPolypharmacy definitions were variable. Numerical definitions of polypharmacy did not account for specific comorbidities present and make it difficult to assess safety and appropriateness of therapy in the clinical setting.

【 授权许可】

CC BY   
© The Author(s). 2017