Polypharmacy in very elderly hospitalised patients: a single centre study
To quantify the extent of polypharmacy and potentially inappropriate medications (PIMS) in very elderly hospitalised patients.
A retrospective audit of prescribed medications among hospitalised medical patients (?80 years). The number of regular medications was categorised as: non-polypharmacy (0-4 drugs), polypharmacy (5-9 drugs) and hyper-polypharmacy (? 10 drugs).
318 patient records were reviewed with a mean age of 86.3 years, Polypharmacy was identified in 50.6% of patients and hyper-polypharmacy in 31.2%, while only 18.2% of patients had non-polypharmacy. 62.3% of patients received at least one psychotropic agent, most commonly anti-depressants (26.1%) followed by sedatives (19.5%). Antidepressant use correlated significantly with a history of falls, P=0.005. Other commonly prescribed medications were proton-pump inhibitors (53.5%), diuretics (48.1%), statins (45.6%), beta-blockers (34.3%) and anti-coagulation agents (21.7%).
Our study showed that over 80% of hospitalised very elderly patients were exposed to polypharmacy, and many patients were prescribed PIMS.