The prevalence and determinants of Polypharmacy in middle-aged population of two Russian cities.

Abstract

Introduction: Polypharmacy has been a global threat these days and raised a question about its determinants. Differences in socioeconomic conditions, comorbid conditions, healthcare services use of individuals were expected to be related to Polypharmacy. Populations with cardiovascular diseases are more likely to be on multiple medications. However, no studies investigated the effects of socioeconomic differences and differences in healthcare use and multi-morbidity in the Russian middle-aged population. So, this study aims to determine the prevalence and determinants of Polypharmacy in two Russian cities. Materials and methods: Data were collected in a cross-sectional Know You Heart study conducted in two big Russian cities from November 2015 to December 2017 (4051 participants). The descriptive statistics for the socioeconomic factors, health care use, and multi-morbidity were presented using percentages, mean and standard deviations. Chi-square test was done to test the difference in proportions. Logistic regression models were used to study the association between study variables and Polypharmacy, and. Odds Ratios (OR) with 95% confidence interval CI) were presented as the measures of association. Results: Out of 4051 participants, 374 were on Polypharmacy. Participants on Polypharmacy were significantly older, were either overweight or obese (86%), with multimorbidity (80%), and used more health care services. 47% of them were above 65 years, 39% were at 55-64 years, 10% were at 45-54 years and only 4% were at 35-44 years. These findings were confirmed by multivariable analysis. Relative to age group 35-44 years the OR and CI for age groups; 55-64 years and 65 years were 4.05(2.32-7.09) and 8.77(5.009-15.388) respectively; for obese relative to normal weight was 2.99(2.15-4.15); for multimorbid participants relative to one or less disease was 4.83(3.68-6.33) where p-trend was <0.001. Similarly, with OR and CI 6.30(4.49-8.85) and 7.72(1.62-36.67) for 5+ times of GP visits and hospitalization respectively relative to no GP visits or hospitalizations, was found that as increased numbers of times of GP visits and hospitalization increased odds of being on PP also increased. Conclusion: One out of ten of our sample was on Polypharmacy. Increasing age, body mass index, comorbidities and uses of health care services increases the likelihood of being on Polypharmacy.