Exploring rates of pre-admission polypharmacy amongst geriatric patients at Wagga Base Hospital


Timothy Bemand, Sarah Thomas,
Paul Finucane

Objectives

Polypharmacy in the elderly is associated with adverse outcomes including cognitive decline, falls, and even death. Falls risk increasing drugs (FRIDs) include those with anti-hypertensive, psychotropic and anti-cholinergic properties. We sought to describe the extent of polypharmacy and use of medications associated with increased falls risk in the very old admitted to Wagga Wagga Base Hospital during two months in 2019.

Design

Cross-sectional study of consecutive patients aged over 80 years admitted to Wagga Wagga Base Hospital over September and October 2019.  Baseline demographic data and medication usage (including FRIDs and anticholinergic burden) on admission was collected through review of electronic medical records. Polypharmacy was defined as use of five or more medications.

Results

Information on medication use was available for 391 patients. Their mean age was 86.7 (± 4.6) years, 56.3% were female and median length of hospitalisation was 4 days. Overall 84.7% of patients experienced polypharmacy and this increased to 87.4% of those aged 90 or above. The mean number of medications on admission was 8.5 (± 4.4) overall. 91.0% of patients were taking at least one FRID with the mean number being 2.8 (± 1.8). Anti-hypertensives were the most commonly used FRID (78.5% of patients), and the anticholinergic risk scale was positive in 26.9%.

Conclusions

Polypharmacy is extremely common among elderly patients at the time of acute hospitalisation in a regional setting. This study highlights the opportunities for clinicians to engage in medication rationalisation to reduce potential medication-related harm.