Global and regional prevalence of polypharmacy and related factors, 1997-2022: An umbrella review

Sunyoung Kim; Hyeri Lee; Jaeyu Park; Jiseung Kang; Masoud Rahmati; Sang Youl Rhee; Dong Keon Yon

doi:10.1016/j.archger.2024.105465

Global and regional prevalence of polypharmacy and related factors, 1997-2022: An umbrella review

Arch Gerontol Geriatr. 2024 Apr 27:124:105465. doi: 10.1016/j.archger.2024.105465. Online ahead of print.

Authors

Sunyoung Kim¹, Hyeri Lee², Jaeyu Park², Jiseung Kang³, Masoud Rahmati⁴, Sang Youl Rhee⁵, Dong Keon Yon⁶

Affiliations

¹ Department of Family Medicine, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, South Korea. Electronic address: ggutsun@naver.com.
² Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Regulatory Science, Kyung Hee University, Seoul, South Korea.
³ Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, United States.
⁴ Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France; Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran; Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran.
⁵ Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, South Korea.
⁶ Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Regulatory Science, Kyung Hee University, Seoul, South Korea; Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, South Korea. Electronic address: yonkkang@gmail.com.

PMID: 38733922
DOI: 10.1016/j.archger.2024.105465

Abstract

Objective: Limited comprehensive evidence exists on the global prevalence of polypharmacy. This knowledge gap contributes to increased healthcare system costs and related public health concerns. Thus, we aimed to synthesize the current evidence on polypharmacy prevalence and associated factors in the general and older populations using an umbrella review.

Methods: Our primary outcomes were global prevalence and related indicators of polypharmacy. We systematically searched Google Scholar, PubMed/MEDLINE, Embase, and CINAHL for studies published between the inception of each database until April 30, 2023.

Results: Eleven meta-analyses incorporating 295 studies and 59,552,762 participants from 41 countries across six continents were identified. The global prevalence of polypharmacy in the general population is 37 %, with higher rates in older individuals (45 %), outpatients (48 %), and inpatients (52 %). North America showed a higher prevalence (52 %) than Asia (36 %) and Europe (36 %). Among frail elderly individuals, the prevalence of polypharmacy is 59 %, with the highest rates in Europe (68 %) and hospital settings (71 %).

Conclusion: The global prevalence of polypharmacy and its associated factors in older adults present a complex, multifaceted, and conflicting picture. Understanding the prevalence of polypharmacy and its associated factors may help reduce the number of multidrug prescriptions.

Keywords: Polypharmacy; Prevalence; Umbrella review.