Prevalence and associations of polypharmacy among Sri Lankans: A hospital-based study

Abstract

Introduction and Objectives Polypharmacy is a global health problem but the prevalence in Sri Lanka is not known. Therefore, we studied the prevalence and associations of polypharmacy in Sri Lanka. Methods We conducted a cross-sectional study of all medical clinics of Colombo North Teaching Hospital from 15 August 2020 to 15 February 2021. 50 patients of each clinic were randomly selected. Data were collected using an interviewer-administered questionnaire by interviewing patients and perusing medical recodes. Polypharmacy was defined as being on five or more medications regularly for one month before enrolment. Data were analyzed using SPSS-22. Results 504 patients; 215(42.7%) males, mean age 59.7+14.3 years were studied from 4 general-medical and 8 speciality clinics. 352(69.8%) were on polypharmacy. 159(46%) were on allopathic and complementary medicines. Polypharmacy prevalence was not different between general-medical (71.3%) and speciality clinics (69.2%), p=0.67. Prevalence was more in patients above 60 years (77.3%), p<0.0001. Polypharmacy was associated with diabetes (OR 3.3, p<0.0001), hypertension (OR 2.5, p<0.001), chronic kidney disease (OR 3.9, p<0.0001) and ischaemic heart disease (OR 3.3, p<0.002) but was not associated with gender (OR 1.1, p=0.776), dyslipidemia (OR 1.2, p=0.407) or stroke (OR 1.2, p<0.521). Of patients on polypharmacy, 68(47.7%) were not complaining while others were worried due to different reasons; kidney/ liver damage (46(13,1%), high-cost (21(6.0%)), side effects (22(6.3%)), frustration (16(4.5%). 72((20.5%) had more than one worry. Conclusion Polypharmacy is a common problem in this hospital-based urban/ semi-urban cohort of Sri Lankans and is more with old age, diabetes mellitus, hypertension, kidney disease and ischemic heart disease.