Prevalence and determinants of polypharmacy among patients with chronic diseases, ministry of health (moh), al-ahsa, saudi arabia, 2020

Purpose of the study: The purpose of this study was to determine the prevalence of polypharmacy and its risk factors among the chronic disease patients attending the different ministry of health Primary health care centers of Al-Ahsa.
Introduction: Polypharmacyis defined as a phenomenon in which there is cumulative use of five or more drugs in the last two weeks. Polypharmacy is a common health problem for many patients worldwide resulting in negative effects on health status and pharmaceutical spending. Studieshave shown that there were different risk factors associated with polypharmacy which included sex (females more common), ageing, being separated/divorced/ widowed, educational level as lack of education, higher body mass index, decreased physical activity, being bedridden during the last two weeks and self‐medication.Therefore, recognition of polypharmacy and its risk factors is the first step toward prevention of irrational use of medicines.
Material and Methods: It was a cross sectional study conducted in Al-Ahsa District of Saudi Arabia. All the Adults attending Ministry of health Primary Health Centers of Al-Ahsa, were the study population. Systematic random selections of the PHCs. were done while sample was then selected from each centerrandomly. The calculated sample size was 290 subjects. Data were collected using structured questionnaires. The questionnaires consisted of Socio-demographic details of the subjects.BMI, smoking status, chronic and associated diseases, number of medications, self-medications, last medical consultation time, another health care service follow up and health satisfaction. The data were entered in the Statistical Package for Social Sciences (SPSS) software version 21 and the same was used for data analysis & inference. Confidence interval (CI) 95% was chosen &the level of significance was set at < 0.05 throughout the study.
Result: Two hundred and fifty out of two hundred ninety participants took part in this survey constituting 86% of the main study sample. The mean age of the participants was 56.27 years (± 18.08 SD).More than fifty one percent of the participants (N=128) were male. Approximately two-third (N=158) of them were married, nearly one-half of the participants (N=112) were unemployed and the majority of the participants (97.6%) were Saudis. Forty two percent of the participants (95% CI 41.01-42.99, N=105) (N=105) were using four and more medicines. The adjusted ORs (AORs) and 95% CIs from multivariable logistic regression on polypharmacy has identified: age (OR= 2.70 95%CI 1.40-4.238), male gender (OR= 2.47 95% CI 1.089-4,680) and coexisting chronic conditions (DM+HTN) (OR= 3.62 95% CI 1.245-8.651). Polypharmacy was more likely among older patients than the younger adult (OR=1.65 95% CI 1.23-1.89). Hypercholesterolemia, depression/anxiety, heart diseases and hypothyroidism were all significantly associated polypharmacy. For example patients with diabetes and hypertension with hypercholesterolemia (OR=4.56 95% CI 2.765-6.452), with depression/anxiety (OR=1.023, 95% CI 0.97-3.43), and with hypothyroidism (OR=3.423, 95% C! 2.31-4.34)
Conclusion: A significant proportion of male patients especially in the older age group with chronic diseases and comorbid conditions such as heart diseases, hypercholesterolemia, depression/anxiety and hypothyroidism were more exposed to polypharmacy in our study. Smoking, Obesity, patients on self-medication as well as those patients who had medical consultation more than 3 months were other risk factors of polypharmacy in our study. Medication reviews are needed to reduce significant polypharmacy related issues in older patients.