Suchergebnisse

The Japanese government is seeking to establish a community health program for the management of polypharmacy in elderly patients. To explore a community-based screening strategy for polypharmacy, this study examined the extent to which certain chronic diseases are strongly associated with polypharmacy among community-dwelling elderly adults in Japan. We used anonymized health insurance claims data from all beneficiaries aged 75 years and older in Tokyo, who received outpatient care between May 2014 and August 2014. We obtained the data from the Tokyo Metropolitan Association of Medical Care Services for Older Senior Citizens. The insurance program universally covers all citizens aged 75 years or older. The data included 134 categories of prescribed drugs and seven chronic diseases: hypertension, dyslipidemia, insomnia, osteoarthritis, diabetes, dementia, and depression. Polypharmacy was defined as the prescription of at least five drugs during a 4-month period. We estimated age- and sex-adjusted odds ratio (OR) for each chronic disease, using multivariate logistic regression analysis. The prevalence of polypharmacy among the beneficiaries (n = 1,308,412) was 34.4%. The prevalence was the highest among octogenarians (37.8%), followed by that among those aged 75–79 years (32.0%), nonagenarians (27.9%), and centenarians (10.9%). We found that the highest OR of having polypharmacy was 4.98 for diabetes (p < 0.001), followed by 4.75 for depression (p < 0.001); the lowest OR was 1.65 for dementia (p < 0.001). These findings emphasize the importance of identifying individual diseases to screen for polypharmacy among community-dwelling elderly patients.