Korean J Fam Pract. 2016; 6(6): 643-650  https://doi.org/10.21215/kjfp.2016.6.6.643
The Effect of Polypharmacy on Mortality in the Elderly
Soo-Jin Cheong1, Jong-Lull Yoon1,*, Seung-Hyun Choi1, Mee-Young Kim1, Jung-Jin Cho1, Young-Soo Ju2
1Department of Family Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong; 2Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
Jong-Lull Yoon
Tel: +82-31-8086-2390, Fax: +82-31-8086-2242
E-mail: lull@hallym.ac.kr
Received: June 30, 2016; Revised: August 27, 2016; Accepted: September 7, 2016; Published online: December 20, 2016.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Polypharmacy is common in elderly patients with multiple chronic health problems. This study estimated the mortality risk associated with polypharmacy using data from a Korean national administrative database.
Methods: Study subjects included all members (n=372,153) of the National Health Insurance Service senior cohort (aged 65 or older) at the point of December 31, 2007. Subjects were divided into three groups based on polypharmacy (6 or more drugs daily) status: continuous polypharmacy, intermittent polypharmacy, and non-polypharmacy. We evaluated the association between polypharmacy and mortality over the 6-year period from 2008 to 2013.
Results: There were 166 participants in the continuous polypharmacy group and 13,070 in the intermittent polypharmacy group. A total of 67,596 persons (18.2%) died over the follow-up period. Among those deaths, 4,082 (6.0%) were from the two polypharmacy groups, 75 from the continuous polypharmacy group (45.2% of continuous polypharmacy patients), and 4,007 from the intermittent polypharmacy group (30.7%). Mortality risk was significantly elevated in both polypharmacy groups after adjustment for age, sex, income, numbers of clinic visit, and regular health screening participation (HR 2.3 for the continuous polypharmacy group and HR 1.6 for the intermittent polypharmacy group). Polypharmacy was associated with increased risk of mortality in the elderly with or without multiple chronic diseases including hypertension, diabetes mellitus, and dyslipidemia.
Conclusion: Polypharmacy is associated with elevated mortality risk in elderly patients. Careful evaluation of general health conditions, health behaviors, and regular medication review are essential for possible reduction of polypharmacy in older patient.
Keywords: Elderly; Polypharmacy; Mortality; Primary Care
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