Prevalence of polypharmacy in community-dwelling older adults from seven centres in five European countries: a cross-sectional study of DO-HEALTH.

Objective: To investigate the prevalence of polypharmacy and characteristics associated with polypharmacy in older adults from seven European cities.
Design: Cross-sectional study of baseline data from DO-HEALTH.
Setting and Participants: DO-HEALTH enrolled 2157 community-dwelling adults age 70 and older from seven centres in Europe. Participants were excluded if they had major health problems or Mini-Mental State Examination Score <24 at baseline.
Primary Outcome Measures: Extensive information on prescription and over-the-counter medications were recorded. Polypharmacy was defined as the concomitant use of five or more medications, excluding vitamins or dietary supplements. Bivariate and multivariable logistic regression was used to test the association of sociodemographic factors (age, sex, years of education, living situation and city) and health-related indicators (number of comorbidities, cognitive function, frailty status, body mass index (BMI), prior fall, self-rated health and smoking status) with polypharmacy.
Results: 27.2% of participants reported polypharmacy ranging from 16.4% in Geneva to 60.8% in Coimbra. In the multivariable logistic regression analyses, older age (OR 1.07; 95% CI 1.04 to 1.10), greater BMI (OR 1.09; 95% CI 1.06 to 1.12) and increased number of comorbidities (OR 2.13; 95% CI 1.92 to 2.36) were associated with polypharmacy. Women were less likely to report polypharmacy than men (OR 0.65; 95% CI 0.51 to 0.84). In comparison to participants from Zurich, participants from Coimbra were more likely to report polypharmacy (OR 2.36; 95% CI 1.56 to 3.55), while participants from Geneva or Toulouse were less likely to report polypharmacy ((OR 0.36; 95% CI 0.22 to 0.59 and OR 0.64; 95% CI 0.42 to 0.96), respectively). Living situation, smoking status, years of education, prior fall, cognitive function, self-rated health and frailty status were not significantly associated with polypharmacy.
Conclusion: Polypharmacy is common among relatively healthy older adults, with moderate variability across seven European cities. Independent of several confounders, being a woman, older age, greater BMI and greater number of comorbidities were associated with increased odds for polypharmacy.
Trial Registration Number: NCT01745263.
Competing Interests: Competing interests: As part of the DO-HEALTH independent and investigator initiated clinical trial, HB-F reports as the PI of the DO-HEALTH trial, grants from European Commission, from University of Zurich, from NESTEC, from PFIZER Consumer Healthcare, from Streuli Pharma, plus nonfinancial support from DSM Nutritional Products and non-financial support from Roche Diagnostics. Further, HB-F reports speaker fees from Wild, Pfizer, Vifor, Mylan, Roche Diagnostics, and independent and investigator-initiated grants from Pfizer and from Vifor, outside the submitted work. BV reports personal fees from BIOGEN, CERECIN, ROCHE, MSD, outside the submitted work. RR reports personal fees from Abiogen, Danone, Echolight, EMF, Mithra, ObsEva, Pfizer Consumer Health, Theramex, outside the submitted work. JEO reports grants from Zurich University, during the conduct of the study. CdGRCM received funding from the National Council for Scientific and Technological Development (CNPq), with process Nos. 164700/2015-3, from the São Paulo Research Foundation (FAPESP), with process No. 2016/13700-9, and Coordination for the Improvement of Higher Education Personnel/PhD Sandwich Programs Abroad (PDSE), with process No. 88881.132169/2016-01. All other authors declare no competing interests.
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