Polypharmacy in the elderly: A population based cross-sectional study in Lazio, Italy

Background Polypharmacy in the elderly is a matter of concern, especially regarding adverse events and drug–drug interactions. Little is known about real world drug use in the elderly in Italy. The present study aimed at describing drug use in the elderly with respect to individual characteristics, performing a cross-sectional population study in Lazio, Italy. Methods From the regional health care assistance file, residents aged 65 years and older (mean age = 75.9 years, SD = 7.4) and alive at the end of 2010 were enrolled. Drug consumption was linked from the drug claims registry for 2010, and hospital admissions were retrieved from the hospital admission registry during 2009–2010. Enrolees were characterised for socio-demographic variables, presence of chronic diseases, and drug consumption, considering large groups, and specific sub-groups. Polypharmacy was defined as use of 6+ drugs (ATC 4th level). Results Of the 1,122,864 elderly residents, 57.9% were women, and 48.8% aged 75+. In the previous two years, 28.3% had been admitted to hospital; most common causes were cerebro- and cardiovascular diseases, diabetes and tumours; 78.9% of the elderly population of the city of Rome lived in low-level socio-economic areas. Only 6.8% had not been prescribed drugs in the 12-months observation period, and 58.8% were exposed to polypharmacy. With respect to the overall population, polypharmacy users were more often females (59.7%), older (54.5% aged 75 + ), had poorer health conditions (37.2% hospitalised), and more often lived in poorer areas (19.9%). Conclusion In Lazio, polypharmacy is an important phenomenon in the elderly population. Female gender, older ages and presence of chronic diseases are related to multiple drug use. The present results offer a useful tool for future initiatives aiming at reducing inappropriate polypharmacy and target interventions to subpopulations at higher risk of being exposed to polypharmacy.