The Prevalence and Characteristics of Older Japanese Adults with Polypharmacy, Based on Regionally Representative Health Insurance Claims Data

Acta Med Okayama. 2020 Feb;74(1):41-48. doi: 10.18926/AMO/57951.

Abstract

We aimed to clarify the prevalence of polypharmacy among elderly individuals in Japan. We used the data obtained from a large-scale population-based representative database of health insurance claims in a single prefecture in Japan. We examined all of the outpatient and pharmaceutical health insurance claims for National Health Insurance and those for Late-stage Elderly Health Insurance in Nagasaki Prefecture, Japan between April and June 2016. When two or more claim forms were issued for a patient in a single month, we combined the data and identified the number of prescribed drugs for each person. The definition of polypharmacy is a the prescription of six or more drugs per month. We investigated the prevalence of polypharmacy among the beneficiaries of the two insurance systems. Of the 605,406 beneficiaries of the 2 insurance systems, 121,033 (20.0%) patients with polypharmacy were identified. The prevalence of polypharmacy increased with age, especially among the beneficiaries aged > 85 years, with about half of the beneficiaries having polypharmacy status. About half of the people aged > 85 years in the database had polypharmacy status. When a drug is prescribed to an elderly individual, it is necessary to consider the possibility of polypharmacy-related problems.

Keywords: Japan; health insurance claims; late-stage elderly health insurance; national health insurance; polypharmacy.

MeSH terms

  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Databases, Factual
  • Female
  • Humans
  • Insurance, Health / statistics & numerical data
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Polypharmacy*
  • Retrospective Studies
  • Sex Distribution