Epidemiological Insights on Medication Concurrency and Polypharmacy in People With Multiple Sclerosis in Greece

Christos Bakirtzis; Ioannis Nikolaidis; Marina-Kleopatra Boziki; Eleni Grigoriadou; Maria-Valeria Karakasi; Theodoros Moysiadis; Evangelia Kesidou; Georgios Papazisis; Nikolaos Grigoriadis

doi:10.7224/1537-2073.2022-046

Epidemiological Insights on Medication Concurrency and Polypharmacy in People With Multiple Sclerosis in Greece

Int J MS Care. 2023 Jul-Aug;25(4):140-144. doi: 10.7224/1537-2073.2022-046. Epub 2023 Jan 16.

Authors

Christos Bakirtzis¹, Ioannis Nikolaidis¹, Marina-Kleopatra Boziki¹, Eleni Grigoriadou¹, Maria-Valeria Karakasi², Theodoros Moysiadis³, Evangelia Kesidou¹, Georgios Papazisis⁴, Nikolaos Grigoriadis¹

Affiliations

¹ From the Multiple Sclerosis Center, 2nd Department of Neurology (CB, IN, M-KB, EG, EK, NG), Aristotle University of Thessaloniki, Thessaloniki, Greece.
² C' Department of Psychiatry (M-VK), Aristotle University of Thessaloniki, Thessaloniki, Greece.
³ The Department of Computer Science, School of Sciences and Engineering, University of Nicosia, Nicosia, Cyprus (TM).
⁴ Department of Clinical Pharmacology (GP), Aristotle University of Thessaloniki, Thessaloniki, Greece.

Abstract

Background: Besides disease-modifying therapies, various pharmacologic agents are frequently prescribed to people with multiple sclerosis (MS) for symptom treatment and for comorbid conditions. The present study aims to investigate the types and frequencies of agents prescribed to people with MS in Greece using records from the nationwide digital prescription database.

Methods: Prescription records for 21,218 people (65.9% women) with MS were included in the study. The criterion for study inclusion was a minimum of 3 months of continuous prescription of an agent. Identified treatments were further examined by age group.

Results: Antispasticity agents (17.5%) and fampridine (14.5%) were the most regularly prescribed symptomatic medications. Antihypertensives (21.1%) and drugs for affective disorders, including antidepressants (36.1%) and anxiolytics (16.2%), were the most frequently prescribed medications for comorbid conditions. Antidepressants were prescribed at almost equally high rates among individuals older than 40 years. Hypertension was one of the leading comorbidities among the study sample, with rates rising significantly after age 40 years and plateauing after age 60 years. Polypharmacy was observed in 22.5% of the study sample, with a higher incidence among people with MS older than 60 years (46.98%).

Conclusions: Agents prescribed for the treatment of disease symptoms and other medical conditions are expected to positively affect quality of life in people with MS. However, polypharmacy seems to be particularly high, especially in the aged population. The potential implications of polypharmacy in the disease course should further be explored.

Keywords: comorbidity; multiple sclerosis; olypharmacy; pharmacoepidemiology; quality of life.

Grants and funding

FINANCIAL DISCLOSURES: Dr Bakirtzis has received travel support and/or research grants and/or lecture fees and/or advisory services from Wireless World Research Forum, the Hellenic Academy of Neuroimmunology, Novartis, Bayer, Merck, Genesis Pharma, Sanofi, Specifar, Roche, Biogen, Elpen, and Mylan. Dr Nikolaidis has received travel support and/or research grants and/or lecture fees and/or advisory services from the Hellenic Foundation for Research and Innovation, the Ministry of Education’s Education and Lifelong Learning Program, the Hellenic Neurological Society, the Hellenic Academy of Neuroimmunology, Biogen Idec, Novartis, Teva Pharmaceutical Industries, Bayer, Genesis Pharma, Sanofi, Specifar, Roche, Mylan, and Merck. Dr Boziki has received travel support and/or research grants and/or lecture fees and/or advisory services from the Hellenic Foundation for Research and Innovation, the Ministry of Education’s Education and Lifelong Learning Program, the Hellenic Neurological Society, the Hellenic Academy of Neuroimmunology, Biogen Idec,Novartis, Teva Pharmaceutical Industries, Bayer, Genesis Pharma, Sanofi, Specifar, Roche, and Merck. Dr Grigoriadis has received travel support and/or research grants and/or lecture fees and/or advisory services from Novartis, Bayer, Merck, Genesis, Sanofi, Specifar, Roche, Biogen, Teva Pharmaceutical Industries, and Mylan. FUNDING/SUPPORT: None.