Medication overload: A closer look at polypharmacy and potentially inappropriate medications among older people in Taiwan and Japan

Lin-Chieh Meng; Taro Kojima; Yusuke Suzuki; Shao-En Weng; Ho-Min Chen; Shih-Tsung Huang; Masahiro Akishita; Liang-Kung Chen; Fei-Yuan Hsiao

doi:10.1016/j.archger.2023.105100

Medication overload: A closer look at polypharmacy and potentially inappropriate medications among older people in Taiwan and Japan

Arch Gerontol Geriatr. 2023 Dec:115:105100. doi: 10.1016/j.archger.2023.105100. Epub 2023 Jun 8.

Authors

Lin-Chieh Meng¹, Taro Kojima², Yusuke Suzuki³, Shao-En Weng¹, Ho-Min Chen⁴, Shih-Tsung Huang⁵, Masahiro Akishita², Liang-Kung Chen⁶, Fei-Yuan Hsiao⁷

Affiliations

¹ Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.
² Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
³ Center for Community Liaison and Patient Consultations, Nagoya University Hospital, Nagoya, Japan.
⁴ Health Data Research Center, National Taiwan University, Taipei, Taiwan.
⁵ Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan.
⁶ Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan. Electronic address: lkchen2@vghtpe.gov.tw.
⁷ Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: fyshsiao@ntu.edu.tw.

PMID: 37499332
DOI: 10.1016/j.archger.2023.105100

Abstract

Background: Polypharmacy and potentially inappropriate medications (PIM) are widely recognized as vital quality indicators of pharmacotherapy in older adults. As Taiwan and Japan grapple with the ongoing challenges of population aging, obtaining an accurate understanding of the prevalence of these indicators is crucial for developing effective strategies to optimize pharmacotherapy in older populations. The present study aims to comprehensively evaluate the prevalence of polypharmacy and PIMs in Taiwan and two Japanese cohorts, shedding light on the similarities and differences in prescribing practices across these populations.

Methods: This study employed a cross-sectional design to investigate individuals aged ≥65 years in Taiwan, as well as two Japanese cohorts: Japan Cohort 1 (dispensing data from chain pharmacies; year 2014 and 2019) and Japan Cohort 2 (claims data; year 2017 and 2019). The prescription records of these participants were collected from the national claims database in Taiwan for the years 2014, 2017, and 2019. To identify polypharmacy and hyper-polypharmacy, the study defined the use of 5-9 and 10+ drugs, respectively. Furthermore, the study identified PIMs based on the STOPP-J criteria. Notably, the study further explored the most frequently used PIMs (by categories) in Taiwan.

Results: In the year 2019, the prevalence of polypharmacy exhibited similar rates in Taiwan (35.4%) and Japan Cohort 2 (33.1%), while surpassing that of Japan Cohort 1 (25.6%). Nonetheless, the incidence of PIMs in Taiwan was the highest (66.5%), exceeding those of the two Japanese cohorts (Cohort 1: 43.7% and Cohort 2: 40.2%) in the same year. Notably, the top three categories of commonly used PIMs in Taiwan comprised non-steroidal anti-inflammatory drugs (NSAIDs), antithrombotic drugs, and benzodiazepines.

Conclusions: This study highlights the varying prevalence of polypharmacy and PIMs between Taiwan and Japan, but emphasizes the need for collaborative efforts towards optimizing pharmacotherapy in older adults.

Keywords: Ageing society; Japan; Polypharmacy; Potentially inappropriate medications; Taiwan.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cross-Sectional Studies
Humans
Inappropriate Prescribing*
Japan / epidemiology
Polypharmacy
Potentially Inappropriate Medication List*
Taiwan / epidemiology