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Prescribed-drug utilization and polypharmacy in a general population in Greece: association with sociodemographic, health needs, health-services utilization, and lifestyle factors

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

Our aim was to analyze, in a multivariate framework, how sociodemographic, health-service utilization, health needs, and lifestyle risk factors influence drug utilization and polypharmacy (PP) in a general population in Greece.

Methods

The cross-sectional study took place in 2006. In total 1,005 individuals (>18 years old) of 1,388 who were approached (response rate 72.4%) were interviewed by trained interviewers. Thirty-seven reported only over-the-counter (OTC) drug use and were excluded. The final sample was 968 individuals. Multivariable logistic regression and multinomial regression analyses were conducted to determine the predictors of drug use and PP at a significance level of p < 0.05.

Results

The results revealed a high rate of drug use and PP. Drug use and PP were more common among women and increased with age. Advanced age 65+ [odds ratio (OR) 11.6), university education (OR 2.3), visits to physician (OR 2.2), comorbidity (OR 6.8), or poor physical and mental health were associated with higher likelihood of using drugs. Minor (two to three drugs) and major (four or more drugs) PP depended on comorbidity, physical health, and increased age. Furthermore, visits to physicians (OR 1.1), smoking (OR 3.0), and obesity (OR 3.8) increased the likelihood of major PP.

Conclusions

Overall, drug utilization and PP depended on health needs followed by education, utilization of health services, and age. Social disparities do persist and, after adjustments for health needs and obesity, had a significant influence on PP.

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References

  1. Eggen AE (1994) Pattern of drug use in a general population-prevalence and predicting factors: the Tomso study. Int J Epidemiol 23:1262–1272. doi:10.1093/ije/23.6.1269

    Article  CAS  PubMed  Google Scholar 

  2. Del Rio C, Prada C, Alvarez J (1997) The use of mediation by the Spanish population. Pharmacoepidemiol Drug Saf 6:41–48. doi:10.1002/pds.250

    Article  PubMed  Google Scholar 

  3. Eggen AE (1997) Patterns of medicine use in a general population (0-80). The influence of age, gender, diseases and place of residence on drug use in Norway. Pharmacoepidemiol Drug Saf 6:179–187. doi:10.1002/pds.258

    Article  CAS  PubMed  Google Scholar 

  4. Simoni M, Pedreschi M, Baldacci S et al (2000) The PO River Delta epidemiological study: use of medicines in a general population sample of north Italy. Pharmacoepidemiol Drug Saf 9:319–326. doi:10.1002/pds.505

    Article  CAS  PubMed  Google Scholar 

  5. Fernandez-Liz E, Modamio P, Catalan A et al (2007) Identifying how age and gender influence prescription drug use in a primary health care environment in Catalonia Spain. Br J Clin Epidemiol 65:407–417

    Google Scholar 

  6. Sanfelix J, Palop V, Pareiro I et al (2008) Gender influence in the quantity of drugs used in primary care. Gas Sanit 22:11–19

    Article  Google Scholar 

  7. Bardel A, Wallander MA, Svardsudd K (2000) Reported current use of prescription drugs and some of its determinants among 35 to 65 years old women in mid-Sweden: a population –based study. J Clin Epidemiol 53:637–643. doi:10.1016/S0895-4356(99)00228-0

    Article  CAS  PubMed  Google Scholar 

  8. Furu K, Straume B, Thelle DS (1997) Legal drug use in a general population: Association with gender, morbidity, health care utilization and lifestyle characteristics. J Clin Epidemiol 50:341–349. doi:10.1016/S0895-4356(99)00362-9

    Article  CAS  PubMed  Google Scholar 

  9. Bekke M, Hunskaar S, Straand J (2006) Self-reported drug utilization, health and lifestyle factors among 70-74 year old community dwelling individuals in Western Norway. The Hordaland Health Study (HUSK). BMC Public Health 6:121. doi:10.1186/1471-2458-6-12

    Article  Google Scholar 

  10. Ringbach Weitoft G, Rosen M, Ericsson O, Ljung R (2008) Education and drug use in Sweden-a nationwide register-based study. Pharmacoepidemiol Drug Saf 17:1020–1028. doi:10.1002/pds.1635

    Article  Google Scholar 

  11. Nielsen M, Hansen EH, Rasmussen N (2003) Prescription and non-prescription medicine use in Denmark: association with socioeconomic position. Eur J Clin Pharmacol 59:677–684

    Article  PubMed  Google Scholar 

  12. Fillenbaum G, Horner R, Hanlon J et al (1996) Factors predicting change in prescription and non-prescription drug use in a community residing black and white elderly population. J Clin Epidemiol 49:587–593. doi:10.1016/S0895-4356(95)00563-3

    Article  CAS  PubMed  Google Scholar 

  13. Henricson K, Stenberg P, Rametsteiner G et al (1998) Socioeconomic factors, morbidity and drug utilization-an ecological study. Pharmacoepidemiol Drug Saf 7:261–267. doi:10.1002/pds.364

    Article  CAS  PubMed  Google Scholar 

  14. Gundgaard J (2005) Income related inequality in prescription drugs in Denmark. Pharmacoepidemiol Drug Saf 14:307–317. doi:10.1002/pds.1039

    Article  PubMed  Google Scholar 

  15. Bjerrum L, Sogaard J, Hallas J, Kragstrup J (1998) Polypharmacy: correlation with sex, age and drug regimen. Eur J Clin Pharmacol 54:197–202

    Article  CAS  PubMed  Google Scholar 

  16. Thomas HF, Sweetnam PM, Janchawee B, Luscombe DK (1999) Polypharmacy among older men in South Wales. Eur J Clin Pharmacol 55:411–415

    Article  CAS  PubMed  Google Scholar 

  17. Haider SI, Johnell K, Thorslund M, Fastbom J (2008) Analysis of the association between polypharmacy and socioeconomic position among elderly aged > or =77 years in Sweden. Clin Ther 30:419–427

    Article  PubMed  Google Scholar 

  18. Haider SI, Johnell K, Weitoft GR et al (2009) The influence of educational level on polypharmacy and inappropriate drug use: a register-based study of more than 600.000 older people. J Am Geriatr Soc 57:62–69

    Article  PubMed  Google Scholar 

  19. Junius-Walker U, Theile G, Hummers-Pradier E (2006) Prevalence and predictors of polypharmacy among older primary care patients in Germany. Fam Pract 24:14–19

    Article  PubMed  Google Scholar 

  20. Little P, Dorward M, Warner G et al (2004) Importance of patients’ pressure and perceived pressure and perceived medical need for investigations, referral, and prescribing in primary care: nested observational study. Br Med J 328:444–447

    Article  Google Scholar 

  21. Veehof LJ, Stewart RE, Meyboom-de Jong B, Haaijer-Ruskamp FM (1999) Adverse drug reactions and polypharmacy in the elderly in general population. Eur J Clin Pharmacol 55:533–536

    Article  CAS  PubMed  Google Scholar 

  22. Alexopoulou A, Dourakis SP, Mantzoukis D et al (2008) Adverse drug reactions as a cause of hospital admissions: a 6-months experience in a single center in Greece. Eur J Intern Med 19:505–510

    Article  PubMed  Google Scholar 

  23. Olivier P, Bertrand L, Tubery M et al (2009) Hospitalizations because of adverse drug reactions in elderly patients admitted through the emergency department: a prospective survey. Drugs Aging 26:475–482

    Article  PubMed  Google Scholar 

  24. Veehof LJG, Stewart RE, Haaijer-Ruskamp FM, Meyboom-de Jong B (2000) The development of polypharmacy. A longitudinal study. Fam Pract 17:261–267

    Article  CAS  PubMed  Google Scholar 

  25. Jyrrka J, Enlund H, Korhonen MJ et al (2009) Patterns of drug use and factors associated with polypharmacy and excessive polypharmacy in elderly persons: results of the Kuopio 75+ study: a cross-sectional analysis. Drugs Aging 26:493–503

    Article  Google Scholar 

  26. Antonakis N, Xylouri I, Alexandrakis M et al (2005) Seeking prescribing patterns in rural Crete: a pharmacoepidemiological study from a primary care area. Rural Remote Health 6:488

    Google Scholar 

  27. Tzimis L, Kafatos A (1998) Drug utilization and health behaviours among indigent elderly patients in Crete, Greece. Pharmacoepidemiol Drug Saf 8:105–114. doi:10.1002/pds.398

    Article  Google Scholar 

  28. OECD Health Data 2009_Frequently Requested Data. http://www.oecd.org/document/16/0,3343,em_2649_34631_2085200_1_1-1_37407,00.html (accessed 2 February 2010)

  29. Yfantopoulos J (2008) Pharmaceutical pricing and reimbursement reforms in Greece. Eur J Health Econ 9:87–97

    Article  PubMed  Google Scholar 

  30. Kontodimopoulos N, Pappa E, Niakas D, Tountas Y (2007) Validity of SF-12 summary scores in a Greek general population. Health Qual Life Outcome 5:55

    Article  Google Scholar 

  31. Pitsavos C, Panagiotakos DB, Chrysohoou C, Stefanadis C (2003) Epidemiology of cardiovascular risk factors in Greece: aims, design and baseline characteristics of the ATTICA study. BMC Public Health 3:32

    Article  PubMed  Google Scholar 

  32. Pappa E, Kontodimopoulos N, Papadopoulos A, Niakas D (2009) Assessing the socioeconomic and demographic impact on health related quality of life: evidence from Greece. Int J Public Health 54:241–249

    Article  PubMed  Google Scholar 

  33. Rosholm J, Christensen K (1997) Relationship between drug use and self-reported health in elderly Danes. Eur J Clin Pharmacol 53:179–183

    Article  CAS  PubMed  Google Scholar 

  34. Bertoldi A, Barros A, Wagner A et al (2008) A descriptive review of the methodologies used in household surveys on medicine utilization. BMC Health Serv Res 8:222

    Article  PubMed  Google Scholar 

  35. Van den Brandt PA, Petri H, Dorant E, Goldbohm RA, van de Crommert S (1991) Comparison of questionnaire information and pharmacy data on drug use. Pharm Weekbl Sci 13:91–96

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Faculty of Social Sciences, Hellenic Open University, Bouboulinas 57-59, 26222, Patras, Greece

    E. Pappa, N. Kontodimopoulos, A. A. Papadopoulos, Y. Tountas & D. Niakas

  2. “Attikon” University Hospital, Athens, Greece

    A. A. Papadopoulos

  3. Center for Health Services Research, Department of Hygiene and Epidemiology, Medical School, Athens University, Athens, Greece

    Y. Tountas

Authors
  1. E. Pappa
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  2. N. Kontodimopoulos
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  3. A. A. Papadopoulos
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  4. Y. Tountas
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  5. D. Niakas
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Correspondence to E. Pappa.

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Pappa, E., Kontodimopoulos, N., Papadopoulos, A.A. et al. Prescribed-drug utilization and polypharmacy in a general population in Greece: association with sociodemographic, health needs, health-services utilization, and lifestyle factors. Eur J Clin Pharmacol 67, 185–192 (2011). https://doi.org/10.1007/s00228-010-0940-0

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  • DOI: https://doi.org/10.1007/s00228-010-0940-0

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