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Prevalence and factors associated with polypharmacy among patients with rheumatoid arthritis: a single-centre, cross-sectional study

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Abstract

Objective

This study aimed to identify factors associated with polypharmacy, including social aspects, among patients with rheumatoid arthritis.

Methods

We conducted this single-centre, cross-sectional study at a 715-bed regional tertiary care teaching hospital in Japan from 1 September to 30 November 2020. Polypharmacy was defined as having five or more medications administered orally regularly, and excessive polypharmacy was defined as having 10 or more medications administered orally regularly. The prevalence of polypharmacy and excessive polypharmacy, distribution of medication types, and factors associated with polypharmacy and excessive polypharmacy were investigated among patients with rheumatoid arthritis.

Results

The proportions of polypharmacy and excessive polypharmacy were 61% and 15%, respectively, in 991 patients. Polypharmacy and excessive polypharmacy were associated with older age (odds ratio, 1.03 and 1.03, respectively), high Health Assessment Questionnaire Disability Index (odds ratio, 1.45 and 2.03, respectively), medication with glucocorticoids (odds ratio, 5.57 and 2.42, respectively), high Charlson comorbidity index (odds ratio, 1.28 and 1.36, respectively), and a history of hospitalisation in internal medicine (odds ratio, 1.92 and 1.87, respectively) and visits to other internal medicine clinics (odds ratio, 2.93 and 2.03, respectively). Moreover, excessive polypharmacy was associated with the presence of public assistance (odds ratio, 3.80).

Conclusions

Considering that polypharmacy and excessive polypharmacy are associated with a history of hospitalisation and glucocorticoid medication in patients with rheumatoid arthritis, medications during hospitalisation should be monitored, and glucocorticoids should be discontinued.

Key points

• The proportion of polypharmacy (five or more medications administered orally regularly) was 61%.

• The proportion of excessive polypharmacy (10 or more medications administered orally regularly) was 15%.

• Medications during hospitalisation should be reviewed and examined, and glucocorticoids should be discontinued.

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Data availability

Owing to the nature of this study, participants did not agree to their data being shared publicly; thus, supporting data are not available.

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Acknowledgements

We would like to thank Editage (www.editage.com) for the English language editing.

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Authors and Affiliations

  1. Department of General Internal Medicine, Tenri Hospital, 200 Mishima, Tenri, Nara, 632-8552, Japan

    Hirofumi Miyake, Ryuichi Minoda Sada, Hiroyuki Akebo & Kazuhiro Hatta

  2. Department of Infection Control, Graduate School of Medicine, Osaka University, Osaka, Japan

    Ryuichi Minoda Sada

  3. Department of Transformative Protection to Infectious Disease, Graduate School of Medicine, Osaka University, Osaka, Japan

    Ryuichi Minoda Sada

  4. Medical Home Care Centre, Tenri Hospital Shirakawa Branch, Nara, Japan

    Yukio Tsugihashi

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  1. Hirofumi Miyake
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  2. Ryuichi Minoda Sada
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  5. Kazuhiro Hatta
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Contributions

All authors contributed to the study conception and design. Material preparation and analysis were performed by HM. Data collection was performed by HM and HA. The first draft of the manuscript was written by HM, and all authors commented on the previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hirofumi Miyake.

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Ethical standards

The Institutional Review Board of Tenri Hospital approved this study protocol (Number 1274), and all participants provided written consent.

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Miyake, H., Sada, R.M., Akebo, H. et al. Prevalence and factors associated with polypharmacy among patients with rheumatoid arthritis: a single-centre, cross-sectional study. Clin Rheumatol 42, 2287–2295 (2023). https://doi.org/10.1007/s10067-023-06646-0

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