Skip to main content
Log in

Polypharmacy among patients admitted to hospital with rheumatic diseases

  • Published:
Pharmacy World and Science Aims and scope Submit manuscript

Abstract

Aim: This study describes polypharmacy among patients admitted to hospital with rheumatic diseases. Methods:The study was performed in departments of rheumatology at nine Norwegian hospitals during five weeks in 1998. Pharmacists recorded all drugs on admittance among patients 18 years or older with rheumatic diseases. Results: Sixty percent of 313 patients had polypharmacy defined as the concurrent use of five or more drugs, and this was most frequent among the older patients. However, they used fewer antirheumatic drugs compared to the younger patients. With regard to the three most common drug groups, older patients used more corticosteroids, and less nonsteroidal antiinflammatory drugs (NSAIDs)and disease modifying antirheumatic drugs (DMARDs), compared to the younger. Eighty‐four percent of patients on methotrexate used folic acid, but only 52% of the patients who used corticosteroids used calcium supplements. Conclusion: Polypharmacy among patients with rheumatic diseases is common, and the present description could be useful for drug‐related interventions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Healthy People 2000. National Health Promotion and Disease Prevention Objectives. Dept of Health and Human Services, Publication No 91-50212, 67. Washington (DC), 1990.

  2. Kruse W, Rampmaier J, Frauenrath-Volkers C, Volkert D, Wankmüller I, Micol W, et al. Drug-prescribing patterns in old age. A study of the impact of hospitalization on drug prescriptions and follow-up survey in patients 75 years and older. Eur J Clin Pharmacol 1991;41:441-7.

    Google Scholar 

  3. Monane M, Monane S, Semla T. Optimal medication use in elders: Key to successful aging. West J Med 1997;167:233-7.

    Google Scholar 

  4. Lindley CM, Tully MP, Paramsothy V, Tallis RC. Inappropriate medication is a major cause of adverse drug events in elderly patient. Age Ageing 1992;21:294-300.

    Google Scholar 

  5. Cooper JW. Adverse drug reaction-related hospitalizations of nursing facility patients: A 4-year study. Southern Med J 1999;92:485-90.

    Google Scholar 

  6. Van den Bemt PMLA, Egberts ACG, Lenderink AW, Verzijl JM, Simons KA, Van der Pol WSCJM, et al. Risk factors for the development of adverse drug events in hospitalized patients. Pharmacy World & Science 2000;22:62-6.

    Google Scholar 

  7. Alderman CP. Patient-oriented strategies for the prevention of drug interactions. Drug Safety 2000;2:103-9.

    Google Scholar 

  8. Stewart R, Cooper J. Polypharmacy in the aged. Drugs Aging 1994;4:449-61.

    Google Scholar 

  9. Magaziner J, Cadigan DA, Fedder Do, Hebel JR. Medication use and functional decline among community-dwelling older women. J Aging Health 1989;1:470-85.

    Google Scholar 

  10. Spagnoli A, Ostino G, Borga AD, D'Ambrosio R, Maggiorotti P, Todisco E, et al. Drug compliance and unreported drugs in the elderly. J Am Geriatr Soc 1989;37:619-24.

    Google Scholar 

  11. Montamat SC, Cusack B. Overcoming problems with polypharmacy and drug misuse in the elderly. Clin Geriatr Med 1992;42:1241-7.

    Google Scholar 

  12. Clemetsen PS, Kristensen KS, Kamp-Jensen M, Kampmann JP. Patienters viden om egen medicin – hjælper mundtlig information? Ugeskrift Læger 1992;153:2264-6.

    Google Scholar 

  13. Anderson G, Kerluke K. Distribution of prescription drug exposures in the elderly: description and implications. J. Clin Epidemiol 1996;49:929-35.

    Google Scholar 

  14. Chrischilles EA, Foley DJ, Wallace RB, Lemke JH, Semla TP, Hanlon JT, et al. Use of medications by persons 65 and over: Data from the established populations for epidemiologic studies of the elderly. J Gerontol 1992;47:M137-44.

    Google Scholar 

  15. Beers MH, Fingold SF, Ouslander JG, Reuben DB, Morgenstern H, Beck JC. Characteristics and quality of prescribing by doctors practising in nursing homes. J Am Geriatr Soc 1993;41:802-7.

    Google Scholar 

  16. Bjerrum L, Rosholm JU, Hallas J, Kragstrup J. Polyfarmaci belyst ved hjælp af en populationsbaseret receptdatabase. Ugeskrift Læger 1999;161:6355-9.

    Google Scholar 

  17. Bell CL. Rheumatoid arthritis. Complications beyond the joints. Postgrad Med 1994;95:127-40.

    Google Scholar 

  18. Blackburn WD. Management of osteoarthritis and rheumatoid arthritis: prospective possibilities. Am J Med 1996;100:24S-30S.

    Google Scholar 

  19. Schuna AA. Update on treatment of rheumatoid arthritis. J AM Pharm Assoc (Wash) 1998;38:728-35.

    Google Scholar 

  20. Eisenberg D, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. 'Unconventional' medicine in the United States-prevalence, costs and pattern of use. N Engl J Med 1993;328:246-52.

    Google Scholar 

  21. Owen SG, Friesen WT, Roberts SM, Francis H, Flux W. Functional capacity and treatment data from a community based study of patients with rheumatoid arthritis. Ann Rheum Dis 1986;45:293-303.

    Google Scholar 

  22. Miller DR. Combination use of nonsteroidal antiinflammatory drugs. Drug Intelligence Clin Pharmacy 1981;15:3-7.

    Google Scholar 

  23. Vliet Vlieland TPM, Zwinderman AH, Vandenbroucke JP, Breedveld FC, Hazes JMW. In-patient treatment for active rheumatoid arthritis: clinical course and predictors of improvement. Br J Rheumatol 1995;34:847-53.

    Google Scholar 

  24. Caldwell JR. Medical treatment of rheumatoid arthritis. J Florida M.A. 1995;82:343-7.

    Google Scholar 

  25. Buchan IE, Bird HA, Drug interactions in arthritic patients. Ann Rheum Dis 1991;50:680-1.

    Google Scholar 

  26. The Norwegian Medicines Control Authority. Terapianbefaling: Behandling av reumatoid artritt. Norwegian Drug Bull 1999;22Suppl 5:5-31.

    Google Scholar 

  27. Simon LS. DMARDs in the treatment of rheumatoid arthritis: Current agents and future developments. Int J Clin Pract 2000;54:243-9.

    Google Scholar 

  28. Jessop JD, O'sullivan MM, Lewis PA, Williams LA, Camilleri JP, Plant MJ, et al. A long-term five-year randomized controlled trial of hydroxychloroquine, sodium aurothiomaleate, auranofin and penicillamine in the treatment of patients with rheumatoid arthritis. Br J Rheumatol 1998;37:992-1002.

    Google Scholar 

  29. Todesco S. Special considerations in the use of NSAIDs in the elderly. Eur J Rheumatol Inflamm 1994;14:7-13.

    Google Scholar 

  30. Johnson AG. NSAIDs and blood pressure. Clinical importance for older patients. Drugs Ageing 1998;1:17-27.

    Google Scholar 

  31. Whelton A. Nephrotoxicity of nonsteroidal anti-inflammatory drugs: physiologic foundations and clinical implications. Am J Med 1999;106(5B):13S-24S.

    Google Scholar 

  32. Twycross R. The risk and benefits of corticosteroids in advanced cancer. Drug Safety 1994;11:163-78.

    Google Scholar 

  33. ACR Task Force on osteoporosis guidelines. Recommendations for the prevention and treatment of glucocorticoidinduced osteoporosis. Arthritis Rheum 1996;39:1791-1801.

    Google Scholar 

  34. The Norwegian Medicines Control Authority. Terapianbefaling: Behandling av osteoporose. Norwegian Drug Bull 1997;20Suppl 1:3-23.

    Google Scholar 

  35. Joyce DA, Will RK, Hoffman DM, Laing B, Blackbourn SJ. Exacerbation of rheumatoid arthritis in patients with methotrexate after administration of folinic acid. Ann Rheum Dis 1991;59:913-4.

    Google Scholar 

  36. Morgan SL, Baggott JE, Vaughn WH, Austin JS, Veitch TA, Lee JY, et al. Supplement with folic acid during methotrexate therapy for rheumatoid arthritis. Ann Intern Med 1994;121:833-41.

    Google Scholar 

  37. Kvien TK, Glennås A, Kundsrød OG, Smedstad LM, Mowinckel P, Førre Ø. The prevalence and severity of rheumatoid arthritis in Oslo. Scand J Rheumatol 1997;26:412-8.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Viktil, K.K., Enstad, M., Kutschera, J. et al. Polypharmacy among patients admitted to hospital with rheumatic diseases. Pharm World Sci 23, 153–158 (2001). https://doi.org/10.1023/A:1011909827909

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1011909827909

Navigation