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Geographical differences in the prevalence of chronic polypharmacy in older people: eleven years of the EPIFARM-Elderly Project

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

Abstract

Purpose

To compare the geographical differences in the prevalence of chronic polypharmacy in community-dwelling older people over 11 years.

Methods

This study analyzed nearly two million patients aged 65–94 years recorded in the Drug Administrative Database of the Lombardy Region (Northern Italy) from 2000 to 2010. Chronic polypharmacy was defined as taking five or more drugs in 1 month for at least 6 months (consecutive or not) in a year.

Results

There was a significant spatial autocorrelation that increased at the municipality level from 2000 (Moran’s I Index = 0.26, z score = 16.91, p < 0.0001) to 2010 (Moran’s I Index = 0.36, z score = 23.78, p < 0.0001). Clusters of high (Z(G) > 1.96) and low (Z(G) < −1.96) prevalence rates of chronic polypharmacy were found and were not influenced by age. Chronic polypharmacy weakly correlated with hospital admission (2000: ρ = 0.08, p = 0.0032; 2005: ρ = 0.11, p < 0.0001; 2010: ρ = 0.18, p < 0.0001), but not with mortality.

Conclusions

There were geographical differences in the prevalence of older people with chronic polypharmacy that were only partly explained by health indicators. Targeted activities on prescription practice to ensure that the prescribing of chronic polypharmacy is appropriate are required.

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Authors and Affiliations

  1. Laboratory for Quality Assessment of Geriatric Therapies and Services, Istituto di Ricerche Farmacologiche Mario Negri-IRCCS, Via Giuseppe La Masa, 19, 20156, Milan, Italy

    Carlotta Franchi, Luca Pasina, Codjo Djignefa Djade & Alessandro Nobili

  2. Laboratory of Mother and Child Health, Istituto di Ricerche Farmacologiche Mario Negri-IRCCS, Milan, Italy

    Massimo Cartabia

  3. Laboratory of Epidemiology and Social Psychiatry, Istituto di Ricerche Farmacologiche Mario Negri-IRCCS, Milan, Italy

    Paolo Risso & Alberto Parabiaghi

  4. IRCCS Maggiore Hospital Foundation and University of Milan, Department of Clinical Sciences and Community Health, Geriatric Unit, Milan, Italy

    Daniela Mari

  5. Laboratory of Geriatric Neuropsychiatry, Istituto di Ricerche Farmacologiche Mario Negri-IRCCS, Milan, Italy

    Mauro Tettamanti

  6. Regional Health Ministry, Lombardy Region, Milan, Italy

    Ida Fortino, Angela Bortolotti & Luca Merlino

Authors
  1. Carlotta Franchi
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  2. Massimo Cartabia
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  3. Paolo Risso
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  4. Daniela Mari
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  5. Mauro Tettamanti
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  6. Alberto Parabiaghi
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  7. Luca Pasina
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  8. Codjo Djignefa Djade
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  9. Ida Fortino
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  10. Angela Bortolotti
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  11. Luca Merlino
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  12. Alessandro Nobili
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Corresponding author

Correspondence to Carlotta Franchi.

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Franchi, C., Cartabia, M., Risso, P. et al. Geographical differences in the prevalence of chronic polypharmacy in older people: eleven years of the EPIFARM-Elderly Project. Eur J Clin Pharmacol 69, 1477–1483 (2013). https://doi.org/10.1007/s00228-013-1495-7

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  • DOI: https://doi.org/10.1007/s00228-013-1495-7

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