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Association of polypharmacy and hyperpolypharmacy with frailty states: a systematic review and meta-analysis
journal contribution
posted on 2023-06-09, 16:05 authored by Katie Palmer, Emanuele R Villani, Davide L Vetrano, Antonio Cherubini, Alfonso Cruz-Jentoft, Denis Curtin, Michael Denkinger, Marta Gutiérrez-Valencia, Adalsteinn Guðmundsson, Wilma Knol, Diane V Mak, Denis O'Mahony, Farhad Pazan, Mirko Petrovic, Chakravarthi RajkumarChakravarthi Rajkumar, Eva Topinkova, Catarina Trevisan, Tischa J M van der Cammen, Rob J Marum, Martin Wehling, Gilsbertus Ziere, Roberto Bernabel, Graziano Onder, European Geriatric Medicine Society Pharmacology special intere, otherersPurpose To investigate: (1) the cross-sectional association between polypharmacy, hyperpolypharmacy and presence of prefrailty or frailty; (2) the risk of incident prefrailty or frailty in persons with polypharmacy, and vice versa. Methods A systematic review and meta-analysis was performed according to PRISMA guidelines. We searched PubMed, Web of Science, and Embase from 01/01/1998 to 5/2/2018. Pooled estimates were obtained through random efect models and Mantel–Haenszel weighting. Homogeneity was assessed with the I 2 statistic and publication bias with Egger’s and Begg’s tests. Results Thirty-seven studies were included. The pooled proportion of polypharmacy in persons with prefrailty and frailty was 47% (95% CI 33–61) and 59% (95% CI 42–76), respectively. Increased odds ratio of polypharmacy were seen for prefrail (pooled OR=1.52; 95% CI 1.32–1.79) and frail persons (pooled OR=2.62, 95% CI 1.81–3.79). Hyperpolypharmacy was also increased in prefrail (OR=1.95; 95% CI 1.41–2.70) and frail (OR=6.57; 95% CI 9.57–10.48) persons compared to robust persons. Only seven longitudinal studies reported data on the risk of either incident prefrailty or frailty in persons with baseline polypharmacy. A signifcant higher odds of developing prefrailty was found in robust persons with polypharmacy (pooled OR=1.30; 95% CI 1.12–1.51). We found no papers investigating polypharmacy incidence in persons with prefrailty/frailty. Conclusions Polypharmacy is common in prefrail and frail persons, and these individuals are also more likely to be on extreme drug regimens, i.e. hyperpolypharmacy, than robust older persons. More research is needed to investigate the causal relationship between polypharmacy and frailty syndromes, thereby identifying ways to jointly reduce drug burden and prefrailty/frailty in these individuals.
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Publication status
- Published
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- Published version
Journal
European Geriatric MedicineISSN
1878-7649Publisher
SpringerExternal DOI
Issue
1Volume
10Page range
9-36Department affiliated with
- BSMS Publications
Full text available
- No
Peer reviewed?
- Yes
Legacy Posted Date
2018-11-29First Compliant Deposit (FCD) Date
2018-11-28Usage metrics
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