• Korean Journal of Clinical Pharmacy
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• v.25 no.3
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• pp.159-165
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• 2015

Objective: Polypharmacy is one of the main causes of inappropriate medication use, adverse drug-related events and cost. It aimed to investigate the status of polypharmacy and potentially inappropriate medication (PIM), the factors affecting polypharmacy and cost in elderly outpatients. Method: A pharmacy claim data were retrospectively analyzed with elderly patients prescriptions at a pharmacy located near a top tier general hospital. The numbers of medications per person, prevalence of polypharmacy and PIM according to the 2012 Beers criteria and Korea PIM list, medication cost and the factors affecting polypharmacy were investigated. Results: Forty-six percentages of the elderly outpatients received polypharmacy and over 21% of them had medications listed in Beers or Korean PIM. In multiregressional analysis, we found that age, gender and insurance types were affective factors of polypharmacy. (p < 0.001, 0.047, 0.009, respectively). The cost of polypharmacy with PIM in elderly outpatients was increased with age. Various approaches of interventions would be further required.

• The Korean Journal of Health Service Management
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• v.7 no.3
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• pp.237-249
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• 2013

This study was done to investigate status of polypharmacy and inappropriate medications use of the elderly of in nursing homes. The subjects of this study were 270 elderly people in the nursing homes of G city and K city, In this study, the medications were classified by Anatomical Therapeutic Chemical (ATC) code, polypharmacy was defined as taking medications more than five, and inappropriate medications use were identified by Beers criteria. Data was analyzed by using descriptive statistics, t-test and one-way ANOVA. Total number of drug types in this study was the average $6.1{\pm}2.6$. The subjects with polypharmacy were 193(71.5%), and with inappropriate medications use were 138(51.1%). There was a significant difference in the polypharmacy according to the number of diseases(p<.001) and in the inappropriate medications use according to age(p=.018). Baesd on this study, polypharmacy and inappropriate medications use of elderly people were main problems that need to carefully assess for safe and correct medication usage in nursing home. Therefore, an ongoing medication monitoring system is necessary to minimize the adverse drug reactions of elderly.

• Journal of Korean Biological Nursing Science
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• v.24 no.3
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• pp.161-170
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• 2022

Purpose: The purpose of this study was to investigate polypharmacy and potentially inappropriate medication (PIM) use in elderly patients admitted to hospitals after falls. Methods: The study surveyed 283 patients 65 or older admitted January 1-December 31, 2016. Data were collected from electronic medical records, and medications administered immediately prior to admission were examined. PIM use for patients was investigated using the Beers criteria, and data were analyzed by Chi-square test and independent ttest. Results: The average age of participants was 79.42± 8.16, and the study included 226 women (79.9%) and 57 men (20.1%). The average number of self-administered medications daily was 4.94± 3.68, and 55.1% took five or more medications. PIM use was found in 107 patients (37.8%). There was a significant difference in polypharmacy according to age, and the proportion of medical aid beneficiaries and prevalence of cardiocerebrovascular, endocrine, and other chronic diseases were higher in the polypharmacy and PIM use patients than in the non-polypharmacy and non-PIM use patients. The number of chronic diseases and medications taken were significantly high among polypharmacy and PIM use patients. Conclusion: It is necessary to minimize polypharmacy and PIM use, and establish a system for systematically evaluating and managing medication use to prevent falls in the elderly.

• Korean Journal of Adult Nursing
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• v.23 no.6
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• pp.554-563
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• 2011

Purpose: The purpose of this study was to investigate factors associated with drug misuse behaviors among polypharmacy elderly. Methods: This was a cross-sectional survey. Participants consisted of 116 polypharmacy elderly who were taking 5 or more medications each day. Data were collected via face to face interviews. Data were analyzed using the PASW 18.0 program. Data concerning predisposing factor (knowledge, benefit), enabling factor (communication with health care provider), and need factor (perceived health status, number of disease) were collected. Results: The total mean score of drug misuse behaviors among polypharmacy elderly was 3.04 out of 10 points. Communication with health care provider, perceived health status, and knowledge were found to be significantly correlated with drug misuse behaviors. In stepwise multiple regression analysis, a total of 42% of the variance in drug misuse behaviors was accounted for communication with health care provider, perceived health status, and knowledge. Conclusion: Therefore, education program for improving communication with health care provider, and knowledge should be designed and provided for polypharmacy elderly.

• Korean Journal of Clinical Pharmacy
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• v.28 no.1
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• pp.1-9
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• 2018

Polypharmacy is increasing owing to an increase in the elderly population and multimorbidities associated with the increased risk of administration of potentially inappropriate medications (PIMs). The negative effects of polypharmacy on various health conditions and aspects, such as fall, fracture, mortality, cognitive function, and dementia, have been reported. The management of excess and inappropriate polypharmacy through proper interventions and local or national guidelines has been highlighted. The purpose of polypharmacy management is to appropriately prescribe medicines that are essential to treat diseases in patients and to avoid inappropriate polypharmacy, such as interactive or duplicate medicines under prescription and PIMs for specific diseases. Community pharmacists in Australia, the EU, USA, and Japan are collaborating with prescribers to review medications to ensure that the patients can be prescribed appropriate medications. The service cost is reimbursed by public or private insurers. A study in the United States has shown that even with medication review costs, the overall medication cost has reduced. In Korea, various projects such as Drug Utilization Review service and safe use of medicines have been conducted; however, no national guidelines or management measures have been established. It is necessary to implement a national long-term plan on polypharmacy management. Furthermore, a phased implementation plan is required. Shortly, active medication review services and education programs for healthcare professionals with the support of the government should be considered in Korea with reference to other countries in order to raise awareness of seriousness and risks of inappropriate polypharmacy.

• Korean Journal of Health Education and Promotion
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• v.17 no.1
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• pp.81-93
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• 2000

This study is intended to investigate medication compliance and polypharmacy of the diabetic patients by age group in order to determine the major factors that influence their compliance. 198 ambulatory diabetic patients were interviewed, and the sample was divided into three groups based on the age: Young age group under 55, Borderline age group between 55 - 65, Old age group over 65. According to the study results, medication compliance for the old age group was 72.6% whereas 85.1% for the young age group. Medication compliance significantly decreased as the age of the patients increased. Also the degree of polypharmacy, the rate which patients take more than 6 prescription drugs, was 45.9% for the old group, whereas 31.2% for the young group. As the most important factor of polypharmacy, the number of doctors was statistically significant. With regard to prescription factors related to medication compliance, the amount of prescribed medication is statistically significant between the compliance group and non-compliance group. In addition, the amount of information provided to patients by pharmacists was determined to be a very significant factor. Also the level of ease in understanding the medication instructions varied significantly between the compliance group and the non-compliance group. In light of the empirical data and results for the diabetic patients, it is necessary to develop and implement various programs to improve medication compliance and to decrease the level of polypharmacy among the elderly, or "old", diabetic patients. patients.

• Korean Journal of Schizophrenia Research
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• v.24 no.1
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• pp.36-43
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• 2021

Objectives: Despite the high discontinuation rate of clozapine in refractory schizophrenia, there is limited evidence regarding the suggested treatment after clozapine discontinuation. Methods: The medical records of 37 patients who discontinued clozapine were retrospectively reviewed. The prescription patterns of antipsychotics, mood stabilizers, and antidepressants were compared at three points before and after clozapine treatment and at the most recent visit. Results: After clozapine discontinuation, 75.6% of the subjects were receiving antipsychotic polypharmacy, and 32.4% were taking more than 3 antipsychotics. The frequently used antipsychotics were olanzapine (21.5%), quetiapine (21.5%), and paliperidone (12.7%). The rates of augmentation with mood stabilizers and antidepressants were 43.2% and 29.7%, respectively. Furthermore, valproate was the most commonly used mood stabilizer (87.5%). Conclusion: Antipsychotic polypharmacy and augmentation are inevitable in schizophrenia patients for whom clozapine has been discontinued. Further research is required to improve the outcomes of polypharmacy and augmentation in schizophrenia patients.

• The Journal of the Korea Contents Association
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• v.19 no.12
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• pp.398-406
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• 2019

This study was conducted to examine the medication non-adherence and related factors based on medication adherence model of older adults that use polypharmacy. A survey was used to collect data from 190 study participants. Among the 190 subjects, 43.2% did not adhere to their polypharmacy intentionally. The reason for medication non-adherence was listed in order of 'when they felt well on symptoms', 'when it was annoying and uncomfortable', and 'when they felt worse due to medication'. Moreover, the older adults often do not seek for medication information actively. Between adherence and non-adherence groups, while there were differences in gender, type of medication, and experience in drug-related side effects, there were no statistically significant differences in medication information contents and route. This study demonstrates that gender, type of medication, and experience in drug-related side effects should be considered to promote medication adherence. In addition, since the elderly with polypharmacy are rarely actively searching for the contents and route of drug information, the contents of drug information need to be provided by the route preferred by the elderly in order to assist in their decision-making process for polypharmacy.

• International journal of advanced smart convergence
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• v.10 no.4
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• pp.206-214
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• 2021

The purpose of this study is to identify the level of polypharmacy use, drug knowledge, and drug misuse behavior in the elderly, and to understand the correlation between them and their effect on drug misuse behavior. The study design was a descriptive survey study, and the participants of the study were 215 elderly people from the local community center. The research tool used drug knowledge, drug misuse behavior, and the data collection period was from February 8 to 19, 2021. The data analysis were descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficient, and regression analysis. As a result of the study, a significant correlation variable for the drug knowledge of the elderly showed a significant correlation with prescription and non-prescription, r=.145 (p<0.05), and r=.-. 136, which showed a negative significant correlation (p<0.05). As for the significant correlation variable in the drug misuse behavior of the elderly, when prescription and non-prescription were combined, there was a significant correlation with r=.256 (p<0.01), and when not using drugs, r=.-.225 was negative. showed a significant correlation (p<0.01). In terms of the effect on drug misuse behavior, chronic disease =.145, prescription and non-prescription use = .233, which had a positive effect, and non-prescription = -.328, indicating a negative and significant effect. The provision of education on the safe use of drugs by the elderly should first be provided in the community. In addition, we need systematic education and social support for the transmission of correct knowledge on multi-drug use by the elderly and for health management.

• Korean Journal of Schizophrenia Research
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• v.22 no.1
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• pp.1-7
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• 2019

Objectives: Clozapine is the drug of choice in treatment-resistant schizophrenia. However, its use is often delayed and a significant proportion of clozapine treated patients fails to respond and experience potentially dangerous side-effects. The aim of this retrospective study was to describe the clinical characteristics of patients started on clozapine and the rate and reason of discontinuation of clozapine. Methods: Medical records of 83 patients started on clozapine during the period of 2012-2016 were reviewed. Results: Clozapine started on patients in chronic phase; the mean age of start was 38.1 years old and the mean number of psychiatric admission was 6.5. A majority (80.7%) of the patients had been subjected to antipsychotic polypharmacy prior to clozapine and most (61.5%) of them were being treated with polypharmacy including clozapine. Overall, 39 (47.0%) subjects had continued clozapine whereas 15 (18.1%) discontinued it; 29 (34.9%) were lost to follow-up. The most common reason for discontinuation was side-effects (n=13) including six life-threatening cases, most of which occurred within 6 months of its start. Conclusion: This study demonstrated that there is some evidence of delays to clozapine use, high rates of polypharmacy and significant rate of discontinuation during the early phase of clozapine treatment.