ArticleBMC health services research2020
Number of consulting medical institutions and risk of polypharmacy in community-dwelling older people under a healthcare system with free access: a cross-sectional study in Japan.
Article in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 20 citations in OpenAlex.
- Evaluation of polypharmacy and potentially inappropriate medication use among geriatric individuals aged 80 years and older.BMC geriatrics · 2026Article
- Community-level social capital and polypharmacy among public assistance recipients in Japan: A multilevel cross-sectional study.SSM - population health · 2025Article
- Factors associated with assertiveness among Japanese community pharmacists: a cross-sectional study.Journal of pharmaceutical health care and sciences · 2025Article
- Development of a Japanese version of the patient perceptions of deprescribing - Short form.Journal of general and family medicine · 2025Article
- Correlation between Phase Angle and the Number of Medications in Older Inpatients: A Cross-Sectional Study.Annals of geriatric medicine and research · 2024Article
- Polypharmacy and potentially inappropriate medications in older adults who use long-term care services: a cross-sectional study.BMC geriatrics · 2024Article
- Measurement of polydoctoring as a crucial component of fragmentation of care among patients with multimorbidity: Cross-sectional study in Japan.Journal of general and family medicine · 2023Article
- Factors related to Japanese internal medicine doctors' retention or migration to rural areas: a nationwide retrospective cohort study.Environmental health and preventive medicine · 2023Article
- Association between smoking habits and dental care utilization and cost using administrative claims database and specific medical check-up data.BMC oral health · 2022Article
- A narrative review of evidence to guide deprescribing among older adults.Journal of general and family medicine · 2021Review
- Association of Self-Reported Medication Adherence with Potentially Inappropriate Medications in Elderly Patients: A Cross-Sectional Pilot Study.International journal of environmental research and public health · 2020Article
- The Integration of Traditional Medicine with Conventional Biomedicine: A Narrative Review of the Japanese Perspective.Journal of integrative and complementary medicineReview
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundUnder the Japanese free access healthcare system, patients are allowed to consult multiple medical institutions (including clinics and hospitals for general or specialist consultation) without primary care referral. This potentially increases the risk of polypharmacy. We examined the association between the number of consulting medical institutions and polypharmacy under a healthcare system with free access.
methodsVia a self-administered questionnaire, we identified people aged ≥65 years with ≥1 disease and ≥1 consulting medical institution in a Japanese city in 2016. The exposure of interest was the number of consulting medical institutions (1, 2, or ≥3) and the outcome was polypharmacy (use of ≥6 types of drugs). We performed a multivariate logistic regression analysis, adjusting for age, sex, household economy, and the number and type of comorbidities. To minimize confounding effects, we also performed propensity-score-matched analysis, categorizing patients into two groups: 1 and ≥2 consulting medical institutions.
resultsOf 993 eligible individuals (mean (standard deviation) age: 75.1 (6.5) years, men: 52.6%), 15.7% (156/993) showed polypharmacy. Proportions of polypharmacy were 9.7% (50/516), 16.6% (55/332), and 35.2% (51/145) for people who consulted 1, 2, and ≥3 medical institutions, respectively. Relative to people who consulted 1 medical institution, adjusted odds ratios (95% confidence intervals) for polypharmacy were 1.50 (0.94-2.37) and 3.34 (1.98-5.65) for those who consulted 2 and ≥3 medical institutions, respectively. In propensity score matching, of 516 and 477 patients who consulted 1 and ≥2 medical institutions, 307 pairs were generated. The proportion of polypharmacy was 10.8% (33/307) and 17.3% (53/307), respectively (P = 0.020). The odds ratio for polypharmacy (≥2 vs. 1 consulting medical institution) was 1.73 (95% confidence interval 1.09-2.76).
conclusionsPatients who consulted more medical institutions were more likely to show polypharmacy. The results could encourage physicians and pharmacists to collect medication information more actively and conduct appropriate medication reviews. Strengthening primary care is needed to address the polypharmacy issue, especially in countries with healthcare systems with free access.
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