ArticleDrugs & aging2023
Classifying Polypharmacy According to Pharmacotherapeutic and Clinical Risks in Older Adults: A Latent Class Analysis in Quebec, Canada.
Article in Drugs & aging, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Polypharmacy Thresholds that Best Predict Emergency Room Visits and Mortality in Older Adults: A Population-Based Study in Québec, Canada.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026Article
- Latent class patterns of medication attitudes and their correlates among older adults in the United States.BMC geriatrics · 2026Article
- Artificial intelligence-driven risk prediction of polypharmacy in older adults: current advances, clinical applications, and future perspectives.Frontiers in public health · 2026Review
- Polypharmacy's Association With Mortality: Confounding From Underlying Morbidity.Journal of the American Geriatrics Society · 2025Article
- Identifying predictors of medication-related harm in older populations: a latent class analysis approach.Age and ageing · 2025Article
- Identification of the Potential Pharmacotherapeutic Risk in Hospitalized Geriatric Patients.Cureus · 2025Article
- Patterns of pharmacological treatment in patients with atrial fibrillation: an analysis from the prospective GLORIA-AF Registry Phase III.BMC medicine · 2025Article
- Unpacking excessive polypharmacy patterns among individuals living with chronic pain in Quebec: a longitudinal study.Frontiers in pain research (Lausanne, Switzerland) · 2025Article
- Association between number of medications and indicators of potentially inappropriate polypharmacy: a population-based cohort of older adults in Quebec, Canada.Therapeutic advances in drug safety · 2024Article
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Authors and funding
8 authors.
Funding
Abstract
introductionThe simplistic definition of polypharmacy, often designated as the concomitant use of five medications or more, does not distinguish appropriate from inappropriate polypharmacy. Classifying polypharmacy according to varying levels of health risk would help optimise medication use.
objectiveWe aimed to characterise different types of polypharmacy among older adults and evaluate their association with mortality and institutionalisation.
methodsUsing healthcare databases from the Quebec Integrated Chronic Disease Surveillance System, we selected a community-based random sample of the population ≥ 66 years old covered by the public drug plan. Categorical indicators used to describe polypharmacy included number of medications, potentially inappropriate medications (PIMs), drug-drug interactions, enhanced surveillance medications, complex route of administration medications, anticholinergic cognitive burden (ACB) score and use of blister cards. We used a latent class analysis to subdivide participants into distinct groups of polypharmacy. Their association with 3-year mortality and institutionalisation was assessed with adjusted Cox models.
resultsIn total, 93,516 individuals were included. A four-class model was selected with groups described as (1) no polypharmacy (46% of our sample), (2) high-medium number of medications, low risk (33%), (3) medium number of medications, PIM use with or without high ACB score (8%) and (4) hyperpolypharmacy, complex use, high risk (13%). Using the class without polypharmacy as the reference, all polypharmacy classes were associated with 3-year mortality and institutionalisation, with the most complex/inappropriate classes denoting the highest risk (hazard ratio [HR] [95% confidence interval]: class 3, 70-year-old point estimate for mortality 1.52 [1.30-1.78] and institutionalisation 1.86 [1.52-2.29]; class 4, 70-year-old point estimate for mortality 2.74 [2.44-3.08] and institutionalisation 3.11 [2.60-3.70]).
conclusionsWe distinguished three types of polypharmacy with varying pharmacotherapeutic and clinical appropriateness. Our results highlight the value of looking beyond the number of medications to assess polypharmacy.
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