Evidence map›Paper›PMID 40840984›Full record

Observational studyBMJ open2025

Medication use patterns and polypharmacy among elderly in Iran: a cross-sectional study using national health insurance claims data.

Seyed Mohammad-Navid Ataei, Ali Golestani, Sepehr Khosravi, Ozra Tabatabaei-Malazy, Mohammad-Reza Malekpour, Mahbube Ebrahimpur, Fatemeh Sadat Mirzadeh, Zahra Shahali, Mohammad Reza Amini, Mohammad Effatpanah

Abstract readObservational Study
In one paragraph

Observational study in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Observational
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Seyed Mohammad-Navid AtaeiNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of).ORCID http://orcid.org/0009-0006-6463-4784
Ali GolestaniNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of).
Sepehr KhosraviNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of).
Ozra Tabatabaei-MalazyEndocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of).ORCID http://orcid.org/0000-0003-0188-9721
Mohammad-Reza MalekpourNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of).
Mahbube EbrahimpurElderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of).
Fatemeh Sadat MirzadehClinical Gerontology & Geriatric Department, Medical School, Tehran University of Medical Sciences, Ziaeian Hospital, Tehran, Iran (the Islamic Republic of).
Zahra ShahaliNational Center for Health Insurance Research, Tehran, Iran (the Islamic Republic of).
Mohammad Reza AminiDiabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of) mramini@tums.ac.ir m.effatpanah@gmail.com.
Mohammad EffatpanahNational Center for Health Insurance Research, Tehran, Iran (the Islamic Republic of) mramini@tums.ac.ir m.effatpanah@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesPolypharmacy, defined as the concurrent use of multiple medications, is a growing concern among the elderly, especially in low-income and middle-income countries such as Iran. This study aims to explore the prevalence and patterns of polypharmacy among the elderly in Iran, using health insurance claims data to identify common drug classes and coprescribed medications, with a focus on informing policy decisions and improving medication management.

designRetrospective population-based observational study.

settingNationwide data from the Iran Health Insurance Organization (IHIO) across 24 provinces.

participants1 876 527 individuals aged 65 years and older, insured by the IHIO from 2014 to 2017. Individuals with incomplete demographic information or lacking medication records in the database were excluded from the analysis. PRIMARY AND SECONDARY OUTCOME MEASURES: Prevalence and patterns of polypharmacy, demographic factors associated with polypharmacy, and common drug classes used. Medications were classified using the Anatomical Therapeutic Chemical system. Polypharmacy was defined as the use of five or more medications, with cumulative polypharmacy considering total drug use over time, and consecutive polypharmacy focusing on the frequency of monthly drug use. Logistic regression and association rule mining were applied to explore demographic factors and medication patterns associated with polypharmacy.

resultsOf the study population, 74.9% experienced cumulative polypharmacy over 6 months and 64.6% over 1 month, with 7.6% experiencing consecutive polypharmacy. Females and those aged 75-79 were more prone to polypharmacy. Systemic glucocorticoids were the most commonly used medications (50.02%), followed by HMG-CoA reductase inhibitors (42.73%) and platelet aggregation inhibitors (41.92%). Polypharmacy was most strongly associated with medications related to the alimentary tract and metabolism, cardiovascular system, nervous system and blood and blood-forming organs.

conclusionsPolypharmacy is highly prevalent among the elderly in Iran, with significant variations by gender, age, insurance fund and region. The findings highlight the need for targeted interventions to manage polypharmacy and improve medication safety in this population.

Indexed as

PolypharmacyAgedAged, 80 and overCross-Sectional StudiesFemaleHumansIranMaleNational Health ProgramsPrevalenceRetrospective StudiesAgedPolypharmacyPrescriptionsPrevalence

Identifiers

PMID40840984
PMCPMC12374635

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.