Journal
MULTIPLE SCLEROSIS JOURNAL
Volume 29, Issue 1, Pages 107-118Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/13524585221122207
Keywords
MS; polypharmacy; population-based data; pharmacoepidemiology; prescription medication use
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This study estimated the prevalence of polypharmacy in individuals with multiple sclerosis (MS) and compared the characteristics of those with and without polypharmacy. The results showed that more than one in four MS patients met the criteria for polypharmacy. The likelihood of polypharmacy was higher in women, older individuals, those with multiple comorbidities, and lower socioeconomic status.
Background: Little is known about polypharmacy and multiple sclerosis (MS). Objectives: To estimate polypharmacy prevalence in a population-based MS cohort and compare persons with/without polypharmacy. Methods: Using administrative and pharmacy data from Canada, we estimated polypharmacy prevalence (> 5 concurrent medications for >30 consecutive days) in MS individuals in 2017. We compared the characteristics of persons with/without polypharmacy and described the number of polypharmacy days, the most common medication classes contributing to polypharmacy and hyper-polypharmacy prevalence (> 10 medications). Results: Of 14,227 included individuals (75% women), mean age = 55.4 (standard deviation (SD): 13.2) years; 28% (n = 3995) met criteria for polypharmacy (median polypharmacy days = 273 (interquartile range (IQR): 120-345)). Odds of polypharmacy were higher for women (adjusted odds ratio (aOR) = 1.14; 95% confidence intervals (CI):1.04-1.25), older individuals (aORs 50-64 years = 2.04; 95% CI:1.84-2.26; > 65 years = 3.26; 95% CI: 2.92-3.63 vs. <50 years), those with more comorbidities (e.g. > 3 vs. none, aOR = 6.03; 95% CI: 5.05-7.22) and lower socioeconomic status (SES) (e.g. most (SES-Q1) vs. least deprived (SES-Q5) aOR = 1.64; 95% CI: 1.44-1.86). Medication classes most commonly contributing to polypharmacy were as follows: antidepressants (66% of polypharmacy days), antiepileptics (47%), and peptic ulcer drugs (41%). Antidepressants were most frequently co-prescribed with antiepileptics (34% of polypharmacy days) and peptic ulcer drugs (27%). Five percent of persons (716/14,227) experienced hyper-polypharmacy. Conclusion: More than one in four MS persons met criteria for polypharmacy. The odds of polypharmacy were higher for women, older persons, and those with more comorbidities, but lower SES.
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