%0 Journal Article
%T Chronic Condition Clusters and Polypharmacy among Adults
%A Ami Vyas
%A Xiaoyun Pan
%A Usha Sambamoorthi
%J International Journal of Family Medicine
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/193168
%X Objective. The primary objective of the study was to estimate the rates of polypharmacy among individuals with multimorbidity defined as chronic condition clusters and examine their associations with polypharmacy. Methods. Cross-sectional analysis of 10,528 individuals of age above 21, with at least one physical condition in cardiometabolic (diabetes or heart disease or hypertension), musculoskeletal (arthritis or osteoporosis), and respiratory (chronic obstructive pulmonary disease (COPD) or asthma) clusters from the 2009 Medical Expenditure Panel Survey. Chi-square tests and logistic regressions were performed to analyze the association between polypharmacy and multimorbidity. Results. Polypharmacy rates varied from a low of 7.2% among those with respiratory cluster to a high of 64.1% among those with all three disease clusters. Among those with two or more disease clusters, the rates varied from 28.3% for musculoskeletal and respiratory clusters to 41.8% for those with cardiometabolic and respiratory clusters. Individual with cardiometabolic conditions alone or in combination with other disease clusters were more likely to have polypharmacy. Compared to those with musculoskeletal and respiratory conditions, those with cardiometabolic and respiratory conditions had 1.68 times higher likelihood of polypharmacy. Conclusions. Rates of polypharmacy differed by specific disease clusters. Individuals with cardiometabolic condition were particularly at high risk of polypharmacy, suggesting greater surveillance for adverse drug interaction in this group. 1. Introduction Care of individuals with multimorbidity defined as the coexistence of two or more chronic conditions is an emerging area of research. Existing studies have reported negative effects of multimorbidity on a variety of health outcomes such as disability, functional status, health-related quality of life, healthcare expenditures, and survival [1¨C12]. Multimorbidity is also associated with healthcare utilization specifically an increased number of hospital admissions [11] and prescription medications among individuals with multiple chronic conditions [13, 14]. In a US study of the elderly, it was found that an overwhelming majority (73%) with three or more chronic conditions were using 5 or more prescription drugs [15]. In an Australian study of multimorbidity across all age groups, it was reported that those with multimorbidity were 7 times to 22 times as likely to use four or more prescription medications as those without multimorbidity [13]. Multiple medications use often results in harmful
%U http://www.hindawi.com/journals/ijfm/2012/193168/