POLPHARMACY AMONG GERIATRIC PATIENTS IN ASEAN COUNTRIES: A COMPARATIVE REVIEW

Abstract

Geriatric patients often face a variety of health conditions that can affect their overall quality of life with the elderly being more susceptible to common chronic conditions such as cardiovascular disease, osteoporosis, osteoarthritis, dementia, and others. This in turn, makes geriatric patients more likely to receive polypharmacy. Polypharmacy is the regular use of five or more medications. Polypharmacy raises concern due to multiple factors. It increases the likelihood of drug-to-drug interactions and adverse drug reactions which is an increased risk due to geriatric patients’ reduced drug clearance and metabolic changes. Polypharmacy also increases the likelihood of non-adherence and poor medication compliance. It affects quality of life and incurs additional drug expenses. This article reviews studies regarding polypharmacy among geriatric patients among countries in The Association of Southeast Asian Nations (ASEAN). The Southeast Asian countries this review focuses on are in particular: Malaysia, Vietnam, Indonesia, Singapore, Philippines, and Thailand. The review found that polypharmacy was found to be prevalent in all aforementioned countries. The studies show that polypharmacy is associated with an increase in age, increase in number of chronic diseases or comorbidities. Multiple studies also pointed out associations between polypharmacy, unnecessary drug therapy, potentially inappropriate medications (PIMs) and adverse drug reactions (ADRs). Another recurring theme throughout the different studies in the different countries is the effect of polypharmacy on medication adherence, with polypharmacy decreasing adherence, and health-related quality of life (HRQoL). Moreover, as the negative consequences of polypharmacy become more apparent, there are emerging studies that show doctors and pharmacists moving towards deprescribing medications, a trend found more common in senior doctors than junior doctors.