NDLI: Number of consulting medical institutions and risk of polypharmacy in community-dwelling older people under a healthcare system with free access: a cross-sectional study in Japan

Content Provider	Springer Nature : BioMed Central
Author	Suzuki, Toshiki Iwagami, Masao Hamada, Shota Matsuda, Tomoyuki Tamiya, Nanako
Abstract	Background Under the Japanese free access healthcare system, patients are allowed to consult multiple medical institutions (including clinics and hospitals for general or specialist consultation) without primary care referral. This potentially increases the risk of polypharmacy. We examined the association between the number of consulting medical institutions and polypharmacy under a healthcare system with free access. Methods Via a self-administered questionnaire, we identified people aged ≥65 years with ≥1 disease and ≥1 consulting medical institution in a Japanese city in 2016. The exposure of interest was the number of consulting medical institutions (1, 2, or ≥3) and the outcome was polypharmacy (use of ≥6 types of drugs). We performed a multivariate logistic regression analysis, adjusting for age, sex, household economy, and the number and type of comorbidities. To minimize confounding effects, we also performed propensity-score-matched analysis, categorizing patients into two groups: 1 and ≥2 consulting medical institutions. Results Of 993 eligible individuals (mean (standard deviation) age: 75.1 (6.5) years, men: 52.6%), 15.7% (156/993) showed polypharmacy. Proportions of polypharmacy were 9.7% (50/516), 16.6% (55/332), and 35.2% (51/145) for people who consulted 1, 2, and ≥3 medical institutions, respectively. Relative to people who consulted 1 medical institution, adjusted odds ratios (95% confidence intervals) for polypharmacy were 1.50 (0.94–2.37) and 3.34 (1.98–5.65) for those who consulted 2 and ≥3 medical institutions, respectively. In propensity score matching, of 516 and 477 patients who consulted 1 and ≥2 medical institutions, 307 pairs were generated. The proportion of polypharmacy was 10.8% (33/307) and 17.3% (53/307), respectively (P = 0.020). The odds ratio for polypharmacy (≥2 vs. 1 consulting medical institution) was 1.73 (95% confidence interval 1.09–2.76). Conclusions Patients who consulted more medical institutions were more likely to show polypharmacy. The results could encourage physicians and pharmacists to collect medication information more actively and conduct appropriate medication reviews. Strengthening primary care is needed to address the polypharmacy issue, especially in countries with healthcare systems with free access.
Related Links	https://bmchealthservres.biomedcentral.com/counter/pdf/10.1186/s12913-020-05205-6.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	14726963
DOI	10.1186/s12913-020-05205-6
Journal	BMC Health Services Research
Issue Number	1
Volume Number	20
Language	English
Publisher	BioMed Central
Publisher Date	2020-04-26
Access Restriction	Open
Subject Keyword	Public Health Health Administration Health Informatics Nursing Research Free access Multiple consultations Number of consulting medical institutions Polypharmacy
Content Type	Text
Resource Type	Article
Subject	Health Policy

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

Polypharmacy and Potential Drug–Drug Interactions in Home-Dwelling Older People – A Cross-Sectional Study

Polypharmacy and Potential Drug–Drug Interactions in Home-Dwelling Older People – A Cross-Sectional Study

Determinants of the intention to use e-Health by community dwelling older people

Factors associated with willingness to receive a novel community care service for older people in Foshan, China: a cross-sectional study

Evidence of association between the use of drugs and community-dwelling older people frailty: a cross-sectional study

Falls prevention interventions for community-dwelling older people living in mainland China: a narrative systematic review

Understanding reasons and determinants of medication non-adherence in community-dwelling adults: a cross-sectional study comparing young and older age groups

Risk assessment for oral urgent treatment in Primary Healthcare: a cross-sectional study

Claims data analysis of medical specialist utilization among nursing home residents and community-dwelling older people

Number of consulting medical institutions and risk of polypharmacy in community-dwelling older people under a healthcare system with free access: a cross-sectional study in Japan

Similar Documents

Polypharmacy and Potential Drug–Drug Interactions in Home-Dwelling Older People – A Cross-Sectional Study

Polypharmacy and Potential Drug–Drug Interactions in Home-Dwelling Older People – A Cross-Sectional Study

Determinants of the intention to use e-Health by community dwelling older people

Factors associated with willingness to receive a novel community care service for older people in Foshan, China: a cross-sectional study

Evidence of association between the use of drugs and community-dwelling older people frailty: a cross-sectional study

Falls prevention interventions for community-dwelling older people living in mainland China: a narrative systematic review

Understanding reasons and determinants of medication non-adherence in community-dwelling adults: a cross-sectional study comparing young and older age groups

Risk assessment for oral urgent treatment in Primary Healthcare: a cross-sectional study

Claims data analysis of medical specialist utilization among nursing home residents and community-dwelling older people

Number of consulting medical institutions and risk of polypharmacy in community-dwelling older people under a healthcare system with free access: a cross-sectional study in Japan