title: Prevalence and predictors of polypharmacy among Korean elderly.
abstract: OBJECTIVE
  Polypharmacy is widespread in the elderly because of their multiple chronic health problems. The objective of this study was to investigate the prevalence and predictors associated with polypharmacy in a nationally representative sample of Korean elderly individuals.
  
  
  METHODS
  We used the Korea Health Insurance Review and Assessment Service - National Patient Sample (HIRA-NPS) data from 2010 and 2011. We used information on 319,185 elderly patients (aged 65 years or older) between January 1, 2010 and December 31, 2011 from the HIRA-NPS database. We defined 'polypharmacy' as the concurrent use of 6 medications or more per person, 'major polypharmacy' as 11 medications or more, and 'excessive polypharmacy' as 21 medications or more. The frequency and proportion (%) and their 95% confidence intervals were presented according to the polypharmacy definition. Polypharmacy was visualized by the Quantum Geographic Information Systems (QGIS) program to describe regional differences in patterns of drug use. Multivariate ordinal logistic regression was performed to estimate odds ratios (ORs) and their 95% confidence intervals (CI) to investigate the risk factors for polypharmacy.
  
  
  RESULTS
  Of the Korean elderly studied, 86.4% had polypharmacy, 44.9% had major polypharmacy and 3.0% had excessive polypharmacy. Polypharmacy was found to be primarily concentrated in the Southwest region of the country. Significant associations between polypharmacy and the lower-income Medical Aid population (OR = 1.52, 95% CI 1.47, 1.56) compared with National Health Insurance patients was observed.
  
  
  CONCLUSIONS
  Nationwide efforts are needed for managing polypharmacy among Korean elderly patients. In particular, a national campaign and education to promote appropriate use of medicines for the Medical Aid population is needed.
authors.affiliation: Korea Institute of Drug Safety and Risk Management (KIDS), Seoul, Korea.
authors.forename: Hong-Ah
authors.initials: HA
authors.lastname: Kim
authors.affiliation: Korea Institute of Drug Safety and Risk Management (KIDS), Seoul, Korea.
authors.forename: Ju-Young
authors.initials: JY
authors.lastname: Shin
authors.affiliation: Korea Institute of Drug Safety and Risk Management (KIDS), Seoul, Korea.
authors.forename: Mi-Hee
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Korea Institute of Drug Safety and Risk Management (KIDS), Seoul, Korea; Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Korea.
authors.forename: Byung-Joo
authors.initials: BJ
authors.lastname: Park
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D004364:Pharmaceutical Preparations; D019338:Polypharmacy; D015995:Prevalence; D056910:Republic of Korea
chemical_list: D004364:Pharmaceutical Preparations