PT  - JOURNAL ARTICLE
AU  - Maria Filkova
AU  - João Carvalho
AU  - Sam Norton
AU  - David Scott
AU  - Tim Mant
AU  - Mariam Molokhia
AU  - Andrew Cope
AU  - James Galloway
TI  - Polypharmacy and Unplanned Hospitalizations in Patients with Rheumatoid Arthritis
AID  - 10.3899/jrheum.160818
DP  - 2017 Dec 01
TA  - The Journal of Rheumatology
PG  - 1786--1793
VI  - 44
IP  - 12
4099  - http://www.jrheum.org/content/44/12/1786.short
4100  - http://www.jrheum.org/content/44/12/1786.full
SO  - J Rheumatol2017 Dec 01; 44
AB  - Objective. Polypharmacy (PP), the prescribing of multiple drugs for an individual, is rising in prevalence. PP associates with an increased risk of adverse drug reactions (ADR) and hospital admissions. We investigated the relationship between PP, characteristics of rheumatoid arthritis (RA), and the risk of unplanned hospital admissions.Methods. Patients from a hospital RA cohort were retrospectively analyzed. Information was collected from electronic medical records. Cox proportional hazards were used to compare hospitalization risk according to levels of PP. Admissions were adjudicated to determine whether an ADR was implicated.Results. The study included 1101 patients; the mean number of all medications was 5. PP correlated with increasing age, disease duration, disease activity, and disability. At least 1 unplanned admission occurred for 16% of patients. Patients taking ≥ 10 medications had an adjusted HR for hospitalization of 3.1 (95% CI 2.1–4.5), compared to those taking 0–5 medications. Corticosteroid use associated with a doubling in adjusted risk of admission of 1.7 (95% CI 1.2–2.4). The most common reason for hospitalization was infection (28%). While in half of all admissions an ADR was a possible contributing factor, only 2% of admissions were found to directly result from an ADR.Conclusion. PP is common in RA and is a prognostic marker associated with increased risk of acute hospitalizations. Our data suggest that PP may be an indicator of comorbidity burden rather than a contributing cause of a drug-related toxicity. PP should be monitored to minimize inappropriate combination of prescribed medications. PP may be a useful predictor of clinical outcomes in epidemiologic studies.