La polypharmacie chez les adultes québécois de moins de 65 ans assurés par le régime public d'assurance-médicaments du Québec (RPAM) : description et analyse

Authors: Diendéré, Relwendé Joël Désiré
Advisor: Sirois, Caroline; Jean, Sonia
Abstract: Polypharmacy, or the simultaneous use of several medications by the same person, is a growing situation around the world. It can lead to many negative health consequences. Given the lack of information in individuals under 65 years of age, this study was conducted to estimate the polypharmacy prevalence and to identify its associated factors in the adult population aged 18 to 64 covered by the public drug insurance plan in Quebec in 2017-2018 (fiscal year 2017). We conducted a descriptive cohort study over fiscal year 2017 with data from the Quebec Integrated Chronic Disease Surveillance System. All adults aged 18 to 64 years, covered by the public drug insurance plan for the entire year, were included. We estimated the prevalence of polypharmacy, which was defined as the use of five or more different medications in the studied year. Sociodemographic and clinical factors associated with polypharmacy were identified using robust Poisson regression models. Results were presented with 99% confidence intervals. Out of 1 597 627 individuals included, 498 220 (31.2%) were exposed to polypharmacy. In the multivariate model, factors associated with polypharmacy included: older age (e.g., 60-64 vs 18-29 years: Relative risk (RR) = 2.25 [99%CI: 2.23-2.27]), female sex (RR = 1.18 [1.17-1.18]), multimorbidity (e.g., multimorbidity score 2 vs 0: RR = 1.49 [1.48-1.18]), and high health care utilisation in the year of analysis and the previous year (e.g., 5 visits to general practitioner vs. 0 visits: RR = 2.85 [2.83-2.88]; 5 specialist visits vs. 0 visit: RR = 2.24 [2.22-2.25]). Nearly one-third of adults under age 65 covered by the public drug insurance plan in Quebec in 2017 were exposed to polypharmacy. To ensure better control of inappropriate polypharmacy with aging, optimizing medication at the onset of chronic diseases is needed.
Document Type: Mémoire de maîtrise
Issue Date: 2021
Open Access Date: 20 September 2021
Permalink: http://hdl.handle.net/20.500.11794/70392
Grantor: Université Laval
Collection:Thèses et mémoires

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