Introduction
The most widely recognised definition of polypharmacy or
‘polypharmacotherapy’ is the use of 5 or more
medications.1,2 The high prevalence of
polypharmacotherapy is a consequence of the increasing rate of
multimorbidity in the ageing population worldwide. In the United
Kingdom, up to one third of 69-year-olds are prescribed
polypharmacotherapy.3 Polypharmacotherapy is
associated with several negative outcomes, including adverse drug
effects, non-adherence, and functional decline.4,5
The risk of hospitalisation with falls increases with
polypharmacotherapy. Fall is one of the most common reasons for
admission to hospital for older adults and are a main cause of morbidity
with an in-hospital mortality rate as high as 16%.6,7
Polypharmacotherapy predisposes to higher anticholinergic burden (ACB),
which is emerging as a risk factor for adverse events that
disproportionately affect older adults, including falls, cognitive
impairment and progression of neurodegenerative
disease.8–12 Many medications used to treat chronic
conditions such as cardiovascular disease, hypertension, depression,
urinary incontinence, pain, and allergies have weak anticholinergic
properties, but the summative effects may have important implications
and worse outcomes in older adults.
The aim of our study was to assess the incidence of polypharmacotherapy
among older hospitalised patients and to explore the relationship
between polypharmacotherapy and cumulative ACB score in these patients
and risk of fall.