Inappropriate Medication Use and Association With Polypharmacy in Surgical Patients: A Retrospective, Population‐Based Cohort Study
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2025
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| author | Freyja Jónsdóttir Anna B. Blöndal Aðalsteinn Guðmundsson Ian Bates Jennifer M. Stevenson Martin I. Sigurðsson |
| author_facet | Freyja Jónsdóttir Anna B. Blöndal Aðalsteinn Guðmundsson Ian Bates Jennifer M. Stevenson Martin I. Sigurðsson Freyja Jónsdóttir Anna B. Blöndal Aðalsteinn Guðmundsson Ian Bates Jennifer M. Stevenson Martin I. Sigurðsson |
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| contents | Inappropriate Medication Use and Association With Polypharmacy in Surgical Patients: A Retrospective, Population‐Based Cohort Study Freyja Jónsdóttir Anna B. Blöndal Aðalsteinn Guðmundsson Ian Bates Jennifer M. Stevenson Martin I. Sigurðsson Acta Anaesthesiologica Scandinavica ABSTRACTBackgroundThis study assessed the prevalence and incidence of potentially inappropriate medication use for older patients undergoing surgery and its association with polypharmacy.MethodsA retrospective, population‐based cohort study with patients ≥ 65 undergoing first surgery at Landspitali—The National University Hospital of Iceland from 2005 to 2018. Participants were categorized by number of medications filled before and following their surgical episode into: non‐polypharmacy (< 5), polypharmacy (5–9), and hyper‐polypharmacy (≥ 10). The prevalence and incidence of PIM use were compared between polypharmacy categories based on the 2019 Beers criteria.ResultsA total of 17,198 admissions associated with surgery were assessed (53.8% female) with a median [IQR] age of 75 [70, 81]. The prevalence of potentially inappropriate medication among patients with non‐polypharmacy (< 5) was 36.6% (95% CI: 35.1–38.2), with polypharmacy (5–9) 80.2% (95% CI: 79.2–81.2), and with hyper‐polypharmacy 95.8% (95% CI: 95.3–96.2). New potentially inappropriate medication use post‐surgery occurred in 38.5% (95% CI: 37.0–40.1). Risk factors included female sex, increased comorbidity, and prior use of a multidose dispensing service. Compared with patients without potentially inappropriate medication use, patients with potentially inappropriate medication use had a higher rate of postoperative diagnosis of medication‐related harm (12.6% vs. 11.3%), increased 30‐day mortality (5.2% vs. 0.3%), longer hospital stay (3 [1, 8] vs. 2 [1, 5] days), and increased 30‐day readmission rate (11.3% vs. 6.5%).ConclusionsPotentially inappropriate medication use is strongly associated with polypharmacy/hyper‐polypharmacy and adverse outcomes in older surgical patients. Surgical hospitalization offers a critical window for medication review, deprescribing, and follow‐up planning to reduce medication‐related harm. 10.1111/aas.70121 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/aas.70121 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_aas_70121 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2025 |
| publisher | Wiley |
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| spellingShingle | Inappropriate Medication Use and Association With Polypharmacy in Surgical Patients: A Retrospective, Population‐Based Cohort Study Freyja Jónsdóttir Anna B. Blöndal Aðalsteinn Guðmundsson Ian Bates Jennifer M. Stevenson Martin I. Sigurðsson Acta Anaesthesiologica Scandinavica Inappropriate Medication Use and Association With Polypharmacy in Surgical Patients: A Retrospective, Population‐Based Cohort Study Freyja Jónsdóttir Anna B. Blöndal Aðalsteinn Guðmundsson Ian Bates Jennifer M. Stevenson Martin I. Sigurðsson Acta Anaesthesiologica Scandinavica ABSTRACTBackgroundThis study assessed the prevalence and incidence of potentially inappropriate medication use for older patients undergoing surgery and its association with polypharmacy.MethodsA retrospective, population‐based cohort study with patients ≥ 65 undergoing first surgery at Landspitali—The National University Hospital of Iceland from 2005 to 2018. Participants were categorized by number of medications filled before and following their surgical episode into: non‐polypharmacy (< 5), polypharmacy (5–9), and hyper‐polypharmacy (≥ 10). The prevalence and incidence of PIM use were compared between polypharmacy categories based on the 2019 Beers criteria.ResultsA total of 17,198 admissions associated with surgery were assessed (53.8% female) with a median [IQR] age of 75 [70, 81]. The prevalence of potentially inappropriate medication among patients with non‐polypharmacy (< 5) was 36.6% (95% CI: 35.1–38.2), with polypharmacy (5–9) 80.2% (95% CI: 79.2–81.2), and with hyper‐polypharmacy 95.8% (95% CI: 95.3–96.2). New potentially inappropriate medication use post‐surgery occurred in 38.5% (95% CI: 37.0–40.1). Risk factors included female sex, increased comorbidity, and prior use of a multidose dispensing service. Compared with patients without potentially inappropriate medication use, patients with potentially inappropriate medication use had a higher rate of postoperative diagnosis of medication‐related harm (12.6% vs. 11.3%), increased 30‐day mortality (5.2% vs. 0.3%), longer hospital stay (3 [1, 8] vs. 2 [1, 5] days), and increased 30‐day readmission rate (11.3% vs. 6.5%).ConclusionsPotentially inappropriate medication use is strongly associated with polypharmacy/hyper‐polypharmacy and adverse outcomes in older surgical patients. Surgical hospitalization offers a critical window for medication review, deprescribing, and follow‐up planning to reduce medication‐related harm. 10.1111/aas.70121 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Inappropriate Medication Use and Association With Polypharmacy in Surgical Patients: A Retrospective, Population‐Based Cohort Study |
| topic | Acta Anaesthesiologica Scandinavica |
| url | https://onlinelibrary.wiley.com/doi/10.1111/aas.70121 |