Polypharmacy is prevalent among individuals with inflammatory bowel disease (IBD), particularly older adults, and may interfere with IBD treatment adherence and therapeutic success, according to study results published in the Journal of Clinical Gastroenterology.

Polypharmacy, which refers to receiving treatment with multiple medications, has been linked to adverse events, drug interactions, inadequate drug compliance, hospitalization, undertreatment, and mortality. Research on the prevalence of polypharmacy in patients with IBD has been limited.

Researchers conducted a retrospective, single-center study using data on 407 patients with Crohn disease (60.4%) or ulcerative colitis (38.8%), who visited an IBD unit from September to October 2018. Polypharmacy was defined as the simultaneous use of 5 or more drugs. At 1 year, researchers evaluated disease outcomes, IBD treatment nonadherence, and undertreatment.


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Study participants had a median age of 48 years, 56% were men, 54% had chronic comorbidities, and 27% of comorbid patients had multiple comorbidities.

The median number of prescriptions per patient was 3 (range, 0-15). Researchers identified polypharmacy in 18.4% of cases, inappropriate prescriptions in 10.5%, and use of high-risk drugs, such as opioids, in 6.1%. In a multivariate analysis, the researchers found that polypharmacy was significantly associated with chronic comorbidity (odds ratio [OR], 10.1; 95% CI, 2.14-47.56; P <.03), multiple comorbidities (OR, 3.53; 95% CI, 1.46-8.51; P =.005), and age older than 62 years (OR, 3.54; 95% CI, 1.67-7.51; P =.001). Polypharmacy was the only factor associated with IBD treatment nonadherence (OR, 2.24; 95% CI, 1.13-4.54; P =.02).

“Our results show that [polypharmacy] is also present in IBD patients, with a prevalence of 1 in 5 patients, and reaching 48% in patients older than 62 years old,” the study authors wrote. “This highlights the fact that [polypharmacy] is a global problem and a common clinical issue in this population.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 

Reference

Mesonero F, Fernández C, Sánchez-Rodríguez E, et al. Polypharmacy in patients with inflammatory bowel disease: prevalence and outcomes in a single-center series. J Clin Gastroenterol. 2022;56(3):e189-e195. doi:10.1097/MCG.0000000000001647