Chronic polypharmacy at all age: a population-based drug utilization study

Polypharmacy is a growing concern often described only in older people by cumulating all drugs taken. We aimed to describe chronic polypharmacy in France, regardless of age. A cross sectional descriptive study was performed using the 1/97(th) representative sample of the French health insurance nationwide database (EGB). All subjects alive on January 1(st) , 2015 and covered by the French healthcare insurance were included, and their information collected until December 31(st) , 2015 or date of death. Drug exposures were estimated from drug dispensing dates and treatment durations. Chronic uses of drug were defined as drugs used daily for more than 6 months. Chronic polypharmacy corresponded to the exposure to five chronic uses of drug or more. In 2015, information of 584,862 subjects was collected (mean age: 42.2 years). Prevalence of chronic polypharmacy was 5.6% and incidence 1.1%. Prevalence of chronic polypharmacy increased noticeably from 0.2% for subjects aged 18 to 40 years to a maximum of 29.2% for subjects aged 80 to 90 years, and then decreased to 23.6% for subjects aged 90 years and more. Lipid modifying agents were the most frequent drugs involved in chronic polypharmacy (10% of exposure). According to age, the most important differences between the younger and older people were found for cardiovascular drugs (43.5% vs. 45.7% of exposure, respectively) and nervous system drugs (13.7% vs. 11.5% of exposure, respectively). This population-based study showed increasing of chronic polypharmacy and evolution of chronic drug patterns with age