Polypharmacy and major adverse events in XXXX : observations from the AFFIRM trial.

@entity1 @entity64 @entity6 @entity955 @entity583 @entity65
BACKGROUND: Polypharmacy, as the use of five or more drugs, has commonly been associated with the elderly and multiple co-morbidities and related to impairment of clinical state and adverse outcomes, in general population. Limited data are available on the relationship between polypharmacy and adverse outcomes in @entity955 ( @entity955 ). We describe the prevalence of polypharmacy and @entity955 , and its association with major adverse events, such as @entity583 . METHODS AND RESULTS: For this study, we analysed all AFFIRM Trial @entity1 with complete pharmacological data. Polypharmacy was recorded in 40  % of 4056 @entity955 @entity1 . The crude incidence of @entity65 was 3.45  % @entity1 -years among @entity1 with polypharmacy, vs 1.65  % @entity1 -years without polypharmacy. Kaplan-Meier analysis showed that @entity1 with polypharmacy had a higher cumulative incidence of @entity65 (p  <  0.001). Cox regression analysis demonstrated that female gender (p  =  0.038), @entity6 (p  =  0.029), previous @entity583 ( @entity583 ) (p  =  0.004), prior @entity64 (p  =  0.011) and polypharmacy (p  =  0.029) were independently associated with @entity65 . Polypharmacy was associated with an adjusted relative risk of 1.30 (95  % CI 1.03-1.64) for @entity65 . A linear increase in the number of drugs was significantly associated with @entity65 . No significant association was found with @entity64 occurrence. CONCLUSIONS: Polypharmacy is highly prevalent in @entity955 @entity1 and associated with a worse clinical outcome, conferring 30  % excess relative risk for @entity65 . Thus, polypharmacy may be a health status marker. Strategies to reduce inappropriate prescription and polypharmacy should be tested in prospective longitudinal studies of @entity955 @entity1 .
