The impact of the COVID-19 pandemic on polypharmacy and the association of polypharmacy with COVID-19 vulnerability
Caroline E Dale, Rohan Takhar, Andrew Lambarth, Andrew Mason, Nathalie Conrad, Christopher Tomlinson, Spiros Denaxas, Mamas A Mamas, Andrew D Morris, Munir Pirmohamed, Kamlesh Khunti, Cathie Sudlow, Angela Wood, Naveed Sattar, Reecha Sofat, on behalf of the CVD-COVID-UK/COVID-IMPACT Consortium
The current medicine spend in the UK is £20 billion per annum. As individuals age, they accrue disease (multimorbidity) and as a result may be commenced on multiple preventative medicines long-term (polypharmacy). Levels of polypharmacy have been rising in the UK, increasing the potential for serious drug-drug interactions. Moreover, previous research suggests both multi-morbidity and polypharmacy are associated with higher risk of COVID-19.
Polypharmacy may be appropriate but may also be inappropriate. Even if appropriate, as the number of medicines accrue so does the potential for adverse effects and or severe interactions which themselves are a significant burden on the individual and on health care. A recent review in the United Kingdom (UK) by the chief pharmaceutical officer outlined the potential harm as well as economic cost from overused and inappropriately used medicines and included some key recommendations to rationalise the use of medicines.
Our previous work has demonstrated that for several conditions, over the COVID-19 period, the use of medicines has changed compared to normal usage. This may also have had an effect on polypharmacy, including inappropriate polypharmacy, given the reduced interaction between patients and GPs as a result of the pandemic. Furthermore, a more nuanced description of patterns of polypharmacy in the UK (beyond N of medicines) may help to better understand risk of adverse COVID-19 outcomes.
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This is a sub-project of project CCU014 approved by the CVD-COVID-UK / COVID-IMPACT Approvals & Oversight Board (sub-project: CCU014_04).
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