Article
Psychotropic polypharmacy in the German National Cohort (NAKO) baseline
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Authors
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Jonas Peltner
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Bonn, Germany
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Britta Haenisch
- Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM), Bonn, Germany
| Published: | September 6, 2024 |
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Outline
Text
Background: Psychotropic drug in Germany has been assessed by several studies in the past. However, little is known about the concomitant use of multiple psychotropic drug classes (psychotropic polypharmacy) although this may pose a risk for adverse events for patients, especially those belonging to vulnerable subpopulations such as older adults.
Objectives: To assess and describe prevalence and predictors of psychotropic polypharmacy in the German National Cohort (NAKO) baseline.
Methods: We included all persons participating in the baseline examination (2014-2019) of the NAKO (N=204,310; 50.4% female). Medication use was assessed by computer-assisted, face-to-face interviews. Participants were asked to bring packages of the medications they used in the past seven days. Based on the pharmaceutical identification number (PZN) and a database-supported identification system detailed information (e.g. ATC code, strength) was recorded for each medication. Psychotropic polypharmacy was defined as concomitant use of two or more psychotropic medications. The proportions of participants using two or more psychotropic medications (ATC-codes N03, N05A, N05B, N05C, N06A, N06B, N06C) was estimated. Analyses were stratified by sex, age and income group. Factors associated with psychotropic polypharmacy (among participants who use antipsychotic medicines) were evaluated by multivariate logistic regression analysis.
Results: Overall, 17,315 out of 204,310 participants reported use of one or more psychotropic medicines in the seven days before their baseline examination. Use of any psychotropic medication was reported by 10.8% of women and 6.1% of men. Psychotropic polypharmacy was reported by 2.4% of all women and 1.5% of all men. Among participants who used psychotropic medicines, 22.3% of females and 24.7% of males used two or more psychotropic medications. The proportion of participants who reported psychotropic polypharmacy increased with age and was highest in participants aged 50 to 59 years. More participants at risk of poverty reported psychotropic polypharmacy than participants in higher income groups. Antidepressants, antiepileptic drugs, and antipsychotics were classes of psychotropic medicines which were frequently taken concomitantly. Factors associated with psychotropic polypharmacy among users of psychotropic drugs included income, self-rated health status, and age.
Conclusions: Psychotropic polypharmacy was frequent among users of psychotropic medicines in the NAKO. Age, income and self-rated health status were found to be predictors of polypharmacy. Although the NAKO study is not representative for the German population and our findings should be confirmed in population representative samples, the potential consequences for patient safety call for further investigation.
The authors declare that they have no competing interests.
The authors declare that an ethics committee vote is not required.
