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Polypharmacy and its correlates in village health clinics across 10 provinces of Western China
  1. Lifang Dong1,2,
  2. Hong Yan1,
  3. Duolao Wang3
  1. 1Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, PR China
  2. 2Shaanxi Center for Disease Control and Prevention, Xi'an, Shaanxi, PR China
  3. 3Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
  1. Correspondence to Professor Hong Yan, PO Box 46, Department of Epidemiology and Health Statistics, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi 710061, PR China; xjtu_yh.paper{at}yahoo.com.cn

Abstract

Background Polypharmacy represents a growing public health concern for its associations with drug-related adverse events, poor adherence, medication errors and increased healthcare costs.

Aim To assess the occurrence of polypharmacy prescribing and to identify the correlates in terms of doctors and patients characteristics in rural Western China.

Methods 20 125 prescriptions were collected from 680 primary health clinics in villages from 40 counties in 10 provinces of Western China. Two outcome variables are used in the analysis: number of drug items prescribed and use of five or more drugs (polypharmacy). A multilevel Poisson regression model and a multilevel logistic regression model were employed to examine the socio-economic, demographic determinants of the above two outcome variables, respectively.

Results The average drug number per prescription was 2.36, and the percentage of polypharmacy was 5.8%. The odds for polypharmacy were higher for village doctors with a heavier workload than those with less workload (OR=1.70; 95% CI 1.26 to 2.29). Patients with injections prescribed had higher odds for polypharmacy than patients without injections (OR=4.61; 95% CI 3.93 to 5.42). Village doctor's workload, subsidy for doctors from government and injection in prescriptions, patient's age and gender were also significant predictors of number of drug items prescribed in the studied areas.

Conclusions Polypharmacy seems to be associated with the village doctors' and patients' background and government policy. Intervention studies are needed to promote rational use of drugs in rural China.

  • Polypharmacy
  • pharmacoepidemiology
  • drug prescription
  • public health
  • rural China
  • drug safety
  • primary healthcare

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Footnotes

  • Funding Chinese Ministry of Health (MOH) the United Nations Children's Fund (Unicef).

  • Competing interests None.

  • Ethics approval Ethics approval was provided by Human Research Ethics Committee of the Xi'an Jiaotong University College of Medicine.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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