Abstract：
Polypharmacy is commonly associated with adverse health outcomes. There are currently no meta-analyses of the prevalence of polypharmacy or factors associated with polypharmacy. We aimed to estimate the pooled prevalence of polypharmacy and factors associated with polypharmacy in a systematic review and meta-analysis.
MEDLINE, EMBASE, and Cochrane databases were searched for studies with no restrictions on date. We included observational studies that reported on the prevalence of polypharmacy among individuals over age 19. Two reviewers extracted study characteristics including polypharmacy definitions, study design, setting, geography, and participant demographics. The risk of bias was assessed using the Newcastle-Ottawa Scales. The main outcome was the prevalence of polypharmacy and factors associated with polypharmacy prevalence. The pooled prevalence estimates of polypharmacy with 95% confidence intervals were determined using random effects meta-analysis. Subgroup analyses were undertaken to evaluate factors associated with polypharmacy such as polypharmacy definitions, study setting, study design and geography. Meta-regression was conducted to assess the associations between polypharmacy prevalence and study year.
106 full-text articles were identified. The pooled estimated prevalence of polypharmacy in the 54 studies reporting on polypharmacy in all medication classes was 37% (95% CI: 31-43%). Differences in polypharmacy prevalence were reported for studies using different numerical thresholds, study setting, and publication year. Sex, study geography, study design and geographical location were not associated with differences in polypharmacy prevalence.
Our review highlights that polypharmacy is common particularly among older adults and those in inpatient settings. Clinicians should be aware of populations who have an increased likelihood of experiencing polypharmacy and efforts should be made to review the appropriateness of prescribed medications and occurrence of adverse effects potentially associated with polypharmacy.
Clinicians should be aware of the common occurrence of polypharmacy and undertake efforts to minimize inappropriate polypharmacy whenever possible.
MEDLINE, EMBASE, and Cochrane databases were searched for studies with no restrictions on date. We included observational studies that reported on the prevalence of polypharmacy among individuals over age 19. Two reviewers extracted study characteristics including polypharmacy definitions, study design, setting, geography, and participant demographics. The risk of bias was assessed using the Newcastle-Ottawa Scales. The main outcome was the prevalence of polypharmacy and factors associated with polypharmacy prevalence. The pooled prevalence estimates of polypharmacy with 95% confidence intervals were determined using random effects meta-analysis. Subgroup analyses were undertaken to evaluate factors associated with polypharmacy such as polypharmacy definitions, study setting, study design and geography. Meta-regression was conducted to assess the associations between polypharmacy prevalence and study year.
106 full-text articles were identified. The pooled estimated prevalence of polypharmacy in the 54 studies reporting on polypharmacy in all medication classes was 37% (95% CI: 31-43%). Differences in polypharmacy prevalence were reported for studies using different numerical thresholds, study setting, and publication year. Sex, study geography, study design and geographical location were not associated with differences in polypharmacy prevalence.
Our review highlights that polypharmacy is common particularly among older adults and those in inpatient settings. Clinicians should be aware of populations who have an increased likelihood of experiencing polypharmacy and efforts should be made to review the appropriateness of prescribed medications and occurrence of adverse effects potentially associated with polypharmacy.
Clinicians should be aware of the common occurrence of polypharmacy and undertake efforts to minimize inappropriate polypharmacy whenever possible.
摘要：
多重用药通常与不良健康结果相关。目前没有关于多重用药的患病率或与多重用药相关的因素的荟萃分析。我们旨在通过系统评价和荟萃分析评估多重用药的合并患病率和与多重用药相关的因素。
MEDLINE,EMBASE,并在Cochrane数据库中搜索日期无限制的研究。我们纳入了观察性研究，这些研究报告了19岁以上个体中多重用药的患病率。两位评审员提取了研究特征，包括多重药房定义，研究设计，设置,地理,和参与者人口统计学。使用纽卡斯尔-渥太华量表评估偏倚风险。主要结果是多重用药的患病率和与多重用药患病率相关的因素。使用随机效应荟萃分析确定具有95％置信区间的多重用药的合并患病率估计值。进行亚组分析以评估与多重用药相关的因素，如多重用药定义，研究设置，学习设计和地理。进行荟萃回归以评估多重用药患病率与研究年之间的关联。
确定了106篇全文文章。在报告所有药物类别中多重用药的54项研究中，多重用药的汇总估计患病率为37％（95％CI：31-43％）。使用不同数值阈值的研究报告了多药房患病率的差异，研究设置，和出版年。性,学习地理,研究设计和地理位置与多重用药患病率的差异无关.
我们的评论强调，多重用药在老年人和住院患者中很常见。临床医生应该意识到经历多重用药的可能性增加的人群，应该努力审查处方药物的适当性和可能与多重用药相关的不良反应的发生。
临床医生应该意识到多重用药的常见情况，并尽可能努力减少不适当的多重用药。
MEDLINE,EMBASE,并在Cochrane数据库中搜索日期无限制的研究。我们纳入了观察性研究，这些研究报告了19岁以上个体中多重用药的患病率。两位评审员提取了研究特征，包括多重药房定义，研究设计，设置,地理,和参与者人口统计学。使用纽卡斯尔-渥太华量表评估偏倚风险。主要结果是多重用药的患病率和与多重用药患病率相关的因素。使用随机效应荟萃分析确定具有95％置信区间的多重用药的合并患病率估计值。进行亚组分析以评估与多重用药相关的因素，如多重用药定义，研究设置，学习设计和地理。进行荟萃回归以评估多重用药患病率与研究年之间的关联。
确定了106篇全文文章。在报告所有药物类别中多重用药的54项研究中，多重用药的汇总估计患病率为37％（95％CI：31-43％）。使用不同数值阈值的研究报告了多药房患病率的差异，研究设置，和出版年。性,学习地理,研究设计和地理位置与多重用药患病率的差异无关.
我们的评论强调，多重用药在老年人和住院患者中很常见。临床医生应该意识到经历多重用药的可能性增加的人群，应该努力审查处方药物的适当性和可能与多重用药相关的不良反应的发生。
临床医生应该意识到多重用药的常见情况，并尽可能努力减少不适当的多重用药。
