Introduction
The most widely recognised definition of polypharmacy or ‘polypharmacotherapy’ is the use of 5 or more medications.1,2 The high prevalence of polypharmacotherapy is a consequence of the increasing rate of multimorbidity in the ageing population worldwide. In the United Kingdom, up to one third of 69-year-olds are prescribed polypharmacotherapy.3 Polypharmacotherapy is associated with several negative outcomes, including adverse drug effects, non-adherence, and functional decline.4,5
The risk of hospitalisation with falls increases with polypharmacotherapy. Fall is one of the most common reasons for admission to hospital for older adults and are a main cause of morbidity with an in-hospital mortality rate as high as 16%.6,7
Polypharmacotherapy predisposes to higher anticholinergic burden (ACB), which is emerging as a risk factor for adverse events that disproportionately affect older adults, including falls, cognitive impairment and progression of neurodegenerative disease.8–12 Many medications used to treat chronic conditions such as cardiovascular disease, hypertension, depression, urinary incontinence, pain, and allergies have weak anticholinergic properties, but the summative effects may have important implications and worse outcomes in older adults.
The aim of our study was to assess the incidence of polypharmacotherapy among older hospitalised patients and to explore the relationship between polypharmacotherapy and cumulative ACB score in these patients and risk of fall.