Evaluation of Polypharmacy using Guidelines for medical treatment and its safety in the elderly 2015 rheumatoid arthritis patients

Abstract

  Polypharmacy（PP）is associated with an increased risk of adverse drug reactions. In Rheumatoid arthritis（RA）patients, the combination with symptomatic treatment drugs in addition to anti-rheumatic drugs is the factor of PP. We investigated PP using a guideline, and the relationship between PP and the kind of drugs in RA.

  Outpatients at our hospital were retrospectively analyzed using information in electronic medical records. The study included 77 patients with RA aged > 75 years who were being treated with methotrexate（MTX）.

  We found that the number of drugs was < 5 in 48 patients, 6-9 in 13 patients, and ≥ 10 in 16 patients. The percentages of the drugs requiring careful prescription were 52%, 84% and 100% in each group. The prescription rates of drug are prednisolone（PSL）36%, non-steroidal anti-inflammatory drugs 53%, folic acid 73%, disease modifying anti-rheumatic drugs 9%, and biologics 13%. PP was correlated with the use of supportive care drugs for the prevention of side effects from MTX and PSL. Our data suggest that PP is common in RA patients, and that it is necessary.

  We pharmacists should monitor the proper use of therapeutic agents based on the guideline. Moreover, early diagnosis and early treatment of RA is necessary for avoidance of the duration of long-term PSL use，and pharmaceutical intervention is also important for that.