Polypharmacy among older men in South Wales

Objective: To describe the pattern of polypharmacy (PP) among older men and to relate medication use to personal, social and medical information. Methods: Information on medication use, both pre scribed and 'over the coun ter' (OTC), was collected from 1906 men, aged 56-75 years, observed on up t o four occasions since 1979 in a community survey - the Caerphilly prospect ive study. On each visit, a variety of questionnaires regarding personal, s ocial and medical factors were completed, and a brief medical examination w as conducted. Medication use was related to some of the questionnaire infor mation and biological measurements collected in order to identify factors a ssociated with PP. Results: A quarter of the men (475/1906) reported using three or more presc ription-only medicines (PoMs), with 9% (163) using five or more (major PP). PP was related to increasing age, lower social class, not being in employm ent, smoking and obesity (high body mass index). Men with a medical history , especially of high blood pressure, angina, heart attack, or hospital admi ssion in the last 5 years, comprised a large proportion of those on major P P. Higher levels of PoM use by this group had been apparent over the previo us 14 years. Men on PP reported lower levels of self-rated health and highe r rates of non-PoM use. Cardiovascular and, to a lesser extent, central ner vous and respiratory system drugs were the main medicines used by men on ma jor PP. Conclusions: PP is common among men aged 56-75 years in Caerphilly, South W ales. It is related to many personal, social and medical factors, and assoc iated with lower self-rated health status and greater use of non-PoMs. Card iovascular medicines are the main contributor to major PP. Those on PP requ ire regular review and, where possible, PP should be reduced as it has many potential adverse effects.