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Polypharmacy and Potentially Inappropriate Medication in Iranian People With Metabolic Syndrome: Epidemiological Aspects and Related Factors, a Multi-Level Cross-Sectional National Study Publisher



Daneshmand M1 ; Jamshidi H1 ; Malekpour MR2 ; Ghasemi E3 ; Moghaddam SS3 ; Mortazavi SS4 ; Shati M5 ; Farjoo MH1 ; Farzadfar F3
Authors
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Authors Affiliations
  1. 1. Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2. Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Geriatric Mental Health Research Canter, School of Behavioural Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Epidemiology, Psychosocial Health Research Institute, Mental Health Research Centre, Tehran, Iran

Source: Health Science Reports Published:2025


Abstract

Background and Aims: Polypharmacy, characterized by the concurrent use of five or more medications in a prescription, potentially resulting in adverse outcomes, is frequently observed among individuals with metabolic syndrome, which encompasses a collection of conditions that co-occur, heightening the likelihood of heart disease, stroke, and type 2 diabetes. This study seeks to ascertain the prevalence of polypharmacy and the use of potentially inappropriate medications (PIMs) among Iranian patients with metabolic syndrome, while also evaluating the contributing individual and sociodemographic factors. Methods: This was a population-based, cross-sectional national study. Two databases were used: (a) Iranians Health Insurance Service database and (b) Iran's STEPS 2016 survey. Patients with metabolic syndrome conjoint in both databases were selected. Among these patients, polypharmacy and PIM were evaluated, and their association with individual and sociodemographic factors was assessed. Univariate and multivariate logistic regression were used to analyze the associations. All statistical analyses were done using SPSS 22 and Python 3. Results: Out of 2075 metabolic syndrome patients, 10.3% had polypharmacy. Polypharmacy significantly increased by age (OR: 4.334, adjusted for > 80-year-olds vs. 25–39-year-olds [CI: 1.664–11.283], p < 0.001), and its prevalence was significantly higher in urban areas (OR: 2.326 [CI: 1.645–3.288], p < 0.001). Polypharmacy was 5.88% in West, 5.41% in Southeast, 5.04% in Central, and 4.83% in North-Northeast of Iran. PIM was 13.2% in ≥ 60 years and significantly higher in urban areas (OR: 2.014 [CI: 1.153–3.519], p < 0.001). Conclusions: Since the area of residency affects polypharmacy and PIM more significantly than wealth status and education level, it is important to implement preventive measures in urban areas. © 2025 The Author(s). Health Science Reports published by Wiley Periodicals LLC.
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