Polypharmacy, certain medication classes seem to worsen COVID-19 outcomes

Pharmacists are well aware that polypharmacy is a major issue among patients, especially older adults. Recent studies have estimated that approximately 36% of older adults take at least 5 prescription medications, and 67% take 5 or more medications or supplements, including OTCs.

But what do clinicians know about polypharmacy and clinical outcomes for COVID-19? Researchers conducted a study, published in JAPhA, to find out.

“The key message is that polypharmacy, as well as certain medication classes, has a negative impact on COVID-19 outcomes,” said lead author Sorochi Iloanusi, BSPharm, a doctoral candidate in the Department of Pharmaceutical Health Outcomes and Policy at the University of Houston.

Examining the available literature from all over the world through an electronic database search, the research team found that 5 out of 7 included studies published between November 2019 and September 2020 connected polypharmacy and negative clinical outcomes among COVID-19 patients. From the sample size, 10,519 patients were COVID-19–positive and 4,818 patients who were COVID-19–positive were labeled as having experienced polypharmacy.

Antipsychotics, non-tricyclic antidepressants, opioid analgesics, and drugs for peptic ulcer and gastroesophageal reflux disease were among the drug classes associated with adverse clinical outcomes for patients with COVID-19.

In addition to polypharmacy being associated with an increased risk of contracting COVID-19, polypharmacy was linked with death among male patients with COVID-19, an increased rate of acute kidney injury, and adverse drug reactions, according to the findings.

“I would say that the most surprising finding for me during this systematic review was that men and women’s risk profile for adverse COVID-19 outcomes associated with certain drug classes were slightly different,” said Iloanusi.

Although non-cardiovascular polypharmacy was associated with adverse COVID-19 outcomes, Iloanusi said cardiovascular polypharmacy showed no such association.

She said readers should interpret the findings cautiously, since the studies included in the review were observational in nature and did not control for comorbidities, which is a strong cofounder for polypharmacy.

For the full article, please visit www.pharmacytoday.org for the January 2022 issue of Pharmacy Today.