Prevalence of Polypharmacy in Chinese Community-Dwelling Older Adults and Forecast by 2035: A Systematic Review and Meta-Analysis.

Purpose: We aimed to derive a pooled polypharmacy prevalence estimate and forecast the total polypharmacy cases by 2035 in Chinese community-dwelling older adults.

Methods: We searched for studies in three databases (CNKI, Scopus and PubMed). We selected studies according to pre-defined inclusion and exclusion criteria. We assessed study quality using a modified Newcastle-Ottawa Scale. Polypharmacy in our study was defined as the concurrent use of at least five different medications. Pooled prevalence was estimated overall and by regions, time periods, and other important factors. We fitted Bayesian random-effects logit models to synthesize single studies and reported a 95% uncertainty interval (95UI).

Results: A total of 25 studies were finally included. The pooled polypharmacy prevalence was estimated to be 31.04% (95UI: 18.16 ~ 47.66). The pooled prevalence was highest in the east region (37.98%, 95UI: 21.92 ~ 57.69), followed by the middle region (33.53%, 95UI: 4.89 ~ 84.46) and the west region (25.85%, 95UI: 8.78 ~ 50.74). The pooled prevalence was 31.10% (95UI: 15.54 ~ 52.72) in the latest 5 years (2017-2021) and 30.88% (95UI: 11.53 ~ 60.56) in the beyond latest 5 years (2005-2016). The per cent change annualized in the forecasted total polypharmacy cases from 2022 to 2035 was estimated to be 3.69%, with the highest total cases forecasted to be 131.7 million (95UI: 77.1 ~ 202.2) in 2035.

Conclusions: Our study suggests that polypharmacy is notably prevalent in Chinese community-dwelling older adults, highlighting the need for the development and delivery of community-based interventions targeted at this population.