Drug storage, polypharmacy and frailty syndrome in older people: an observational study.

Introduction: the increasing prevalence of polypharmacy in the older population could lead to inappropriate storage of medicines at home. Since polypharmacy is associated with frailty, the main objective of the Karukera Study of Aging - Drug Storage (KASADS) study was to investigate the association between drug storage and frailty. If such an association exists, drug storage could be a simple tool for the identification of medication vulnerability by non-medical staff in the elderly.

Methods: observational, cross-sectional study in community-dwelling older adults (>65 years old). Drug storage was defined as any drug in excess compared to a medical prescription, any unused and/or expired drug, or any drug without a medical prescription. Frailty was measured with the Study of Osteoporotic Fractures (SOF) scale, and polypharmacy was defined as a prescription of at least 5 drugs. Bivariate and multivariate analyses were performed to study the associations between drugs storage, frailty, and polypharmacy.

Results: during the study period (01/10/2019 to 15/03/2020), 115 elderly people were interviewed in their own homes. The average age was 76.0 ± 7.8 years old. Seventy-two percent of the participants met the criteria for polypharmacy and 30.4% were prefrail/frail. They stored an average of 14.7 ± 18.2 boxes. Drug storage was associated with polypharmacy (17.5 boxes versus 10.0; p=0.031) but not with frailty (15.6 versus 14.3; p=0.724). In multivariate analysis, drug storage was associated with not having a school degree (OR: 1.78; 95%CI: 1.13-2.79), suffering from dyslipidemia (OR: 2.00; 95% CI: 1.28-3.17) and suffering from cognitive disorders evaluated by the Mini Mental State Examination (MMSE) score (OR: 1.10; 95%CI: 1.02-1.17).

Conclusion: drug storage was not significantly associated with frailty. Nevertheless, it was associated with polypharmacy and other medical outcomes, and could therefore represent a new area for research in geriatrics and pharmacy.