Determination of Social Support Status and Risk of Mental Illness in Patients Using Multiple Drugs in Primary Care

Author :  

Year-Number: 2021-3
Yayımlanma Tarihi: 2021-12-15 20:39:41.0
Language : İngilizce
Konu : Family Physician
Number of pages: 88-97
Mendeley EndNote Alıntı Yap




Aim: Multiple drug use (polypharmacy) increases the risk of numerous negative health consequences. The aim of this study was to examine the factors that may lead to polypharmacy in adult patients followed in primary care and to determine the social support status and anxiety-depression risk in patients using multiple drugs.

Methods: This cross-sectional study was conducted with 3 family medicine units in the Adana province. A total of 393 adult patients who were receiving two or more drugs daily were included. Sociodemographic data were recorded and risk factors for polypharmacy were questioned. The Multidimensional Scale of Perceived Social Support (MSPSS) and the Hospital Anxiety Depression Scale (HADS) were applied.

Results: Out of 393 participants, 52.9% were female and the mean age was 60.1±11.0 years. The mean number of chronic diseases was 2.7±.2. The mean number of drugs used was 4.7±2.2. Of the participants, 31.3% had risk of depression and 24.2% had risk of anxiety. The number of drugs used increased as age, body mass index (BMI), waist circumference and number of chronic diseases increased. The MSPSS total score decreased as age increased. The risk of anxiety and depression was significantly greater in women, participants with low education and those who had no partner.

Conclusions: Significant physical and mental problems occur in individuals who use multiple drugs, especially in the elderly. The present study revealed that predictors of polypharmacy include age, BMI, waist circumference and number of chronic diseases. Primary care physicians should be aware of these predictors when prescribing additional medication.


  • 1. Çurgunlu A. Polifarmasi kavramı. Akademik Geriatri Dergisi 2011; 2: 68-70.

  • 2. Veehof L, Stewart R, Haaijer-Ruskamp F, Meyboom-De JB. The development of polypharmacy: A longitudinal study. Family Practice 2010; 17: 261–267.

  • 3. Zarowitz BJ, Stebelsky LA, Muma BK, Romain TM, PETERSON EL. Reduction of high-risk polypharmacy drug combinations in patients in a managed care setting. Pharmacotherapy 2005; 25: 1636-1645.

  • 4. Papapetrou I, Jelastopulu E, Symeonidou E, Kleridou M, Floridou D, Charalambous G. Investigation of polypharmacy and rational prescribing in elderly patients in a health centre of Nicosia. Cyprus. China-USA Business Review 2012; 11: 1587-1594.

  • 5. Erdinçler DS. Yaşlıda akılcı ilaç kullanımı. İ.Ü. Cerrahpaşa Tıp Fakültesi Sürekli Tıp Eğitimi Etkinlikleri 2010; 69: 9-31.

  • 6. Slone Epidemiology Center. Patterns of medication use in the United States. A Report from the Slone Survey, Boston University; 2006. Retrieved Apr 2018 from: 2012/11/SloneSurveyReport2006.pdf

  • 7. Halli-Tierney AD, Scarbrough C, Carroll D. Polypharmacy: Evaluating Risks and Deprescribing. Am Fam Physician. 2019;100(1):32-38.

  • 8. Vatcharavongvan P, Puttawanchai V. Elderly Patients in Primary Care are Still at Risks of Receiving Potentially Inappropriate Medications. J Prim Care Community Health. 2021 Jan-Dec; 12:21501327211035088. PMID: 34315288.

  • 9. Asma S, Gereklioğlu Ç, Korur AP, Erdoğan AF. Multimorbiditesi olan yaşlı hastalarda çoklu ilaç kullanımı: aile hekimliğinde önemli bir problem. TJFMPC 2014; 8 (1): 8-12

  • 10. Brünn R, Müller BS, Flaig B, Kellermann- Mühlhoff P, Karbach U, Söling S, Muth C, van den Akker M; AdAM Study consortium. "I must, and I can live with that": a thematic analysis of patients' perspectives on polypharmacy and a digital decision support system for GPs. BMC Fam Pract 2021;22(1):168. doi: 10.1186/s12875-02101517-6. PMID: 34418964.

  • 11. Marx G, Püsche K, Ahrens D. Polypharmacy: a dilemma in primary care? Results of group discussions with general practitioners. Gesundheitswesen 2009;71 (6):339-48.

  • 12. Allen J, Gay B, Crebolder H, Heyman J, Svab I, Ram P, editors. Aile Hekimliği Avrupa Tanımı WONCA AVRUPA 2005, Türkiye Aile Hekimleri Uzmanlık Derneği Yayınları-4, Nisan 2011: pp 13-14.

  • 13. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 1988; 52(1): 30–41.

  • 14. Eker D, Arkar H, Yaldız H. Çok Boyutlu Algılanan Sosyal Destek Ölçeğinin gözden geçirilmiş formunun factor yapısı, geçerlik ve güvenirliği. Türk Psikiyatri Dergisi 2001;12 (1):18-25.

  • 15. Zigmond AS, Snaith PR. The Anxiety And Depression Scale. Acta PsychiatrScand 1983; 67 (6): 361-70.

  • 16. Aydemir Ö, Güvenir T, Küey L, Kültür S. Hastane Anksiyete ve Depresyon Ölçeği Türkçe formunun geçerlilik ve güvenilirliği. Türk Psikiyatri Dergisi 1977; 280-287.

  • 17. Kostev K, Jacob L. Multimorbidity and polypharmacy among elderly people followed in general practices in Germany. Eur J Intern Med 2018 Sep; 55:66-68.

  • 18. Morin L, Johnell K, Laroche M-L, Fastbom J, Wastesson JW. The epidemiology of polypharmacy in older adults: register-based prospective cohort study. Clin Epidemiol 2018;10:289–298.

  • 19. Piccoliori G, Mahlknecht A, Sandri M, Valentini M, Vögele A, Schmid S, Deflorian F, Engl A, Sönnichsen A, Wiedermann C. Epidemiology and associated factors of polypharmacy in older patients in primary care: a northern Italian cross-sectional study. BMC Geriatr. 2021 Mar 20;21(1):197. PMID: 33743582.

  • 20. Kardas P, Urbański F, Lichwierowicz A et al. Prevalence and Age Structure of Polypharmacy in Poland: Results of the Analysis of the National Real-World Database of 38 Million Citizens. Front Pharmacol. 2021;12:655364. PMID: 33935769.

  • 22. Lim LM, McStea M, Chung WW et al. Prevalence, risk factors and health outcomes associated with polypharmacy among urban community-dwelling older adults in multiethnic Malaysia. PLoS ONE 2017;12 (3): e0173466.

  • 23. Slater N, White S, Venables R, Frisher M. Factors associated with polypharmacy in primary care: a cross-sectional analysis of data from The English Longitudinal Study of Ageing (ELSA). BMJ Open. 2018;8(3):e020270.

  • 24. Unsar S, Dindar İ, Kurt S. Activities of daily living, quality of life, social support and depression levels of elderly individuals in Turkish society. J Pak Med Assoc 2015; 65( 6):

  • 25. Wongpakaran N, Wongpakaran T, SirirakT et al. Predictors of polypharmacy among elderly Thais with depressive and anxiety disorders: findings from the DAS study. BMC Geriatrics 2018;18:309.

  • Article Statistics