COPD increases the risk of a person having additional health conditions and taking multiple medications, a British study shows.
The research, “Examining patterns of multimorbidity, polypharmacy and risk of adverse drug reactions in chronic obstructive pulmonary disease: a cross-sectional UK Biobank study,” was published in the journal BMJ Open.
Many COPD patients develop other conditions — including heart disease, high blood pressure, lung cancer, obesity, and depression — that lead to poor outcomes and higher death rates.
Despite the importance of dealing with multiple disorders at a time, disease-specific guidelines often lack recommendations on how to do this. Because COPD patients can have many other conditions, the disease may be a perfect starting point for addressing this issue, researchers said.
Having several health conditions at a time usually means a person is taking a lot of medications, increasing their risk of adverse drug reactions and hospital admissions, particularly if they are older.
Research has shown that COPD increases a person’s risk of having to take many medicines. But little information has been available on the harmful drug side effects that people with both COPD and other conditions can experience.
They screened the people in the groups for four or more diseases at one time, or multimorbidity; taking five or more medications at one time, or polypharmacy; and the risk of patients having adverse events from multiple drugs. They defined the adverse event risk category as those taking three or more medications for constipation, falls, depression, urine retention, bleeding or a kidney injury.
Patients volunteered to work with the researchers, giving them self-reports on the information they were seeking.
Researchers’ overriding goal was to identify which diseases played the biggest role in increasing COPD patients’ risk of adverse events from multiple medications.
One finding was that 85 percent of COPD patients had at least three other diseases, putting them in the multimorbidity category. In addition, 52 percent were taking five or more medications, putting them in the polypharmacy category. In fact, 15 percent reported taking 10 or more medications.
Many COPD patients were also taking three or more medications for constipation, falls, depression, urine retention, bleeding, and a kidney injury, putting them at risk of drug-to-drug adverse events.
Patients with COPD and a cardiovascular condition were at the highest risk of an adverse event stemming from medications for falls or a kidney injury, researchers reported. This was particularly true of patients with severe airflow obstruction.
Another finding was that people with COPD and a mental health condition were at the highest risk of an adverse event stemming from medications for depression, urine retention or bleeding.
The study was the first analysis of the risk of COPD patients having specific drug-related adverse events, the team noted.
The bottom line was that “for the first time, our data demonstrate that those with COPD were more likely than those without to be prescribed multiple medications,” the researchers said.
The study’s strengths included its large sample size and the fact that it represented all parts of the country, the team said.
Because all of the participants were volunteers, the study population differed from the U.K.’s general population in socioeconomic factors, smoking habits, obesity, and self-reported health conditions. In addition, the study’s reliance on self-reported patient information could have generated inaccuracies or bias, the scientists said.
“Future research should examine the effects on healthcare outcomes of co-prescribing multiple drugs with similar potential ADRs [adverse drug reactions],” they wrote. “Clinical guidelines should emphasise assessment of multimorbidity and ADR risk.”