A. Lauria1, S. Armen1, K. Fitzgerald1, J. Chandler1, R. Staszak1, S. Allen1 1Penn State Hershey Medical Center,Hershey, PA, USA
Introduction: Elderly drivers are frequently prescribed multiple medications to treat an increasing number of medical co-morbidities. Polypharmacy (>5 medications) lead to an increased risk of collisions and higher morbidity and mortality than those on fewer medications. The purpose of the current study was to describe the incidence of polypharmacy among elderly drivers prior to a motor vehicle collision. We hypothesized that polypharmacy before an MVC is common and directly related to the number of co-morbidities and is exacerbated by injuries sustained in the MVC.
Methods: A retrospective chart review was performed over a 3-year study period at our urban Level 1 trauma center. IRB approval was obtained. Elderly drivers (>65 years) involved in an MVC were studied. Demographic information, ISS, pre-existing conditions (PEC) as well as the number and types of pre-MVC and post-MVC discharge medications were collected.
Results:Polypharmacy is very common among elderly drivers (55.5%) who present to our urban trauma center and is often unassociated with the number of PEC’s (mean 0.98 PEC’s with median 1 PEC, range 0-5) at the time of admission. The incidence of polypharmacy significantly worsens upon hospital discharge especially in those patients discharged home (Pre-MVC 55.5% vs. Post-MVC: 79.0%, P=0.001). Many elderly drivers were noted to be on several medications prior to the MVC and were discharged home on significantly more medications following their hospitalization (Pre-MVC: 5.8 + 3.9 medications (range 0-16) vs. Post-MVC: 8.1 + 4.4 medications (range 0-20), P=0.001).
Conclusion:Polypharmacy exists in epidemic proportions, is often out of proportion to a patient’s PEC’s and exacerbated after hospitalization. Polypharmacy may place elderly patients at increased risk for future injury. Interventions to minimize polypharmacy are necessary to ensure that all unnecessary medications are discontinued in a timely fashion to mitigate the risk of future injury.