The risks of polypharmacy following spinal cord injury

The Journal of Spinal Cord Medicine, 2017 · DOI: 10.1179/2045772314Y.0000000235 · Published: March 1, 2017

Spinal Cord Injury Pharmacology Healthcare

Simple Explanation

Polypharmacy, the use of multiple medications, is a common practice in managing complications after spinal cord injury (SCI). However, balancing the benefits and risks of multiple medications presents a challenge. Patients with SCI often need long-term medication to manage secondary issues like spasticity, infections, pain, and pressure sores, and they also face a higher risk of chronic conditions like diabetes and heart disease. This study examined the prevalence of polypharmacy in individuals with SCI, the use of high-risk medications, and the resulting risks for drug-related problems (DRPs).

Study Duration

3 years

Participants

13160 individuals with SCI and 13148 age- and sex-matched individuals without SCI

Evidence Level

Not specified

Key Findings

1
Patients with SCI were prescribed significantly more medications than their counterparts without SCI.
2
A higher percentage of individuals with SCI were prescribed medications from multiple high-risk classes, such as analgesic-narcotics, anticonvulsants, antidepressants, and skeletal muscle relaxants.
3
The SCI group had a higher incidence of drug-related problems (DRPs).

Research Summary

This study highlights the high incidence of polypharmacy among individuals with spinal cord injury (SCI) and the associated increased risk of drug-related problems (DRPs). A significant percentage of individuals with SCI are prescribed five or more medications concomitantly, with a substantial number also taking high-risk medications, leading to a greater likelihood of experiencing DRPs. The findings emphasize the need for healthcare providers to recognize and address polypharmacy in patients with SCI to improve rehabilitation goals and community integration following neurologic injury.

Practical Implications

Clinical Practice

Healthcare providers should carefully review medication regimens of SCI patients to minimize polypharmacy and high-risk medication combinations.

Patient Education

Patients with SCI should be educated about the risks of polypharmacy and encouraged to discuss their medications with their healthcare providers.

Further Research

Future studies should investigate specific drug interactions and long-term outcomes associated with polypharmacy in the SCI population.

Study Limitations

1
The study lacked data regarding medication use prior to the spinal cord injury.
2
The use of E-codes may not cover all possible treatment-related problems and their use could under-represent the actual number of DRPs.
3
The study did not account for medications obtained from other sources (i.e. not prescribed by a healthcare provider).

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