TABLE 2.
Stratified meta-analysis of the prevalence of polypharmacy, hyperpolypharmacy, and potential inappropriate medication (PIM) use in India.
| Characteristics | Number of studies | Pooled prevalence in percentage (95% CI) | p For interaction a | I 2 (%) | Z | Heterogeneity between groups | ||
|---|---|---|---|---|---|---|---|---|
| 1. Polypharmacy | Q | df | p | |||||
| Year of publication | 0.001 | 0.43 | 2 | 0.807 | ||||
| ≤2012 | 3 | 48 (42–56) | - | 7.08 | ||||
| 2013–2016 | 8 | 46 (34–58) | 98.4 | 7.57 | ||||
| ≥2017 | 10 | 51 (41–61) | 97.3 | 10.1 | ||||
| Study duration | 0.001 | 26.43 | 3 | <0.001 | ||||
| <6°months | 5 | 59 (47–72) | 97.6 | 9.28 | ||||
| 6–12°months | 12 | 46 (36–55) | 97.7 | 9.51 | ||||
| >1°year | 2 | 47 (44–50) | - | 34.6 | ||||
| Mean age | 0.001 | 0.41 | 2 | 0.81 | ||||
| <70 | 8 | 46 (33–59) | 99.1 | 6.90 | ||||
| ≥70 | 8 | 50 (42–58) | 93.9 | 12.36 | ||||
| NA | 5 | 52 (37–66) | 97.1 | 6.96 | ||||
| Percentage of female | 0.001 | 0.04 | 1 | 0.84 | ||||
| <50% | 15 | 49 (41–58) | 98.6 | 11.0 | ||||
| ≥50% | 6 | 48 (38–58) | 93.1 | 9.37 | ||||
| Average number of drugs | 0.001 | 14.55 | 2 | 0.001 | ||||
| <5.5 | 2 | 61 (57–65) | - | 30.2 | ||||
| ≥5.5 | 15 | 49 (41–58) | 98.6 | 11.07 | ||||
| NA | 4 | 45 (36–54) | 88.8 | 9.78 | ||||
| Number of PIM use | 0.001 | 0.37 | 1 | 0.54 | ||||
| <3 | 12 | 47 (41–53) | 95.3 | 14.7 | ||||
| ≥3 | 9 | 52 (37–66) | 99.0 | 7.2 | ||||
| Quality of studies b | 0.001 | 0.66 | 1 | 0.42 | ||||
| High (≥7) | 18 | 48 (40–54) | 98.4 | 12.36 | ||||
| Low (<7) | 3 | 56 (38–74) | - | 6.01 | ||||
| 2. Hyperpolypharmacy | ||||||||
| Year of publication | 0.001 | 29.81 | 2 | 0.001 | ||||
| ≤2012 | 2 | 50 (47–53) | - | 37.0 | ||||
| 2013–2016 | 7 | 20 (10–31) | 98.7 | 3.76 | ||||
| ≥2017 | 5 | 39 (19–58) | 98.2 | 3.79 | ||||
| Study duration | 0.001 | 72.9 | 3 | 0.001 | ||||
| <6°months | 1 | 27 (19–36) | - | 6.08 | ||||
| 6–12°months | 10 | 28 (18–37) | 98.6 | 5.46 | ||||
| >1°year | 1 | 54 (50–57) | - | 30.79 | ||||
| Mean age | 0.001 | 8.83 | 2 | 0.012 | ||||
| <70 | 6 | 37 (24–51) | 98.8 | 5.55 | ||||
| ≥70 | 6 | 24 (8–40) | 98.8 | 2.99 | ||||
| Na | 2 | 17 (15–20) | - | 12.45 | ||||
| Percentage of female | 0.001 | 0.82 | 1 | 0.365 | ||||
| <50% | 10 | 33 (22–44) | 98.8 | 5.99 | ||||
| ≥50% | 4 | 25 (9–40) | 97.9 | 3.07 | ||||
| Average number of drugs | 0.001 | 0.001 | ||||||
| <5.5 | 1 | 3 (1–7) | - | 1.75 | ||||
| ≥5.5 | 10 | 36 (26–46) | 98.6 | 6.82 | ||||
| Na | 1 | 23 (8–37) | - | 3.06 | ||||
| Number of PIM use | 0.001 | 0.70 | 1 | 0.403 | ||||
| <3 | 9 | 34 (21–47) | 98.85 | 5.12 | ||||
| ≥3 | 5 | 25 (9–41) | 98.12 | 3.08 | ||||
| Quality of studies b | 0.001 | 31.2 | 1 | 0.001 | ||||
| High (≥7) | 12 | 34 (24–43) | 98.7 | 6.76 | ||||
| Low (<7) | 2 | 5 (2–5) | - | 3.53 | ||||
| 3. PIM use | ||||||||
| Year of publication | 0.449 | 3.33 | 2 | 0.189 | ||||
| ≤2012 | 5 | 22 (15–29) | 93.9 | 5.87 | ||||
| 2013–2016 | 10 | 31 (24–39) | 97.3 | 8.17 | ||||
| ≥2017 | 12 | 28 (23–34) | 96.3 | 10.04 | ||||
| Study duration | 0.930 | 7.46 | 3 | 0.059 | ||||
| <6°months | 7 | 27 (19–34) | 96.2 | 7.0 | ||||
| 6–12°months | 15 | 31 (24–37) | 97.0 | 9.21 | ||||
| >1°year | 3 | 23 (20–27) | - | 12.41 | ||||
| Mean age | 0.072 | 5.76 | 2 | 0.056 | ||||
| <70 | 9 | 24 (19–30) | 96.7 | 8.64 | ||||
| ≥70 | 9 | 35 (28–42) | 93.9 | 9.66 | ||||
| Na | 9 | 25 (19–32) | 94.5 | 7.68 | ||||
| Percentage of female | 0.179 | 1.57 | 1 | 0.210 | ||||
| <50% | 20 | 26 (22–30) | 96.0 | 12.92 | ||||
| ≥50% | 7 | 34 (22–46) | 96.3 | 5.74 | ||||
| Average number of drugs | 0.548 | 4.08 | 2 | 0.130 | ||||
| <5.5 | 4 | 23 (18–27) | 70.5 | 9.54 | ||||
| ≥5.5 | 17 | 27 (22–31) | 96.1 | 12.11 | ||||
| Na | 6 | 35 (22–48) | 97.5 | 5.31 | ||||
| Number of PIM use | 0.782 | 0.15 | 1 | 0.702 | ||||
| <3 | 17 | 27 (23–32) | 95.7 | 11.57 | ||||
| ≥3 | 10 | 29 (22–36) | 96.8 | 8.24 | ||||
| Quality of studies b | 0.112 | 5.30 | 1 | 0.021 | ||||
| High (≥7) | 23 | 27 (23–30) | 96.2 | 13.50 | ||||
| Low (<7) | 4 | 37 (29–46) | 75.8 | 8.68 | ||||
a
p-value from meta-regression analyses,
b
New-Castle Ottawa scale score, PIM: potential inappropriate medication.