Polifarmacia in medicina interna generale nella Svizzera Italiana: un’analisi dei dati SWICOS

Abstract

Polypharmacy, defined as the concurrent daily use of five or more distinct medications, represents an increasingly relevant challenge in clinical practice. Although the term has existed since the 19^th century, its clinical significance has grown substantially over recent decades. Using data from the Swiss Cohort Study (SWICOS) - a prospective, population-based investigation conducted between 2015 and 2018 - we assessed the prevalence and determinants of polypharmacy in the Mesolcina valley. Data collection included demographic characteristics, lifestyle factors, comorbidities, and pharmacological treatments. Polypharmacy prevalence was evaluated in 474 participants aged 18 years or older (268 [56%] women and 206 [44%] men). The most frequently used drug classes, listed in decreasing order of frequency, were: analgesics and anti-inflammatory agents (N=108), vitamins (N=86), cardiovascular medications (N=81), proton pump inhibitors (N=44), lipid-lowering agents (N=40), antiplatelet agents (N=33), psychotropic drugs (N=28), oral contraceptives (N=18), antidiabetic agents (N=14), and anticoagulants (N=8). Prevalence of polypharamacy increased significicantly with age: it was observed in 10 of 236 individuals (4.2%) aged 18–49 years, in 23 of 180 (13%) aged 50–69 years, and in 24 of 58 (41%) aged ≥70 years. Prevalence was similar between sexes. In conclusion, polypharmacy increases with advancing age in Mesolcina valley, reflecting broader demographic and clinical trends observed in aging populations.