Polypharmacy among persons residing in long-term care facilities before and during the COVID-19 pandemic in Canada: A retrospective cohort analysis

According to the World Health Organization, one in nine persons are designated older adults, or 60 years of age or older, and the percentage of the global population over 60 years will nearly double from 12% to 22% between 2015 and 2050 (World Health Organization [WHO, 2022]). Individuals living in long-term care facilities (LTCFs) are often frail, and present with co-morbidities that demand the administration of multiple drugs referred to as “polypharmacy”. Polypharmacy poses a significant concern for individuals in LTCFs due to several factors. The metabolic changes and reduced drug clearance associated with aging make older individuals more susceptible to adverse drug reactions and drug-drug interactions, resulting from the utilization of multiple medications (Dagli et al., 2014). Furthermore, the COVID-19 pandemic has brought attention to the significant vulnerability of individuals receiving care in LTCFs, attributable to both the potential for inappropriate polypharmacy and the direct risk of COVID-19 and its potential complications. There have been limited studies examining the prevalence and factors associated with polypharmacy among persons living in LTCFs, especially in the context of the COVID-19 pandemic in Canada. This study intends to fill this information gap by using secondary data to determine the prevalence and risk factors of polypharmacy among newly admitted Canadians in LTCFs before and during the COVID-19 pandemic. Identifying risk factors may lead to more effective and tailored therapy or even prevention of inappropriate prescribing especially in the context of the COVID-19 pandemic.