Impact of Polypharmacy and Risk Factors for Exacerbation of Lower Urinary Tract Symptoms in Patients with Urological Conditions: A Retrospective Study in a Japanese Municipal Hospital

  • Yoshizawa Shunsuke
    Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University
  • Tachi Tomoya
    Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University Department of Pharmacy, Gifu Municipal Hospital Department of Clinical Pharmacy, Graduate School of Pharmaceutical Sciences, Nagoya City University
  • Takahashi Yuta
    Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University
  • Aoyama Satoshi
    Department of Pharmacy, Gifu Municipal Hospital
  • Noguchi Yoshihiro
    Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University
  • Tanaka Kazuhide
    Department of Pharmacy, Gifu Municipal Hospital
  • Yasuda Masahiro
    Department of Pharmacy, Gifu Municipal Hospital
  • Mizui Takashi
    Department of Pharmacy, Gifu Municipal Hospital
  • Komeda Hisao
    Department of Urology, Gifu Municipal Hospital
  • Yoshimura Tomoaki
    Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University
  • Teramachi Hitomi
    Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University

抄録

<p>Polypharmacy exacerbates lower urinary tract symptoms (LUTS). Japan exhibits a higher prevalence of concomitant medication use in drug therapy than other countries. Previous age- and sex-specific reports exist; however, none include patients of all ages. Therefore, this retrospective study determined the impact of polypharmacy and its associated risk factors on LUTS exacerbation in outpatients with urological conditions. We included patients receiving medication who visited the Department of Urology at the Gifu Municipal Hospital (Gifu, Japan) between January, 2018 and December, 2018. The association between LUTS and polypharmacy and the risk factors for LUTS exacerbation were investigated. Patients were categorized into two groups according to their polypharmacy status. We performed propensity score matching and compared the International Prostate Symptom Score (IPSS) between the groups using the unpaired t-test. Multiple logistic regression analysis was performed to examine the risk factors, including “polypharmacy” and “taking multiple anticholinergic medications” for LUTS exacerbation. When comparing the IPSS between the groups, the polypharmacy group was found to have significantly higher scores than the non-polypharmacy group in six items, including “total score” and “storage score.” Multiple logistic regression analysis results showed high significance in three items, including “polypharmacy” (odds ratio (OR) = 1.67, 95% confidence interval (CI): 1.03–2.71) and “taking multiple anticholinergic medications” (OR = 8.68, 95% CI: 1.05–71.7). In conclusion, this study revealed that “polypharmacy” and “taking multiple anticholinergic medications” were risk factors for LUTS. Particularly, “polypharmacy” is associated with storage symptom exacerbation. Therefore, eliminating “polypharmacy” and “taking multiple anticholinergic medications” is expected to improve LUTS.</p>

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