Association Between Consulting Multiple Healthcare Facilities and Medication Burden Among Older Outpatients
- 1Division of Geriatric and Community Medicine, Tohoku Medical and Pharmaceutical University, Sendai, JPN
Abstract
Polypharmacy, which is defined as five or more medications, is a major challenge in older adults and is associated with adverse drug events, poor medication adherence, and increased healthcare utilization. Fragmented healthcare, characterized by consultations with multiple medical facilities, may contribute to medication burden through multiple prescribing and insufficient medication reconciliation. However, quantitative evidence supporting this association remains limited. This study investigated the relationship between the number of healthcare facilities consulted and the total number of medications prescribed among older outpatients. This retrospective observational study included 317 outpatients aged ≥ 65 years who attended Tohoku Medical and Pharmaceutical University Hospital. Data on the number of regularly prescribed medications and the number of healthcare facilities consulted were extracted from electronic medical records. The association between these variables was evaluated using Spearman's rank correlation analysis. Multiple regression analysis was additionally performed to examine whether the association remained significant after adjustment for age. Statistical analyses were conducted using SAS version 9.4 (SAS Institute Inc., Cary, NC, USA), with P < 0.05 considered statistically significant. The mean age of the participants was 78.8 ± 15.6 years, and 191 (60.3%) were women. A significant positive correlation was observed between the number of healthcare facilities consulted and the total number of prescribed medications (Spearman's correlation coefficient = 0.39, P < 0.0001). Medication burden increased progressively as the number of healthcare facilities increased. The association remained significant after adjustment for age, indicating that age alone did not account for the observed relationship. Consulting multiple healthcare facilities was significantly associated with increased medication burden among older outpatients. These findings suggest that fragmented healthcare utilization may contribute to polypharmacy independently of age. Older adults receiving care from multiple healthcare providers may represent a priority population for pharmacist-led medication reconciliation, comprehensive medication review, and interprofessional care coordination to reduce medication-related problems and optimize pharmacotherapy.
Related
- Multidrug resistance in bacteria causing community-acquired urinary tract infections among adult outpatients attending primary healthcare facilities in Mwanza, Tanzania
- Association of healthcare access, demographic and psychosocial factors with herbal medicine use: a survey of paediatric and adult outpatients
- A PRCI-Based Individualized Risk Prediction Model for Potentially Inappropriate Medication in Older Outpatients
- Medication Complexity and Insomnia Severity in Psychiatric Outpatients: A Moderation Analysis Across Mood and Non-Mood Disorders.
- Multimorbidity and Medication Order Patterns in Skilled Nursing Facilities: A Real-World Evidence Study
BibTeX
@article{ejima2026association,
title = {{Association Between Consulting Multiple Healthcare Facilities and Medication Burden Among Older Outpatients}},
author = {Hatsuho Ejima and Yuiko Suzuki and Ryo Nonaka and Saki Nakayama and Yurika Hirota and Atsuhiro Kanno and Katsutoshi Furukawa},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.117252},
url = {https://europepmc.org/article/PMC/PMC13722514},
note = {CC BY},
}
RIS
TY - JOUR
TI - Association Between Consulting Multiple Healthcare Facilities and Medication Burden Among Older Outpatients
AU - Hatsuho Ejima
AU - Yuiko Suzuki
AU - Ryo Nonaka
AU - Saki Nakayama
AU - Yurika Hirota
AU - Atsuhiro Kanno
AU - Katsutoshi Furukawa
PY - 2026
DA - 2026/09/30
JO - Cureus
DO - 10.7759/cureus.117252
UR - https://europepmc.org/article/PMC/PMC13722514
AB - Polypharmacy, which is defined as five or more medications, is a major challenge in older adults and is associated with adverse drug events, poor medication adherence, and increased healthcare utilization. Fragmented healthcare, characterized by consultations with multiple medical facilities, may contribute to medication burden through multiple prescribing and insufficient medication reconciliation. However, quantitative evidence supporting this association remains limited. This study investigated the relationship between the number of healthcare facilities consulted and the total number of medications prescribed among older outpatients. This retrospective observational study included 317 outpatients aged ≥ 65 years who attended Tohoku Medical and Pharmaceutical University Hospital. Data on the number of regularly prescribed medications and the number of healthcare facilities consulted were extracted from electronic medical records. The association between these variables was evaluated using Spearman's rank correlation analysis. Multiple regression analysis was additionally performed to examine whether the association remained significant after adjustment for age. Statistical analyses were conducted using SAS version 9.4 (SAS Institute Inc., Cary, NC, USA), with P < 0.05 considered statistically significant. The mean age of the participants was 78.8 ± 15.6 years, and 191 (60.3%) were women. A significant positive correlation was observed between the number of healthcare facilities consulted and the total number of prescribed medications (Spearman's correlation coefficient = 0.39, P < 0.0001). Medication burden increased progressively as the number of healthcare facilities increased. The association remained significant after adjustment for age, indicating that age alone did not account for the observed relationship. Consulting multiple healthcare facilities was significantly associated with increased medication burden among older outpatients. These findings suggest that fragmented healthcare utilization may contribute to polypharmacy independently of age. Older adults receiving care from multiple healthcare providers may represent a priority population for pharmacist-led medication reconciliation, comprehensive medication review, and interprofessional care coordination to reduce medication-related problems and optimize pharmacotherapy.
SN - 2168-8184
ER -