Polypharmacy and Activities of Daily Living in Older Patients Undergoing Cerebrovascular Rehabilitation: An Observational Study Using Japanese Real-World Data - Summary - MDSpire
To examine the association between polypharmacy status during hospitalization and functional outcomes among older adults receiving convalescent rehabilitation for cerebrovascular disease.
Approach:
Design and data: Retrospective observational study using anonymized inpatient and pharmacy claims data from the Japan Medical Data Center database, covering April 2014 to January 2025.
Participants: Patients aged 65 years or older admitted for the first time to a convalescent rehabilitation ward for cerebrovascular rehabilitation were included, subject to the study’s exclusion criteria.
Exposure and outcomes: Polypharmacy was defined as use of at least six medications. Patients were classified according to polypharmacy status at admission and discharge: persistent non-polypharmacy, polypharmacy at admission only, polypharmacy at discharge only, or polypharmacy at both admission and discharge. Outcomes were FIM gain, FIM efficiency, and length of stay.
Key Findings:
Polypharmacy was common among older patients receiving convalescent rehabilitation for cerebrovascular disease.
FIM gain did not differ significantly by polypharmacy-status group.
Compared with the persistent non-polypharmacy group, each of the other three groups had lower FIM efficiency and longer hospital stays.
Interpretation:
In this observational study, polypharmacy-status groups differed in FIM efficiency and length of stay, but not significantly in FIM gain. These associations do not show that polypharmacy caused the differences.
Limitations:
The retrospective observational design cannot establish causation.
The information available here does not provide the sample size, effect estimates, confidence intervals, or full statistical analysis; the magnitude and precision of the reported differences therefore cannot be assessed.
Conclusion:
Polypharmacy status during hospitalization was associated with lower FIM efficiency and longer hospital stays, but not with significant differences in FIM gain. Further research is needed to clarify these associations.
