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Polypharmacy and its rising global prevalence is a growing public health burden. Six clusters were identified: cluster 1 mostly included patients who were hospitalized for a long time 4. Given limited health care resources, individuals with any of the identified phenotypes may be preferential candidates for participation in intervention programs for optimal medication use. Polypharmacy is a growing major public health burden with rising global prevalence; the proportion of the older population continues to increase and they usually have a number of chronic health conditions 1.
Although there is no clear consensus on the definition of polypharmacy, the term is commonly defined as the routine use of five or more concurrent medications 2 , 3 , 4. Patients with polypharmacy have a higher risk of harmful effects, such as medication errors, adverse drug reactions, falls, dizziness, and increases in hospitalization and mortality 8 , 9 , It has been reported that inappropriate management of polypharmacy has a significant impact on avoidable expenditure on health care resources and costs, leading to a large economic burden 11 , Accordingly, the World Health Organization has asked countries and the concerned authorities to prioritize medication safety in polypharmacy, take early action, and reduce avoidable medication-related harm Although some countries are developing evidence-based strategies and introducing them for the optimal use of multiple medications, structured management programs or their supporting policies are still limited in many countries, including Korea 14 , 15 , 16 , 17 , It is emphasized that a comprehensive consideration in the clinical context, rather than a simple approach with the number of medications used, is essential to develop rational policies to improve polypharmacy use behavior 2 , 3 , To the best of our knowledge, most studies on polypharmacy conducted in Korea have only targeted certain vulnerable patient groups, such as the elderly and severely ill, and only simple status, including the prevalence of polypharmacy and its mortality, have been reported 6 , 7 , In-depth research to determine several distinct phenotypes of patients with polypharmacy could be helpful in developing effective management strategies by diversifying their countermeasures accordingly.
Therefore, using a large nationwide cohort of Korean adults, this study aimed to identify subpopulations of patients with polypharmacy and characterize their unique patterns through cluster analysis. A total of , patients were included in the training set for cluster analysis. Their mean age was Of all patients, 88, The mean number of outpatient visits was Among medical institutions by type, the medical clinic was visited by most patients Patients visited a mean of 4.
The results of determining the optimal number of clusters, using the elbow method, are presented in Fig. The scree plots provided the optimal number of clusters, which was determined to be six. Of the six clusters of patients with polypharmacy, cluster 4 had the largest distribution. In cluster 5, the proportion of females was In cluster 6, In cluster 3, On the other hand, there was no medical aid beneficiary in cluster 4 and The characteristics of health care utilization by cluster are shown in Fig.
