Association Between Consulting Multiple Healthcare Facilities and Medication Burden Among Older Outpatients

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.