A study published in Pharmacoeconomics and Policy analyzed polypharmacy in Côte d'Ivoire using insurance data (2014−2018) and found a high prevalence of multiple medication use, especially among children under 15, a finding that shifts the focus away from the elderly, who are typically considered the primary at-risk group in such studies.
"While populations in developed countries are aging, the African continent is characterized by its growing young population," shares corresponding author Jérôme Kouame. "This demographic context makes the high rates observed in those under 15, ranging from 37.8% for simultaneous use on a single day to 5.7% for continuous use, a particularly urgent concern for public health policymakers in Côte d'Ivoire and similar settings."
The study is characterized by a detailed, three-part definition of polypharmacy. By analyzing simultaneous (5+ drugs on one day), cumulative (5+ drugs per month for three months), and continuous (5+ drugs for at least two quarters in a year) patterns, it provides a nuanced view of medication use over time. "Our methodological approach reveals that while the most acute form (simultaneous polypharmacy) decreased from 28.0% to 17.5% from 2014 to 2018, the more persistent forms linked to chronic management remain a challenge," says Kouame.
The results shine a new light on profound geographic inequalities in healthcare practices within the country. Compared to the Abidjan-1-Grands-Ponts health region, other regions had 1.3 to 9 times higher odds of cumulative or continuous polypharmacy. This stark disparity suggests that factors like prescribing practices, healthcare access, or disease patterns vary significantly by region.
"These findings highlight the need for interventions promoting the rationale use of medicines across all regions of the country to reduce the risks and costs associated with polypharmacy," adds Kouame.
This research also changes the conversation by providing the first major, data-driven snapshot of polypharmacy patterns in a West African population using insurance claims. "It improves the existing understanding, which largely stems from studies in elderly populations in high-income countries, by documenting a widespread issue affecting the younger population in a middle-income country," says Kouame. "The most surprising element is the central role of children and adolescents in this narrative, coupled with the strong influence of a patient's geographic location, pointing to systemic factors that require targeted policy and clinical interventions."
