ISSN: 1859 - 2872
Polypharmacy and frailty in Vietnamese older inpatients
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Abstract
Background: Frailty and polypharmacy are two major geriatric syndromes that frequently co-occur and may exacerbate adverse outcomes in older adults. Although their relationship has been well studied internationally, data from Vietnam - particularly among hospitalized patients - remain limited. Objective: To determine the prevalence of polypharmacy and frailty among older inpatients in Vietnam, and to explore their association using the Clinical Frailty Scale (CFS). Subject and method: A cross-sectional study was conducted at 108 Military Central Hospital from April to July 2025. Patients aged ≥60 years admitted to internal medicine wards were enrolled. Frailty was assessed using the Clinical Frailty Scale (CFS) and categorized into robust, pre-frail, and frail. Polypharmacy was defined as the concurrent use of ≥5 medications, and severe polypharmacy as ≥10 medications. Medication adherence and relevant clinical characteristics were recorded. Multivariable logistic regression was performed to identify independent predictors of frailty, adjusting for potential confounders including age, sex, smoking status, and medication-related factors. Result: Among 188 patients (mean age 72 ± 7 years; 97.3% male), the prevalence of polypharmacy was 64.4% and severe polypharmacy 6.9%. Polypharmacy rates increased with frailty: 53.6% in robust, 75.3% in pre-frail, and 80.0% in frail patients (p = 0.005). Frail patients had a higher mean number of medications (7 ± 2) compared to robust patients (5 ± 3, p=0.017). Although frail patients showed lower adherence (70%) than pre-frail (92.6%) and robust (87.6%) groups, the difference was not statistically significant (p=0.080). In multivariable analysis, age was the only independent predictor of frailty (OR = 1.09, 95% CI: 1.04 - 1.15, p<0.001). Conclusion: Polypharmacy is highly prevalent among Vietnamese inpatients and strongly associated with frailty in unadjusted analyses, though this link appears to be mediated largely by age. Integrating frailty screening (CFS) into clinical pharmacy practice and targeting medication optimization in older adults may help improve safety and outcomes in this vulnerable population.
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References
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