Does residing in urban or rural areas affect the incidence of polypharmacy among older adults in western China?

The aim of this study is to explore the differences among older adults who are rural or urban residents with respects to their socioeconomic position, chronic health conditions and medication use. This cross-sectional study included 887 community-dwelling older adults (≥60 years) from western China. Trained interviewers collected data from all of the study subjects through face-to-face interviews. Polypharmacy was defined as the concomitant use of five or more medications. A total of 717 participants were included in the study analyses. Compared with their urban counterparts, the older adults in rural China were more likely to have more chronic health conditions, and a lower education level, annual income and insurance coverage rate. In addition, the rural inhabitants were less likely to use medications (58.7% vs. 75.7%, p<0.001). The intensity of medication use (the mean number of drugs) was 1.7 for rural residents and 2.3 for urban residents (p<0.001). The prevalence of polypharmacy was significantly lower in rural residents than urban residents (11.5% vs. 17.5%, p=0.021). Urban residence (odds ratios (OR) 1.89, 95% confidence intervals (CI) 1.03-3.48), number of chronic conditions (OR 1.95, 95% CI 1.16-3.30), diabetes (OR 4.14, 95% CI 2.33-7.37), and cardiovascular disease (CVD) (OR 2.09, 95% CI 1.25-3.51) were positively associated with polypharmacy, whereas good self-rated health (OR 0.32, 95% CI 0.16-0.65) was negatively associated with polypharmacy. In conclusion, urban residence is independently associated with polypharmacy in Chinese elders regardless of chronic health conditions and socioeconomic status.