Over 70% of MS patients in rehab take 5 or more medications, study finds
Clinical, lifestyle factors linked to potentially harmful 'polypharmacy'
Written by |
Multiple types of medications are available to people with MS. (Photo from iStock)
- Polypharmacy, or taking five or more medications, was found for more than 70% of multiple sclerosis patients in outpatient rehabilitation, according to a new study.
- These medications often include supplements and drugs for symptoms like muscle stiffness, pain, and mental health issues.
- Specialists should manage polypharmacy, per the study, which notes risk factors such as being retired, using cannabinoids, and having coexisting conditions.
More than 70% of people with multiple sclerosis (MS) receiving outpatient rehabilitation take at least five medications — often including vitamin supplements and drugs used to manage symptoms such as muscle stiffness, pain, and mental health issues — to treat their MS.
That’s according to a real-world study in Canada, which also found that one quarter of patients are taking more than 10 medications at the same time.
These results suggest that polypharmacy — defined as the use of five or more medications — is common among people with MS undergoing rehabilitation. Several clinical and lifestyle factors were linked to a higher prevalence of polypharmacy, including being retired, using cannabinoids, and having other coexisting conditions, according to the researchers.
The team noted that polypharmacy “is linked to many adverse outcomes” among patients.
As such, these findings demonstrate that physical medicine and rehabilitation specialists working with people with MS “should be well-informed regarding common side effects, potentially harmful drug-drug interactions, and strategies for reducing polypharmacy,” the scientists wrote.
The study, “Prevalence and factors associated with polypharmacy among people with multiple sclerosis (PwMS) receiving outpatient rehabilitation: A cross-sectional study,” was published in the journal Multiple Sclerosis and Related Disorders.
People with MS experience a wide range of mental and physical symptoms, and often have coexisting conditions such as high blood pressure and chronic lung disease. As many of these issues require treatment, it’s not uncommon for patients to be taking several medications simultaneously.
Little is known about medication use among patients in rehab
However, relatively little research has examined medication use in people with MS receiving outpatient physical medicine and rehabilitation.
To learn more, researchers examined medical records from 475 people with MS who were referred for rehabilitation at a large specialized MS clinic in Canada between 2021 and 2023. Participants had an average age of 53.1 years and nearly two-thirds were women.
“The purpose of this study was to describe patterns of medication use among [people with] MS,” the researchers wrote.
Polypharmacy was identified in 72% of patients, who were taking an average of 8.9 medications. In comparison, those without polypharmacy were taking about three medications on average. Hyperpolypharmacy — defined as taking more than 10 medications — was reported in about one quarter of participants.
Individuals with polypharmacy were significantly older, had been living with MS for longer, and had more coexisting health conditions than those taking fewer medications, the data showed. These patients also had slightly higher disability levels.
The most frequently used medications were vitamin D, by 74%, baclofen, by 31%, and vitamin B12, by 18%. Baclofen is a muscle relaxant commonly used to treat spasticity, a symptom of MS characterized by muscle stiffness and involuntary muscle spasms.
Looking at drug combinations, the team noted that most combinations involved supplements and other medications used to ease symptoms. The three most common combinations were supplements and pain medications, supplements and medications for mental health problems, and supplements and spasticity medications, each used by about one-third of patients.
More meds used by retirees, those with other conditions, study finds
Further analyses identified several factors associated with a higher prevalence of polypharmacy. Among them were being retired, using cannabinoids, or having at least one physical health or mental health coexisting condition.
“It is known that many [people with] MS report self-treatment with cannabis to address spasticity, pain, mood and sleep problems, and in one study, 26 % used both prescribed medications and cannabis,” the researchers wrote.
In contrast, working full-time or part-time was associated with a lower prevalence of polypharmacy. The researchers noted that these patients, who are still working, may have fewer symptoms and coexisting conditions, or have higher levels of education, which has been linked to a lower risk of polypharmacy.
Overall, the findings highlight how common polypharmacy is among people with MS receiving rehabilitation care, and that it is “associated with a number of sociodemographic, behavioural, and clinical/comorbidity factors,” the researchers wrote, calling for action by rehab specialists.
“Rehabilitation physicians treating [people with] MS should consider and address polypharmacy guided by established tools,” the team wrote.
Still, the researchers noted that larger studies are needed to better understand the main risk factors and long-term patterns of polypharmacy in this patient population.
