Polypharmacy Exposure, Aging Populations, and COVID-19: Considerations for Healthcare Providers and Public Health Practitioners in Africa

• Type of Material: Article
• Authors: Jamaji Nwanaji-Enwerem, Emory University; Edward W Boyer, Harvard Medical School; Ayobami Olufadeji, Harvard Medical School
• Language: English
• Date: 2021-10-01
• Publisher: MDPI
• Publication Version: Final Published Version
• Copyright Statement: © 2021 by the authors.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3390/ijerph181910263
• Title of Journal or Parent Work: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
• Volume: 18
• Issue: 19
• Grant/Funding Information: This work received no external funding.
• Keywords: Environmental Sciences & Ecology; registry; pharmaceuticals; BURDEN; shared decision making; Life Sciences & Biomedicine; medicine; pandemic; surveillance; ADVERSE EVENTS; policy; Science & Technology; geriatrics; Environmental Sciences; Public, Environmental & Occupational Health; African; MALARIA MISDIAGNOSIS
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Given the continent’s growing aging population and expanding prevalence of multimor-bidity, polypharmacy is an increasingly dire threat to the health of persons living in Africa. The COVID-19 pandemic has only exacerbated these issues. Widespread misinformation, lack of vaccine access, and attempts to avoid being infected have resulted in increases in Africans’ willingness to take multiple prescription and nonprescription medications and supplements. Issues with counterfeit pharmaceuticals and the relatively new recognition of emergency medicine as a specialty across the continent also create unique challenges for addressing this urgent public health need. Experts have called for more robust pharmaceutical regulation and healthcare/public health infrastructure investments across the continent. However, these changes take time, and more near-term strategies are needed to mitigate current health needs. In this commentary, we present a nonexhaustive set of immediately implementable recommendations that can serve as local strategies to address current polypharmacy-related health needs of Africans. Importantly, our recommendations take into consid-eration that not all healthcare providers are emergency medicine trained and that local trends related to polypharmacy will change over time and require ever-evolving public health initiatives. Still, by bolstering training to safeguard against provider availability biases, practicing evidence-based prescribing and shared decision making, and tracking and sharing local trends related to polypharmacy, African healthcare providers and public health practitioners can better position themselves to meet population needs. Furthermore, although these recommendations are tailored to Africans, they may also prove useful to providers and practitioners in other regions facing similar challenges.