Prevalence and predictors of polypharmacy and psychotropic use among Australian Defence Force veterans transitioning from military to civilian life

Abstract

Background

Polypharmacy is a growing concern among veterans due to high rates of multi-morbidity and its complex pharmacologic management. This study examined the prevalence and predictors of polypharmacy among Australian Defence Force (ADF) veterans transitioning from military to civilian life.

Methods

A retrospective cohort analysis was conducted using electronic medical records from 1210 ADF veterans attending a medical service. General polypharmacy was defined as ≥5 medications, and psychotropic and other N-class polypharmacy as ≥2 medications within those classes. Multivariable logistic regression identified demographic and clinical predictors.

Results

General polypharmacy occurred in 19.1% of veterans, psychotropic polypharmacy in 9.8% and other N-class polypharmacy in 14.6%. Veterans with post-traumatic stress disorder (PTSD) had significantly higher rates of psychotropic (25.9% vs 4.5%) and general polypharmacy (33.7% vs 14.4%) (p < .001). Psychiatric comorbidity burden was the strongest predictor of psychotropic polypharmacy (OR 1.91), while PTSD independently doubled the odds (OR 2.07). General polypharmacy was primarily associated with medical (OR 1.51) and psychiatric comorbidities (OR 1.41).

Conclusions

Polypharmacy is common among Australian veterans transitioning from military to civilian life, particularly those with PTSD and multiple comorbidities, highlighting the need for early medication review and deprescribing strategies.