Polypharmacy

There is no clear consensus in the literature on how to define polypharmacy [65, 66]. We adopted the definition proposed by Maher, Hanlon and Hajjar [67], which suggests that polypharmacy occurs if the average number of medications is nine or above. We therefore identified the number of residents who took nine or more medications at least once during each period. As proposed by Sirois and Émond [66], we opted for a cumulative count of a resident’s medication and identified medications taken regularly for chronic conditions and those taken sporadically to account for changes in residents’ health status. A cumulative count including both chronic and sporadic use of medications generates a higher prevalence of polypharmacy but also reveals the actual use of medications and exposure to polypharmacy [66].