Impact of Traditional Korean Medicine on Reducing Polypharmacy and Potentially Inappropriate Medications in Elderly Stroke Patients: A Retrospective Cohort Study.

PURPOSE: Elderly stroke survivors often face multimorbidity, leading to polypharmacy and potentially inappropriate medications (PIMs). This study investigated whether a holistic, multitarget traditional Korean medicine (TKM) inpatient approach is associated with a reduction in polypharmacy and PIMs in this population. PATIENTS AND METHODS: We retrospectively reviewed electronic medical records of 1175 elderly patients (≥65 years) hospitalized for cerebrovascular disease between 2015 and 2019. Primary outcomes included changes in the total number of medications, prevalence of polypharmacy (≥6 drugs), and PIMs (per STOPP criteria) before and after TKM treatment. Secondary outcomes included functional improvement measured by the modified Barthel Index (MBI). Factors influencing polypharmacy reduction were analyzed using backward elimination logistic regression. RESULTS: The present study included 1175 patients (mean age 75.0 years; 673 (57.3%) female), predominantly with cerebral infarction (969 (82.5%)) and high rates of baseline hypertension (969 (72.8%)) and diabetes (435 (37.0%)). Following TKM treatment, the average number of prescribed conventional drugs significantly decreased from 8.00 (IQR 6.00) to 7.00 (IQR 4.00) (p < 0.001). Polypharmacy prevalence dropped from 876 (74.5%) to 762 (64.9%) (p < 0.001), and PIMs decreased from 269 (22.9%) to 224 (19.1%) (p < 0.001). Reduced PIMs showed a positive trend toward higher MBI scores at discharge (p = 0.062). Regression analysis showed that hypertension, diabetes, osteoarthritis, and initial PIMs negatively affected polypharmacy reduction. Conversely, a history of cerebrovascular surgery and the application of pharmacopuncture were significant positive predictors. CONCLUSION: Inpatient TKM treatment was significantly associated with a reduced burden of polypharmacy and PIMs in elderly stroke patients, which correlated with functional recovery. TKM's individualized, multi-component framework may offer a viable clinical alternative to manage medication burden in multimorbid elderly patients.