Introduction: Elderly individuals have co-morbid conditions that require multiple medications, leading to polypharmacy and associated drug-related problems.
Aims: The study aimed to evaluate the prescription patterns, polypharmacy, potentially inappropriate medications, and potential drug-drug interactions in the geriatric population at the outpatient pharmacy department of a secondary care hospital.
Methodology: This was a prospective, descriptive study. Ambulatory patients over 65 years old attending the outpatient pharmacy were included. A total of 272 patients were enrolled, and data were collected once for each patient. WHO/International Network for Rational Drug Use (INRUD) indicators were used to assess the rationality of prescribing patterns. Anticholinergic Medication Burden was calculated using the Anticholinergic Burden (ACB) Calculator. Prescriptions were screened for polypharmacy and Potentially Inappropriate Medications (PIMs) using Beers and START/STOPP criteria. Potential drug–drug interactions (pDDIs) were analyzed using the Lexicomp database. Data analysis was performed using SPSS 28.0.
Results: The average age of patients was 73.75 ± 7.41 years. Most patients (56.98%) had three to four co-morbidities, with hypertension being the most common (23.64%). The average number of drugs per prescription was 8.84 ± 3.87. The most commonly prescribed drugs were for diabetes (14.62%). Most patients (54.41%) had an ACB score of 1–2, and those taking seven or more drugs had significantly higher ACB scores (p<0.0001). According to Beers criteria, 212 medications were potentially inappropriate, while STOPP criteria identified 140 PIMs. Polypharmacy was observed in 40.44% and hyperpolypharmacy in 45.2% of patients. Polypharmacy showed significant association with hypertension, diabetes mellitus, dyslipidemia, and ischemic heart disease. A significant association was also found between polypharmacy and the presence of at least one PIM. The prevalence of pDDIs was 93.75%, with 2044 interactions identified, most being moderate.
Conclusion: The study highlights the high prevalence of polypharmacy, potentially inappropriate medications, and potential drug-drug interactions among elderly patients. The significant association between polypharmacy and chronic disease conditions emphasizes the need for vigilant prescription monitoring.
