Prevalence of polypharmacy and its associated factors: a cross-sectional study among elderly population
DOI:
https://doi.org/10.18203/2320-6012.ijrms20252406Keywords:
Elderly, Multimorbidity, Polypharmacy, Self-medicationAbstract
Background: Polypharmacy is the concurrent use of multiple medications, defined as the routine use of five or more medications. With such a dynamically growing elderly population, concerns regarding polypharmacy and its effect on this geriatric population need to be studied. Hence, this study aims to estimate the prevalence of polypharmacy among elderly and its associated factors and impact.
Methods: A cross-sectional study was conducted in the outpatient department (OPD) of an Urban Health Training Centre affiliated to a tertiary health care hospital in Maharashtra among 150 elderly patients above 60 years of age. Association between polypharmacy and study variables were assessed using Chi-square test.
Results: Mean age of participants was 69.23±5.90 years. Prevalence of polypharmacy in our study was 76 (50.67%). It was observed that maximum patients 48 (32%) took 5 medicines and hypertension was the most common morbidity 68 (45.33%).
Conclusions: The associated factors with polypharmacy were found to be age, education, socioeconomic status, number of morbidities, number of doctors consulted, hospital admission in the last 3 months. The impact of polypharmacy on adverse drug reactions, out of pocket expenditures and adherence to medications were found to be significant.
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References
Masnoon N, Shakib S, Kalisch-Ellett L, Caughey GE. What is polypharmacy? A systematic review of definitions. BMC Geriatr. 2017;17(1):230. DOI: https://doi.org/10.1186/s12877-017-0621-2
World Health Organization. Medication Safety in Polypharmacy. Available at: https://www.who.int/ docs/default-source/patient-safety/who-uhc-sds-2019-11-eng.pdf. Accessed on 13 April 2025.
Malik C, Khanna S, Jain Y, Jain R. Geriatric population in India: Demography, vulnerabilities, and healthcare challenges. J Family Med Prim Care. 2021;10(1):72-6. DOI: https://doi.org/10.4103/jfmpc.jfmpc_1794_20
Varghese D, Ishida C, Patel P, Haseer Koya H. Polypharmacy. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.
Johns Hopkins Medicine. Polypharmacy in Adults 60 and Older. Available at: https://www.hopkins medicine.org/health/wellness-and-prevention/ polypharmacy-in-adults-60-and-older. Accessed on 13 April 2025.
Hosseini SR, Zabihi A, Jafarian Amiri SR, Bijani A. Polypharmacy among the elderly. J Mid-life Health. 2018;9:97-103. DOI: https://doi.org/10.4103/jmh.JMH_87_17
Sinha A, Mukherjee S, Tripathi S, Dutta S. Issues and challenges of polypharmacy in the elderly: A review of contemporary Indian literature. J Family Med Prim Care. 2021;10(10):3544-7. DOI: https://doi.org/10.4103/jfmpc.jfmpc_2581_20
Rathod G, Nalini GK, Nagaral JV, Sahana GN, Deepak P, Prema M, et al. Factors associated with polypharmacy in geriatrics. Int J Basic Clin Pharmacol. 2017;6:1763-7. DOI: https://doi.org/10.18203/2319-2003.ijbcp20172745
Bhagavathula AS, Vidyasagar K, Chhabra M, Rashid M, Sharma R, Bandari DK, et al. Prevalence of Polypharmacy, Hyperpolypharmacy and Potentially Inappropriate Medication Use in Older Adults in India: A Systematic Review and Meta-Analysis. Front Pharmacol. 2021;12:685518. DOI: https://doi.org/10.3389/fphar.2021.685518
Government of India. Ministry of Statistics and Programme Implementation. Elderly in India 2021. Available at: https://mospi.gov.in/sites/default/files/ publication_reports/Elderly%20in%20India%202021.pdf. Accessed on 13 April 2025.
Press Information Bureau. World Senior Citizen Day 2024. Available at: https://pib.gov.in/PressNote Details.aspx?NoteId=152034&ModuleId=3®=3&lang=1. Accessed on 13 April 2025.
Science Direct. Adverse Drug Reaction. Available at: https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/adverse-drug-reaction. Accessed on 13 April 2025.
Press Information Bureau. The Decline in Out-of-Pocket Expenditure (OOPE) in Health in India. Available at: https://pib.gov.in/PressNoteDetails. aspx?NoteId=153407&ModuleId=3®=3&lang=1. Accessed on 13 April 2025.
Rakesh KB, Chowta MN, Shenoy AK, Shastry R, Pai SB. Evaluation of polypharmacy and appropriateness of prescription in geriatric patients: A cross-sectional study at a tertiary care hospital. Indian J Pharmacol. 2017;49(1):16-20. DOI: https://doi.org/10.4103/0253-7613.201036
Priya S, Gupta NL, Chauhan HS. Polypharmacy – prevalence and risk factors among elderly patients. Available at: https://gmch.gov.in/sites/default/files/ documents/6_POLYPHARMACY_43_52.pdf. Accessed on 13 April 2025.
Prasanna L, Unnisa A. Prevalence And Clinical Consequences Of Polypharmacy On Medication Profile Among The Elderly In A Tertiary Care Teaching Hospital. Asian J Pharm Clin Res. 2020;13(6):121-6. DOI: https://doi.org/10.22159/ajpcr.2020.v13i6.37623
Anthoorathodi JB, Joju A, Reji AM, Asokan AP, Naseem A, Cherian A, et al. A cross sectional study on the prevalence of polypharmacy and potentially inappropriate medications among elderly patients in a tertiary care centre in central Kerala. Int J Community Med Public Health. 2021;8:1415-9. DOI: https://doi.org/10.18203/2394-6040.ijcmph20210836
Eltaher SM, Araby EM. Prevalence and Factors Associated with Polypharmacy among Elderly Persons. Egypt J Comm Med. 2019;37(3):55-61. DOI: https://doi.org/10.21608/ejcm.2019.43370
Shalini MD, Joshi MC. Study of polypharmacy and associated problems among elderly patients. Internet J Med Update. 2012;7:35-9.
Ahmed B, Nanji K, Mujeeb R, Patel MJ. Effects of polypharmacy on adverse drug reactions among geriatric outpatients at a tertiary care hospital in Karachi: a prospective cohort study. PLoS One. 2014;9(11):112133. DOI: https://doi.org/10.1371/journal.pone.0112133
Lim LM, McStea M, Chung WW, Nor Azmi N, Abdul Aziz SA, Alwi S, et al. Prevalence, risk factors and health outcomes associated with polypharmacy among urban community-dwelling older adults in multi-ethnic Malaysia. PLoS One. 2017;12(3):173466. DOI: https://doi.org/10.1371/journal.pone.0173466