A Prospective Observational Study on Prevalence of Polypharmacy and Medication Inappropriateness Among Geriatric Patients in a Tertiary Care Teaching Hospital, Davangere

Introduction

Polypharmacy and the use of Potentially Inappropriate Medications (PIMs) are common among older adults because of multiple comorbidities and age-related changes in pharmacokinetics and pharmacodynamics. This study aimed to evaluate the prevalence of polypharmacy and medication inappropriateness using the 2023 AGS Beers Criteria and to assess prescribing patterns and comorbidities among elderly patients.

Materials and Methods

A prospective observational study was conducted among 160 geriatric inpatients admitted to the Departments of General Medicine and Orthopaedics of a tertiary care teaching hospital. Prescriptions were analysed for polypharmacy, PIMs, and WHO prescribing indicators.

Results

Among the study population, 61% were males and 39% were females, with the majority aged 65-74 years. Polypharmacy was highly prevalent, with 55% of patients receiving 5-9 medications and 28% receiving ≥10 medications. Overall, 77% of prescriptions were appropriate, whereas 23% contained at least one PIM, most commonly diclofenac and chlorpheniramine. An average of 7.4 drugs were prescribed per prescription. Only 39.8% of medications were prescribed by generic name, and 56.3% were from the essential drug list. Antibiotics and injections were prescribed in 78.1% and 86.25% of encounters, respectively. Hypertension and diabetes mellitus were the most common coexisting conditions among the patients.

Conclusion

The study highlights a high prevalence of polypharmacy and identifies the presence of potentially inappropriate prescribing, emphasizing the need for regular prescription review and adherence to the Beers Criteria to improve geriatric patient safety.