• LAKSHMI PRASANNA MN Department of Pharmacy Practice, Vijaya Institute of Pharmaceutical Sciences, Andhra Pradesh, India.
  • AZIZ UNNISA Department of Pharmaceutical Chemistry, University of Hail, Hail, Saudi Arabia.


Objective: A sharp increase in chronic diseases for elderly patients has been observed in recent years resulting in polypharmacy, which may lead to drug-drug interactions (DDI’s), drug-related problems, adverse drug reactions (ADR’s), and many more issues in these patients. The present study was conducted to assess the clinical consequences of polypharmacy and its prevalence in the older adult population.

Methods: Our work is a prospective, observational study carried out in a tertiary care teaching hospital. The polypharmacy prescriptions were identified (taking at least five medications), and drug-drug interactions were detected by Micromedex® DrugReax® System 2.0 version. The medication profiles were also checked for inappropriate prescribing according to Beers Criteria 2015.

Results: In the study, the mean age of patients was found to be 72.4±8.8 years. Most of the patients (81.8%) had more than two and less than five diseases. The mean number of drugs prescribed in all the prescriptions was found to be 7.4±2.6. According to Beers Criteria-2015, 3.83% of the total medications prescribed were inappropriate, 74.1% of moderate DDI’s were observed in patients, and 50.2% of the DDI’s observed theoretically were documented as fair.

Conclusion: The impact of polypharmacy on consequences such as the length of stay, DDI’s, and DRP’s was also found to be significant. This study concludes that the medication profile of older adult patients should be assessed regularly for the rationality of drug therapy to maximize the therapeutic response positively with the lowest number of medications possible.

Keywords: Older adults, Polypharmacy, Drug-related problems, Beer’s Criteria


1. Bushardt RL, Massey EB, Simpson TW, Ariail JC, Simpson KN. Polypharmacy: Misleading but manageable. Clin Interv Aging 2008;3:383-9.
2. Shalini MD, Joshi MC. Study of polypharmacy and associated problems in elderly patients. Internet J Med Update 2012;7:35-9.
3. Franchi C, Cartabia M, Risso P, Mari D, Tettamanti M, Parabiaghi A, et al. Geographical differences in the prevalence of chronic polypharmacy in older people: Eleven years of the EPIFARM elderly project. Eur J Clin Pharmacol 2013;69:1477-83.
4. John NN, Udupi RH, Binu KM. Incidence of polypharmacy induced drug interaction in a tertiary care hospital. Int J Pharm Sci Res 2012;7:2119-21.
5. Robert LM, Joseph TH, Emily RH, et al. Clinical consequences of polypharmacy in elderly. Expert Opin Drug Saf 2014;13:1-11.
6. The American Geriatrics Society Beers Criteria Update Expert Panel. American geriatrics society 2015 updated beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc 2015;63:2227-46.
7. Prism 5 statistics guide. HJ Motulsky-Graph Pad Software; 2007.
8. Jhon NN, Kumar NA. A study on polypharmacy in senior Indian population. Int J Pharm Chem Biol Sci 2013;3:168-71.
9. Dhikav V, Mansi S, Kumar SA, Singh AK. Polypharmacy and use of potentially inappropriate medications in patients with dementia and mild cognitive impairment. Asian J Pharm Clin Res 2014;7:218-20.
10. Harugeri A, Joseph J, Parthasarathi G, Dip G, Ramesh M, Guido S. Prescribing patterns and predictors of high-level polypharmacy in the elderly population: A prospective surveillance study from two teaching hospitals in India. Am J Geriatr Pharmacother 2010;8:271-80.
11. Jesus D, Mercedes G. Excessive polypharmacy, and survival in polypathological patients. Eur J Clin Pharmacol 2015;71:733-39.
12. Mizokami F, Koide Y, Noro T, Furuta K. Polypharmacy with common diseases in hospitalized elderly patients. Am J Geriatr Pharmacother 2012;10:123-8.
13. Nobili A, Merengoni A, Tettamanti M, Salerno F, Pasina L, Franchi C, et al. Association between clusters of diseases and polypharmacy in hospitalized elderly patients: Results from the REPOSI study. Eur J Intern Med 2011;22:597-602.
14. Díez-Manglano J, Barquero-Romero J, Mena PA, Recio-Iglesias J, Cabrera-Aguilar J, López-García F, et al. Polypharmacy in patients hospitalised for acute exacerbation of COPD. Eur Respir J 2014;44:791-4.
15. Nobili A, Licata G, Salerno F, Pasina L, Tettamanti M, Franchi C, et al. Polypharmacy, length of hospital stay, and in-hospital mortality among elderly patients in internal medicine wards. The REPOSI study. Eur J Clin Pharmacol 2011;67:507-19.
16. Salih BS, Yousuf M, Durihim H, Almodaimegh H, Ntamim H. Prevalence and associated factors of polypharmacy among adult Saudi medical outpatients at a tertiary care center. J Fam Community Med 2013;20:162-7.
17. Ayesha R, Laxminarayana K, Astha S, Sushma M, Jayanthi CR. Polypharmacy leading to adverse drug reactions in elderly in a tertiary care hospital. Int J Pharm Bio Sci 2012;3:218-24.
18. Veena DR, Padma L, Sapna P. Drug prescribing pattern in elderly patients in a teaching hospital. Drug prescribing pattern in elderly patients in a teaching hospital. IOSR J Dent Med Sci 2012;1:39-42.
19. Chowta MN, Adhikari PM, Raj M, Laxman A, Kariappa J, George J, et al. Evaluation of appropriateness of prescription and polypharmacy in the geriatric population: A cross sectional study at a comprehensive geriatric clinic in a tertiary care hospital. Int J Pharm Pharm Sci 2016;8:119-23.
20. Corsonello A, Pedone C, Corica F, Incalzi RA. Polypharmacy in elderly patients at the discharge from the acute care hospital. Ther Clin Risk Manage 2007;3:197-203.
21. Siddarama R, Bharath NJ, Joshisree KP, Sahithi V. Polypharmacy induced drug interactions, adverse drug reactions (ADR) and medication errors in tertiary care South Indian hospital. Int J Pharm Pharm Sci 2019;11:88-93.
22. Sari SP, Darajat AF, Nursanti B. Drug interactions among patients with hypertension taking angiotensin converting enzyme inhibitors in an Indonesian hospital. Int J Appl Pharm 2018;10:138-41.
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How to Cite
MN, L. P., and A. UNNISA. “PREVALENCE AND CLINICAL CONSEQUENCES OF POLYPHARMACY ON MEDICATION PROFILE AMONG THE ELDERLY IN A TERTIARY CARE TEACHING HOSPITAL”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 13, no. 6, Apr. 2020, pp. 121-6, doi:10.22159/ajpcr.2020.v13i6.37623.
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