Polypharmacy and Geriatric Patients: Patterns of Prescribing in the Tribhuvan University Teaching Hospital in Nepal

Abstract

Introduction Polypharmacy is common occurrence in geriatric patients due to multiple illnesses. Objectives To analyze prescribing patterns in geriatric patients admitted in Tribhuvan University Teaching Hospital (TUTH), Maharajgunj, Kathmandu, Nepal. Methods Total of 3750 patients were admitted during a 1year period from 1 July 2002 to 30 June 2003, out of which 546 patients (14.6%) were aged 65 and above. One hundred randomly selected records of geriatric patients admitted to the medical wards of TUTH during the study period was analyzed. Results The mean duration of hospital stay was 7.7 days. An average of 10.73 drugs was prescribed. The average number of drugs prescribed rises to 13.76 if individual components of the fixed dose product are calculated. The average number of drugs during discharge was 5.13. Intravenous fluids were the most frequently prescribed drugs. About one third (31.03%) of the drugs were prescribed by generic names. Eighty-nine percent of the patients received more than 5 drugs during hospital stay. Of the all drugs prescribed, 63.75% were prescribed from within the National List of Essential Drugs. About three-quarters (73%) were prescribed antibiotics and 72 percent of patients received drugs intravenously. Amoxycillin and Clavulanic acid combination product was most frequently prescribed antibiotic. Conclusion Major polypharmacy was common in the medical wards of the TUTH. This can misled us while calculating number of drugs prescribed to the patients if all the ingredients of the fixed dose combination products are not considered.