Abstract
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.
Highlights
Providing rational health care is defined as treating the disease following the therapy guidelines, which often implies treatment with multiple pharmacological and non-pharmacological therapies, one of the impending outcomes of which is polypharmacy
This study focuses on interventions to improve the optimal use of medication in the older adult population, which have increased risk due to ADRs and drug-drug interactions
The use of medications is, in part necessary, for the treatment of multiple comorbidities, but polypharmacy is complex, and in particular, it increases the safetyrelated problems of the medications
Summary
Providing rational health care is defined as treating the disease following the therapy guidelines, which often implies treatment with multiple pharmacological and non-pharmacological therapies, one of the impending outcomes of which is polypharmacy. The prevalence of polypharmacy is 5–78% has been reported, the figure having quintupled with an aging population between 2000 and 2010 [3]. Patients are the people more vulnerable to polypharmacy because, as a group, they take more drugs than other young population due to multiple comorbidities. They are known to be at risk of the side effects because of age-associated reduction in physiological capacity or increased stress [2]. In India, the older adults (aged 65 years or above) account for 7% of the total population. The prevalence of polypharmacy was 25, 20% more among the older men (26.10%) than women (24.20%) in India [2]
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