Abstract

Meenu Pandey* and N. K. Meera

ABSTRACT

Polypharmacy indicates use of multiple medications than clinically necessary. It is most common in the elderly due to occurrence of altered pharmacokinetics, pharmacodynamics, physiological changes and also presence of multiple morbidities. Poly-pharmacy in the elderly increases the potential for drug-drug interactions and potentially inappropriate medication. Hence, an optimal drug therapy to improve the quality of life of the elderly patients is one of the major challenges for a healthcare provider. Method: A prospective, observational study was conducted in elderly patients of age >65years for a period of three years in the department of pulmonary medicine of a tertiary care hospital in Bangalore, India. Patient details regarding demographics, all relevant clinical data including past medical history, medication usage, pulmonary function test report were documented in a well-designed and internally validated case report form based on data obtained from medical records of patients, self-reporting by patient or the care giver and laboratory reports. Drug interactions were analyzed using Lexicomp database. Result: Among 418 elderly inpatients recruited during the study, the mean age was 70.02±5.55 years. Polypharmacy (>5 medications/day) was found in 411 patients (98.3%). Out of total drug interactions, 90.4% were pharmacodynamics while 62.7% were pharmacokinetic in nature. Severity assessment showed, 18.7% major, 92.3% moderate while 56.7% minor drug interactions. Conclusion: Polypharmacy in the elderly is a common practice and a concern with respect to the poor clinical outcome. Medication appropriateness in this vulnerable group is the challenge for healthcare team.