Assessment of patterns and associated aspects of polypharmacy among the geriatric population of Kangra (Himachal Pradesh)

INTRODUCTION: Polypharmacy, defined by the World Health Organization as “the administration of many drugs at the same time or the administration of an excessive number of drugs,” is frequent among the elderly as they often suffer from chronic diseases with concomitant pathologies. Polypharmacy is a debated concept. Various definitions have ranged from two medications at a time to 18 or to more medications than clinically necessary. Five or more concurrent regular medications appear to be the most common definition. Despite the uncertainty around a definition, experts generally agree on the magnitude, potential for harm, and potential for the reduction in medication regimens for elderly people.AIM: The study aimed to assess the patterns of polypharmacy and its associated aspects among the elderly outpatient department (OPD) patients.OBJECTIVES: (1) The objectives of this study were as follows: to study patterns of polypharmacy and its associated aspects and (2) to study general ailments and their association with polypharmacy.MATERIALS AND METHODS: A cross-sectional study was conducted on 371 elderly patients of ≥60 years old with concomitant use of 4 or more medications, defined as polypharmacy.RESULTS: The results of the present study regarding drug use pattern revealed that majority, i.e., 50.9% were questioned most of the times for medicines before prescribing new set of medicines, 41.0% mostly preferred self-medication, 53.1% had no knowledge about the use of medication, 89.2% had no knowledge of the clinical purpose of the medicine they were using, 51.8% mostly forgot the dose and time of medicines, 18.6% had faced intolerable consequences of discontinuing medicine use, and 13.7% had encountered serious problem due to stocking up of the medicines. Majority, i.e., 84.6% experienced side effects of taking medication. The association reveals that polypharmacy was affected significantly by knowledge about the use of medication (P = 0.01), remembering the doses and timing of the medicines (P = 0.01), and encountering serious problem due to stocking up of the medicines (0.01), nasal problems (P = 0.001), and throat problems (P = 0.001).CONCLUSION: There is a pattern of polypharmacy that combines the factors such as aging and the risk of polypharmacy.RECOMMENDATION: The application of specific criteria before prescribing drugs, appropriate monitoring of drug therapy, and careful periodic review of the patient's list of medicines will assist with preventing the lethal complications of polypharmacy. The results indicate the need for additional research into many other aspects of polypharmacy.