Polypharmacy, medication adherence, and inappropriate drug use in geriatric patients: A cross-sectional study in a tertiary care hospital

Abstract

Polypharmacy, which means taking several medications at the same time, creates serious challenges for older adults. It can reduce the effectiveness of health care and affect their overall well-being. According to the World Health Organization, polypharmacy is linked to problems such as falls, longer hospital stays, and poor medication adherence. Because older people often have chronic illnesses, they need more medicines, which increase the chance of harmful drug interactions. Studying polypharmacy helps doctors make better treatment plans by looking at side effects and how well patients follow their medication routines. By using this knowledge, healthcare providers can improve care and help elderly patients’ live healthier lives. The aim of this study is to find out how common polypharmacy is among elderly patients, what causes it, how it usually happens, and how it affects their ability to follow their medication plans in a tertiary care hospital. This cross-sectional study was conducted on a sample of 500 geriatric patients aged 65 years and above, recruited from a tertiary care hospital. The cohort included 200 individuals from outpatient (OP) departments and 300 from inpatient (IP) departments. Polypharmacy prevalence and medication adherence were assessed using validated tools: the Beers Criteria for identifying potentially inappropriate medications (PIMs) and the Medication Adherence Rating Scale-5 (MARS-5) for evaluating adherence behavior. Data collection focused on demographic variables, comorbidities, drug utilization patterns, and adherence scores to explore associations and trends within the study population. Polypharmacy was more common in hospitalized patients, 273 out of 301, than in those visiting OP clinics, 92 out of 201. Among IPs, most were male (74.5%), while most OPs were female (75.1%). The largest age group was 65–70 years, making up 51.8% of the participants. A total of 144 patients were taking nine or more medications. Among those with polypharmacy, the most common health issues were hypertension (45%) and diabetes (26.7%). Gastrointestinal (GI) drugs were the most frequently used (17.5%). According to the Beers Criteria, many of the PIMs were GI drugs (45.95%), with pantoprazole being the most common (40.32%). The average medication adherence score (MARS-5) was 20, and 38.36% of patients showed high adherence to their treatment. The study shows that OP clinics focus more on nonmedication options and tend to use fewer drugs. Men aged 65–70 years are more likely to take multiple medications, which need special attention. Prescription patterns show many older adults take nine or multiple medicines, which raises worries about negative effects, medication interactions, and challenges following treatment plans. Healthcare providers must clearly explain medication instructions and potential drug interactions. Effective communication improves patient adherence and medication safety.