Prevalence, Prescribing Patterns, and Determinants of Polypharmacy among Geriatric Inpatients: A Retrospective Observational Study at a Tertiary Care Teaching Hospital

Abstract

Background: Polypharmacy has become an important challenge in geriatric care owing to the high prevalence of multimorbidity and age-related physiological changes that increase susceptibility to medication-related harm. Hospitalized older adults are particularly vulnerable to adverse drug reactions, drug–drug interactions, and potentially inappropriate prescribing. This study aimed to assess the prevalence, prescribing pattern, and clinical correlates of polypharmacy among geriatric inpatients in a tertiary care teaching hospital. Methods: A retrospective observational study was conducted over six months (January–June 2025) involving 200 hospitalized patients aged ≥60 years with a hospital stay of at least 48 hours. Demographic, clinical, and medication-related data were retrieved from medical records. Polypharmacy was classified as mild (2–4 drugs), moderate (5–9 drugs), and excessive (≥10 drugs). Potentially inappropriate medications were identified using the 2023 AGS Beers Criteria. Statistical analysis was performed using SPSS version 26.0, with p <0.05 considered statistically significant. Results: The mean age of the study population was 69.2 ± 7.3 years , and 54% were men. Patients received a mean of 8.1 ± 2.9 medications during hospitalization. Moderate polypharmacy was observed in 62% of patients, while 20% had excessive polypharmacy. Antihypertensive agents (72%), nutritional supplements (63%), antidiabetic drugs (59%), and gastroprotective medications (58%) were the most frequently prescribed therapeutic classes. Polypharmacy was significantly associated with the presence of three or more comorbidities ( p <0.01), prolonged hospitalization ( p <0.05), and concurrent use of multiple nutritional or herbal supplements ( p <0.05). Potential drug–drug interactions were identified in 29% of prescriptions, 17% contained potentially inappropriate medications, and 29 adverse drug reactions were documented. Conclusion: Polypharmacy is common among hospitalized older adults and is closely linked to multimorbidity and increased medication burden. Routine medication review, medication reconciliation, and evidence-based deprescribing, supported by validated geriatric prescribing tools, may help improve medication safety and optimize therapeutic outcomes in this vulnerable population.