ASSESSMENT OF POLYPHARMACY AND ITS CLINICAL CONSEQUENCES AMONG GERIATRIC PATIENTS: A PROSPECTIVE CROSS-SECTIONAL STUDY
Abstract
Background: Polypharmacy is a common and clinically significant problem in geriatric patients, arising from the presence of multiple chronic conditions and predisposing to drug–drug interactions (DDIs), adverse drug reactions (ADRs), potentially inappropriate medications (PIMs), and poor medication adherence. Objective: To evaluate Poly-pharmacy and its associated clinical consequences among geriatric patients, including DDIs, ADRs, PIMs, medication adherence assessed using the General Medication Adherence Scale (GMAS), and risk stratification using the GerontoNet ADR risk score. Methods: A prospective, observational, cross-sectional study was conducted among 313 geriatric patients at a tertiary care hospital. Demographic, diagnostic, and prescription data, along with DDIs, ADRs, PIMs, GerontoNet risk scores, and GMAS adherence levels, were recorded and analyzed using the Chi-square test, Mann–Whitney U test, Kruskal-Wallis test, Spearman correlation, and multiple linear regression. Results: The mean patient age was 72.64 ± 6.58 years, and polypharmacy was highly prevalent. DDIs were observed in the majority of patients, with a strong positive correlation between the number of medications and DDI occurrence (ρ = 0.68, p < 0.001). ADRs occurred in 44.1% of patients and were significantly more frequent among those receiving PIMs (p = 0.002), with a moderate positive correlation between medication count and ADRs (ρ = 0.42, p < 0.001). Medication adherence declined with increasing medication burden (ρ = -0.49, p < 0.001 between GMAS score and medication count), and regression analysis identified the number of medications as the strongest predictor of adherence. Conclusion: Polypharmacy is highly prevalent among geriatric patients and is significantly associated with increased DDIs, ADRs, PIM use, and reduced medication adherence. Rational prescribing, regular medication review, and the use of validated tools such as GMAS and GerontoNet can improve patient outcomes and enhance medication safety.