AN ANALYSIS OF THE PREVALENCE OF POLYPHARMACY AMONG INPATIENTS OF A TERTIARY CARE HOSPITAL IN KERALA
DOI:
https://doi.org/10.22159/ajpcr.2022.v15i5.44479Keywords:
Inpatients, Polypharmacy, Prevalence, PrescriptionAbstract
Objectives: The aim of the study was to estimate the prevalence of polypharmacy, identify the age groups commonly associated with polypharmacy, study the correlation between duration of hospital stay and polypharmacy, and identify the diseases commonly associated with polypharmacy
Methods: Record-based, prospective, and cross-sectional study among 370 inpatients of a tertiary care hospital in Kerala. Prescriptions containing ≥3 drugs were collected from inpatient medical records of patients with at least 3 days hospital stay. The number of drugs ≥5 was considered as polypharmacy in the present study.
Results: The prevalence of polypharmacy was 93% and average the number of drugs per prescription was 8.81±3.097. Average number of drugs per prescription was significantly high among patients >60 years. Percentage of prescriptions with polypharmacy among patients with duration of stay 3–5 days, 6–8 days, and ≥ 9 days was found to be 89.4, 98.6, and 100, respectively. There was a significant positive association between duration of hospital stay and percentage of prescriptions with polypharmacy as well as average number of drugs per prescription. Diseases or comorbidities most commonly associated with polypharmacy were hypertension, diabetes mellitus, cerebrovascular accidents, coronary artery disease, and dyslipidemia.
Conclusion: The prevalence of polypharmacy was high in the present study (93%) when compared to similar studies. Age >60 years was strongly associated with the prevalence of polypharmacy, but gender was not found to be factor. Duration of hospital stay was an important factor positively associated with percentage of prescriptions with polypharmacy as well as number of drugs per prescription.
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Mohammed SS, Sreenath MK, Vishnu VG, Jose F, Siraj ST, Anand VP. The prevalence of polypharmacy in South Indian patients: A pharmacoepidemiological approach. IJPP 2012;5:40-4.
Good CB. Polypharmacy in elderly patients with diabetes. Diabetes Spec 2002;15:240-8. doi: 10.2337/diaspect.15.4.240
Hajjar ER, Hanlon JT, Sloane RJ, Lindblad CI, Pieper CF, Ruby CM, et al. Unnecessary drug use in frail older people at hospital discharge. J Am Geriatr Soc 2005;53:1518-23. doi: 10.1111/j.1532- 5415.2005.53523.x, PMID 16137281
Kurfees JF, Dotson RL. Drug interactions in the elderly. J Fam Pract 1987;25:477-88. PMID 3681207
Flaherty JH, Perry HM 3rd, Lynchard GS, Morley JE. Polypharmacy and hospitalization among older home care patients. J Gerontol A Biol Sci Med Sci 2000;55:M554-9. doi: 10.1093/gerona/55.10.m554, PMID 11034227
Reus VI. Rational polypharmacy in the treatment of mood disorders. Ann Clin Psychiatry 1993;5:91-100. doi: 10.3109/10401239309148969, PMID 8102302
Nolan PE Jr., Marcus FI. Cardiovascular drug use in the elderly. Am J Geriatr Cardiol 2000;9:127-9. doi: 10.1111/j.1076-7460.2000.80021.x, PMID 11416550
Incalzi RA, Gemma A, Capparella O, Terranova L, Porcedda P, Tresalti E, et al. Predicting mortality and length of stay of geriatric patients in an acute care general hospital. J Gerontol 1992;47:M35-9. doi: 10.1093/geronj/47.2.m35, PMID 1538063
Linjakumpu T, Hartikainen S, Klaukka T, Veijola J, Kivelä SL, Isoaho R. Use of medications and polypharmacy are increasing among the elderly. J Clin Epidemiol 2002;55:809-17. doi: 10.1016/s0895- 4356(02)00411-0, PMID 12384196
Rieckert A, Trampisch US, Klaaßen-Mielke R, Drewelow E, Esmail A, Johansson T, et al. Polypharmacy in older patients with chronic diseases: A cross-sectional analysis of factors associated with excessive polypharmacy. BMC Fam Pract 2018;19:113. doi: 10.1186/s12875- 018-0795-5, PMID 30021528
Halvorsen KH, Selbaek G, Ruths S. Trends in potentially inappropriatemedication prescribing to nursing home patients: Comparison of threecross-sectional studies. Pharmacoepidemiol Drug Saf 2017;26:192-200. doi: 10.1002/pds.4142, PMID 27935150
Rollason V, Vogt N. Reduction of polypharmacy in the elderly: A systematic review of the role of the pharmacist. Drugs Aging 2003;20:817-32. doi: 10.2165/00002512-200320110-00003, PMID 12964888
Rakesh KB, Chowta MN, Shenoy AK, Shastry R, Pai SB. Evaluation of polypharmacy and appropriateness of prescription in geriatric patients: A cross-sectional study at a tertiary care hospital. Indian J Pharmacol 2017;49:16-20. doi: 10.4103/0253-7613.201036, PMID 28458417
Salwe KJ, Kalyansundaram D, Bahurupi Y. A study on polypharmacy and potential drug-drug interactions among elderly patients admitted in Department of Medicine of a tertiary care hospital in Puducherry. J Clin Diagn Res 2016;10:FC06-10. doi: 10.7860/JCDR/2016/16284.7273, PMID 27042480
Gupta R, Malhotra A, Malhotra P. A study on polypharmacy among elderly medicine in-patients of a tertiary care teaching hospital of North India. Natl J Physiol Pharm Pharmacol 2018;8:1297-301. doi: 10.5455/ njppp.2018.8.0518424052018
Slabaugh SL, Maio V, Templin M, Abouzaid S. Prevalence and risk of polypharmacy among the elderly in an outpatient setting: A retrospective cohort study in the Emilia-Romagna region, Italy. Drugs Aging 2010;27:1019-28. doi: 10.2165/11584990-000000000- 00000, PMID 21087071
Rathod G, Nalini GK, Nagaral JV, Sahana GN, Deepak P, Prema M, et al. Factors associated with polypharmacy in geriatrics. Intl J Basic Clin Pharmacol 2017;6:1763-7.
Dutta M, Prashad L. Prevalence and risk factors of polypharmacy among elderly in India: Evidence from SAGE Data. Int J Public Ment Health Neurosci 2015;2:2394-4668.
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