Study of Polypharmacy and Associated Problems Among Elderly Patients (Original Work) (Report‪)‬

INTRODUCTION In India, life expectancy has steadily gone up from 32 years at the time of independence to over 63 years in 2001. In 2011 life expectancy has reached 66.8 years, in males it is 65.77 years and 67.95 years in females. There is no United Nations standard numerical criterion, but the UN agreed cut-off is 60+ years when referring to the elderly population (1). In India, the elderly (above 60 years) account for 7% of the total population. According to Census 2011, 5.5% of the India population is above 65 years of age. By 2020, 10.4% of population amounting to 142 million people 60 years or older will be living in India (2). A number of factors are believed to increase the risk of drug related problems in the elderly, including medication errors, inappropriate use of medications, polypharmacy, non-adherence to therapy and self medication (3). The term "Polypharmacy" is appropriately defined as the use of multiple medications and/or the administration of more medications than are clinically indicated, representing unnecessary drug use (4). The most common results of polypharmacy are increased adverse drug reactions, drug-drug interactions and higher costs (5). Polypharmacy is most common in the elderly but is also widespread in the general population (6). Patients at greatest risk of polypharmacy consequences include the elderly, psychiatric patients, patients taking five or more drugs concurrently, those with multiple physicians and pharmacies, recently hospitalized patients, individuals with concurrent comorbidities (7), low educational level (8), and those with impaired vision or dexterity. The study was primarily targeted at the elderly because, as a group they take more drugs than their younger counterparts and are known to be at risk of the side effects of many of the drugs they consume because of age-associated physiologic changes that may cause reduction in functional reserve capacity (i.e. the ability to respond to physiologic challenges or stress). These physiological changes with age have important practical implications for the clinical management of elderly patients: drug metabolism is altered, changes in response to commonly used drugs make different drug dosages necessary and there is need for rational preventive programs of diet and exercise in an effort to delay or reverse some of these changes (9).