Trends of Polypharmacy Among Elderly Patients Attending An out Patient Clinic.

Abstract

Elderly patient often require multiple medications (polypharmacy (PP)) to adequately manage their co-morbidities. The objectives of this study were to analyze the number of medicines per prescription in elderly patients in terms of monopharmacy, minor and major polypharmacy, to identify the demographic trend of polypharmacy among these elderly and to determine the therapeutic groups of medicines involved in combinations resulting in polypharmacy. A retrospective study was carried out using consecutively selected 1000 prescriptions of elderly patients attending the pharmacy outpatient department of Olabisi Onabanjo University Teaching Hospital Sagamu Ogun State Nigeria. Mean age +_ SD was 69.6 +_ 6.99 years and age range was 60-101 years for these elderly patients. The ratio of female to male was 1.2:1.Average number of medicines per prescription was 3.96.Polypharmacy occurred in 93.2% of the elderly patients with 57.5% and 35.7% being minor (2-4) and major ( >_ 5 drugs) PP respectively, while monopharmacy (one drug) occurred in 6.5% of the elderly patients. Therapeutic groups most responsible for polypharmacy were analgesics 122(18.5%), antihypertensive 181 (47.2%), vitamins/minerals234(45.4%) and antidiabetics 77(65.9%). The occurrence of both polypharmacy and monopharmacy reduced as the age group increased and female were more predisposed to polypharmacy. However while there was a significant difference between age groups and minor/major polypharmacy (P=0.0254;F=9.888) none existed for gender(P=0.3926;t=1.081). This study calls for an alert on the side of health care professionals to prescribe with care and to combine therapies only when benefits outweigh risk.

Key words: Trends, Elderly, Monopharmacy, Minor Polypharmacy, Major Polypharmacy