Prevalence and Risk Factors of Polypharmacy Among Elderly Patients Attending A General Medicine Outpatient Department: Cross-Sectional Study.

Original Article

Abstract

Background: Why it Matters: The more chronic conditions that elderly adults experience, the greater the risk of them being prescribed five or more medications, or "polypharmacy. It has been linked with drug side effects, drug interactions, non-adherence to medication, falls, hospitalization, and higher health care costs. The objectives of this study were to assess the incidence of polypharmacy and to identify the risk factors in elderly people visiting a general medicine outpatient department.

Objectives: To determine the prevalence of polypharmacy and identify the demographic and clinical factors associated with polypharmacy among elderly patients attending a general medicine outpatient department.

Methods: This cross-sectional study was conducted over six months in the department  of Pharmacology, Khyber Medical College, Peshawar from jan 2025 to june 2025 . A total of 100 patients aged ≥60 years were recruited using consecutive non-probability sampling after obtaining written informed consent. Demographic characteristics, comorbidities, and medication histories were collected through patient interviews and medical record review. Polypharmacy was defined as the regular use of five or more medications. Data were analyzed using SPSS version 26.0. Continuous variables were expressed as mean ± standard deviation, while categorical variables were presented as frequencies and percentages. Associations were assessed using the independent t-test and Chi-square test, followed by multivariable logistic regression to identify independent predictors of polypharmacy. A p-value <0.05 was considered statistically significant.

Results: The mean age of the participants was 69.4 ± 6.8 years, and 56% were male. Polypharmacy was identified in 46 (46.0%) patients. The prevalence was significantly higher among patients aged ≥70 years (p=0.021), those with three or more chronic diseases (p<0.001), and patients with hypertension (p=0.018), diabetes mellitus (p=0.011), chronic kidney disease (p=0.027), and ischemic heart disease (p=0.034). Multivariable logistic regression demonstrated that multimorbidity (adjusted OR=3.84, 95% CI: 1.62–9.11; p=0.002) and age ≥70 years (adjusted OR=2.31, 95% CI: 1.08–4.96; p=0.031) were independent predictors of polypharmacy.

Conclusion: Polypharmacy was common among elderly outpatients and was independently associated with advanced age and multimorbidity. Routine medication review, rational prescribing, and DE prescribing strategies should be incorporated into geriatric outpatient care to minimize medication-related harm and improve therapeutic outcomes.