Determining the prevalence and scope of polypharmacy in geriatric patients at a private hospital in Pietermaritzburg, KwaZulu-Natal.

Abstract

Background: Polypharmacy can be defined as the use of multiple medicines by a single patient and includes inappropriate medicine use. This is common among the elderly, especially in patients 60 years and older. The use of multiple medicines has been shown to predispose patients to adverse medicine reactions. Objective: The goal of this study was to determine if polypharmacy is prevalent in geriatric patients in a private hospital in KwaZulu-Natal, Pietermaritzburg, and if so to determine the extent of the problem. Methods: A cross sectional descriptive study involving chart review of geriatric patients was carried out in a hospital. Prescriptions were reviewed for concomitant use of five or more medicines, adverse medicine reactions, therapeutic duplication, contraindications and inappropriate use of medicines. Demographic data e.g. age, sex, and medical aid membership were reviewed. Diagnosis, allergies and number of chronic disease states were also analysed. Results: The majority of the patients reviewed had between one to two chronic diseases. The youngest age group 60-69 years age had the most number of patients with between 1-2 chronic diseases. Females outnumbered males in all three age categories reviewed. The most common chronic disease was hypertension. The 120 study patients were prescribed a combined total of 859 medicines. The average number of medicines per patient was 7.2 (used to determine the degree of polypharmacy) ranging from two to twenty one. A total of 75 % (n=90) of the study patients received 5 and more medicines. Prescription medicine use was assessed according to gender of the study population. Polypharmacy was more prevalent in females when compared to the males. Polypharmacy was prevalent in each age category with the 60-69 years age group having the highest prevalence. Polypharmacy was evident from the results obtained. Conclusion: Prescribing trends in geriatric patients together with inappropriate medicine use were identified. The results of this study can be used by healthcare professionals to be aware of the prevalence of polypharmacy in their settings. Health care professionals can adopt an informed approach to address the needs of the geriatric population regarding polypharmacy. Strategies for pharmacists to manage polypharmacy can include medicine review, communication with the prescriber and patient, reduction in a geriatrics regimen to the fewest possible essential medicines. Prescribers and dispensers can utilize the information to decide whether the medicine is essential and if the geriatric can tolerate possible interactions or adverse effects.