Critical and Clinical evaluation of Potentially Inappropriate Medications use in geriatric patients admitted to Medicine, Psychiatry and Oncology departments-A cohort observational study

Multimorbidity leads to use of multiple drugs, a condition known as polypharmacy. A simple

definition of polypharmacy would be the administration of more medicines than are clinically

indicated. In some studies, authors have defined the concomitant ingestion of four or more as

Polypharmacy while some other studies mentioned the use of five and more medications as

polypharmacy. The chances of unintended adverse drug reactions due to drug-drug interactions

are greater in geriatric patients because an assortment of different drugs may be administered to a

patient depending on the disease or symptoms.

The majority of patients admitted in department of medicine are between age group 65-75 years.

In admitted elderly patients mean number of drugs prescribed was increased as age of patients

increased but this was not true for discharged patients in which older elderly patients received

less number of drugs.

Polypharmacy is unavoidable as elderly patients usually suffer from many chronic diseases

which demand use of multiple drugs resulting in complex regimen.

Multiple physicians treating one patient, increasing comorbidities, and an increase in the variety

of drugs available contribute to the adverse effects of polypharmacy on the elderly patient.

Application of Beers criteria, appropriate  therapeutic drug monitoring , and careful, periodic

review of the patients medication list will assist with preventing the sometimes lethal

complications of polypharmacy.

Polypharmacy has somewhat variably been incorporated into  geriatric assessment  studies in

geriatric oncology, and polypharmacy has not been consistently evaluated as a predictor of

negative outcomes in patients with cancer. There is a great need to create standardized

interventions to improve polypharmacy in geriatrics, and particularly in geriatric oncology. The

process of deprescribing is aimed at reducing medications for which real or potential harm

outweighs benefit.