PREVALENCE 0F POLYPHARMACY AMONG THE GERIATRIC POPULATION IN THE FIELD PRACTICE AREA OF URBAN HEALTH TRAINING CENTRE.
Dr. Chandan Kumar
INDEX
S.No CONTENTS PAGE NO.
1. INTRODUCTION 5-6
2. AIMS AND OBJECTIVES 7
3. REVIEW 8-9
4. METHODOLOGY 10-12
5. OBSERVATION AND RESULTS 13-30
6. DISCUSSION 31-34
7. CONCLUSION AND SUMMARY 35-36
8. REFERENCES 37-39
9. ANNEXURE 40-43
INTRODUCTION
The growing size of the elderly population in developing world including India is
undoubtedly posing mounting pressures on various socio-economic fronts
including increased interpersonal and health problems, health care expenditures.
Polypharmacy in a managed care setting presents a unique set of challenges and
opportunities. Despite improved health care system issues of elderly health
are yet not well addressed.
Polypharmacy, a preventable and significant contributor to morbidity and
mortality in the geriatric population. Aging is associated with multiple chronic
diseases which are inter-related to the problems influenced by inappropriate
intake of medication which is a less explored aspect of geriatric health. Population
ageing is a result of high life expectancy and declining fertility. It is now a global
phenomenon as in almost every country older population is rapidly increasing.
The aged population is being projected to be around 1.5 billion in 2050, with 80%
of them in the developing countries. There are numerous definitions used in
the literature for polypharmacy.
Therefore, there is a great challenge and an emerging need to pay attention to age-
related issues of this kind as the care of elderly are human right issue and is inbuilt
in the value system of Indian culture. It is our responsibility to provide elderly a
safe supportive environment for their well-being. Though, Government of India is
fully committed and is playing a vital role in formulating and implementing
policies in order to create an enabling environment for the older persons to lead
an active and productive life, yet the efforts fall short of the need in this context.[1]
AIM OF THE STUDY:
To study polypharmacy and potentially inappropriate medication among geriatric
population of the field practice area of urban health training centre,Peddawaltair,
GVPIHC&MT.
OBJECTIVES:
1. To estimate the prevalence of Polypharmacy among the geriatric population in
the field practice Area of Urban Health Training Centre.
2. To study the pattern of therapy amongst the study population.
3. To study the Adverse Drugs Reactions among the study population.
REVIEW
A cross-sectional study was conducted on 371 elderly patients of ≥ 60 years old with concomitant use of 4 or more medications, defined as Polypharmacy. The results found that the percent prevalence of polypharmacy among the study population was 33.7%. The commonest disease affecting elderly was joint diseases, followed by hypertension, diabetes mellitus, respiratory disorders and sleep disorders. The study found that the use of polypharmacy was affected significantly by age (p= 0.01), place of residence (p = 0.05) and source of income (p= 0.04). No statistically significant relationship between polypharmacy and other factors (gender, educational status, family status, marital status) was found. [2]
An observational study was done in geriatric patients (≥65years) of either gender. The data collected from patients included: Socio-demographic data such as age, gender, marital status, educational status, socioeconomic status, occupation, nutritional status, history of alcohol/smoking, exercise history, details of comorbid diseases, medication history, findings of clinical examination etc. In this study, polypharmacy was considered as having 5 or more medications per prescription.[3]
A cross-sectional population study performed in Lazio, Italy, From the regional health care assistance file, residents aged 65 years and older (mean age = 75.9 years, SD = 7.4) and alive at the end of 2010 were enrolled. Drug consumption was linked from the drug claims registry for 2010, and hospital admissions were retrieved from the hospital admission registry during 2009–2010. Enrolees were characterised for socio-demographic variables, presence of chronic diseases, and drug consumption, considering large groups, and specific sub-groups. Polypharmacy was defined as use of 6+ drugs.[4]
A cross-sectional study design with linked health administrative databases for all persons aged ≥66 years eligible for health insurance in Ontario, Canada at the two index dates. Descriptive analyses and multivariable logistic regression models were conducted; models included interaction terms between age, multimorbidity level, and time period to estimate polypharmacy and hyper-polypharmacy probabilities, risk differences and risk ratios for 2016 vs 2003. Multimorbidity, polypharmacy and hyper-polypharmacy increased significantly over the 13 years. At both index dates prevalence estimates for all three were higher in women, but a greater absolute increase in polypharmacy over time was observed in men (6.6% [from 55.7% to 62.3%] vs 0.9% [64.2%-65.1%] for women) though absolute increases in multimorbidity were similar for men and women (6.9% [72.5%-79.4%] vs 6.2% [75.9%-82.1%], respectively).[5]
METHODOLOGY
Study design: Observational, descriptive, cross- sectional study.
Place of study: Peddajalaripeta area of the field practice area of UHTC,
Pedda Waltair.
Duration of study: 2months (28th October to 27th December)
Sampling frame: All the people,65 years and above resident in
study area of field practice area.
Study Population: Sampled old people,65 years and above and resident in
study area of field practice area.
Inclusion criteria:
1.Study subjects 65 years and above.
2.Those present at the time of the study and who responded.
3.Study subjects who do not respond and the necessary data is given by the
informant.
Exclusion criteria:
1.Study subjects below the age of 65 years.
2.Subjects who do not respond and who do not have an informant.
3.Study subjects who seriously ill and non-cooperative.
Sample size:
A sample of 178 study subject were chosen from old people 65 years and above in
Peddajalaripeta.
Sample size was calculated using the formula :
n≥ N/1+Nd²
where N=320; d=0.05.
The size of the study sample (n) should be minimum of 178 study subjects.
Sampling technique:
The sampling technique applied was multistage and simple random
sampling.
Study procedure:
The UHTC Pedawaltair has 4 areas namely
1. Pedajalaripeta
2. Pedawaltair
3. Chinnawaltair
4. East point colony
1st stage: Among the 4 areas of UHTC, Pedajalaripeta area was chosen by
Simple Random Sampling Technique.
2nd stage: All the people of age 65 years and above were enumerated
and 178 of them were chosen by Simple Random Sampling Technique.
The households where people 65 and above residing were enumerated.
This constitutes the sampling frame and by using simple random sampling
Technique, 178 of them were selected using inclusion and exclusion criteria.
DATA COLLECTION METHOD:
A predesigned and pretested study instrument was used and it was translated into
local vernacular language. The study subjects were interviewed by conducting
door to door survey at the households of selected study population. Those present
at the time of the study, able to respond and in those who responded with the help
of informants were included in the study.
IEC AND CONSENT:
Permission from institutional ethical committee was taken prior to the start of the
study. Informed consent was taken from the study subjects after duly explaining
the study.
STATISTICAL ANALYSIS:
The data collected was entered into excel sheet and using SPSS v.23 the data was
analyzed. Appropriate statistical methods would be applied depending upon the
nature of the distributional study population.
OBSERVATION AND RESULTS
Table-1: Age distribution of study subjects(n=179)
Age group (in years) Count Percentage
≥ 80 11 6.15
65-69 66 36.87
70-74 75 41.90
75-79 27 15.08
Total 179 100.00
In this study maximum number of participants were aged 70-74 years (41.90%),
followed by 65-69 years (36.87%), 75-79 years (15.08%) and >=80 years (6.15%).
Graph-1: Age distribution (n=179)
Table-2: Gender distribution of study subjects(n=179)
Gender Count Percentage
Female 70 39.11
Male 109 60.89
Total 179 100.00
Among the study population, more than half of the population were
males(60.89%) where as 45.52% are females.
Graph-2: Gender distribution of study subjects(n=179)
Table-3: Distribution of study subjects according to medicines consuming for
any disease(n=179).
MEDICATION Count Percentage
YES 164 91.62
NO 15 8.38
Total 179 100.00
Among the study population of 179, 91.62% of them are taking medication and
8.38% are not taking any medication.
Graph-3: Distribution of study subjects according to medicines consuming for any disease(n=179).
Table-4: Distribution of study subjects according to diseases suffering(n=179).
Diseases Count Percentage
ARTHRITIS 35 8.97
ASTHMA 20 5.13
CANCER 11 2.82
CATARACT 16 4.10
CHRONIC BRONCHITIS 6 1.54
CKD 18 4.62
CNS IMPAIRMENT 12 3.08
DM 97 24.87
EMPHYSEMA 0 0.00
HEARING LOSS 15 3.85
HTN 102 26.15
OSTEOPOROSIS 10 2.56
OTHERS 25 6.41
PARKINSONS DISEASE 3 0.77
STROKE 9 2.31
TB 11 2.82
Total 390 100.00
Among the study population ,the maximum proportion of population suffering
from HTN (26.15%) followed by DM (24.8%),arthritis(8.97%) and minimum
population from Parkinson’s disease(0.77%).
Graph-4: Distribution of study subjects according to diseases suffering(n=179).
Table-5: Distribution of study subjects based on number of medicines consumed on daily basis(n=179).
medicines consuming on a daily basis Count Percentage
1 36 20.11
2 25 13.97
3 50 27.93
4 30 16.76
5 27 15.08
6 10 5.59
7 1 0.56
Total 179 100.00
Among the study population, the maximum proportion of subjects consuming 3
medicines constitute 27.93% and minimum proportion of subjects consuming 7
medicines constitute 0.56% on daily basis.
Graph-5:Distribution of study subjects based on number of medicines
consumed on daily basis(n=179)
Table-6:Distribution of study subjects based on polypharmacy(n=179).
polypharmacy Count Percentage
Present 38 21.23
Absent 141 78.77
Total 179 100.00
Among the study population , 21.23% of the study subjects were seem to be having
polypharmacy while 78.77% of them were not.
Graph-6:Distribution of study subjects based on polypharmacy(n=179).
The above graph shows the count of polypharmacy. 21.23% of the study subjects were seem to be having polypharmacy while 78.77% of them were not.
Table-7: Distribution of study subjects based on categories of drugs consumed (n=179).
Drugs consumed Count Percentage
ANTACIDS 34 6.59
ANTIANGINAL 15 2.91
ANTIARRHYTHMICS 0 0.00
ANTIBIOTICS 23 4.46
ANTICANCER 10 1.94
ANTICOAGULANTS 8 1.55
ANTIDEPRESSANTS 1 0.19
ANTIEMETICS 11 2.13
ANTIEPILEPTICS 10 1.94
ANTIHELMENTHICS 0 0.00
ANTIHYPERTENSIVES 98 18.99
ANTIHYSTAMINES 3 0.58
ANTIRHEUMATICS 15 2.91
ANTISPASMODICS 0 0.00
ANTITUSSIVES 4 0.78
BRONCHODILATORS 30 5.81
DIURETICS 18 3.49
HYPOGLYCEMIC 94 18.22
HYPOLIPIDEMICS 8 1.55
NSAIDS 47 9.11
OTHERS 69 13.37
PPI'S 15 2.91
SEDATIVES 3 0.58
Total 516 100.00
Among the study population, maximum proportion. of study subjects were seen consume anti-hypertensives(18.99%), followed by hypoglycemics(18.22%) while minimum proportion of study subjects are taking anti-depressants(0.19%) and none of them were taking antiarrhythmics, anti-helmenthics, anti-spasmodics.
Graph-7: Distribution of study subjects based on categories of drugs
consumed (n=179).
Table-8: Distribution of study subjects based on person prescribing the drugs (n=179).
Person prescribing the drugs Count Percentage
Government doctor 108 60.34
Private doctor 64 35.75
RMP 7 3.91
Total 179 100.00
Among the study population, maximum proportion of subjects were prescribed by
government doctor(60.34%) followed by private doctor(35.75%) and
RMP(3.91%).
Graph-8: Distribution of study subjects based on person prescribing the drugs (n=179).
Table-9: Distribution of study subjects based on taking drugs from pharmacy without prescription (n=179).
Drugs consuming directly from pharmacy without prescription Count Percentage
Yes 17 9.50
No 162 90.50
Total 179 100.00
Among the study population, 9.50% of study subjects were taking medicine
Without prescription while 90.50% of them were not taking medicine
without prescription.
Graph-9: Distribution of study subjects based on taking drugs from pharmacy without prescription (n=179).
Table-10: Disribution of study subjects based on drugs consumed without
prescription(n=179).
Drugs Consumed Count Percentage
ANTACIDS 12 19.60
ANTIANGINAL 1 1.64
ANTIBIOTICS 5 8.20
ANTICANCER 2 3.28
ANTICOAGULANTS 1 1.64
ANTIEMETICS 4 6.56
ANTIHYPERTENSIVES 9 14.75
ANTIRHEUMATICS 2 3.82
BRONCHODILATORS 1 1.64
HYPOGLYCEMIC 9 14.75
NSAIDS 4 6.56
OTHERS 4 6.56
PPI'S 4 6.56
SEDATIVES 3 4.92
Total 61 100.00
Among the study population, the maximum proportion of study subjects are
consuming antacids(19.60%) without doctors prescription followed by anti
hypertensives (14.75%) and hypoglycemics (14.75%) while minimum proportion
of them were taking antianginals (1.64%), anticoagulants(1.64%),
bronchodilators(1.64%).
Graph-10: Disribution of study subjects based on drugs consumed without
prescription(n=179).
Table-11: Distribution of study subjects based on medication other than allopathy (n=179).
medication consumed other than
allopathy Count Percentage
Yes 23 12.85
No 156 87.15
Total 179 100.00
Among the study population,87.15% of the study subjects were taking allopathy
while 12.85% of them were taking other than allopathy.
Graph-11: Distribution of study subjects based on medication other than allopathy (n=179).
Table-12: Distribution of study subjects consuming medicines based on systems of medicine other than allopathy(n=179).
Systems other than Allopathy Count Percentage
AYURVEDA 14 53.85
HOMEOPATHY 12 46.15
SIDDHA 0 0.00
YUNANI 0 0.00
Among the study population, 53.85% of the study subjects were taking Ayurvedic medication followed by Homeopathy (46.15%) while none of them are taking Siddha and Yunani.
Graph-12: Distribution of study subjects consuming medicines based on systems of medicine other than allopathy(n=179).
Table-13:Distribution of study subjects based on adverse drug reactions after consuming medication(n=179)
adverse drug reactions after taking medications Count Percentage
Yes 12 6.70
No 167 93.30
Total 179 100.00
Among the study population , 6.70% of the study subjects were suffering from
adverse drug reactions after taking medication while 93.30% of them were not.
Graph-13: Distribution of study subjects based on adverse drug reactions
after consuming medication(n=179)
Table-14: Distribution of study subjects based on medication consumed for
adverse drug reactions(n=179)
Medicine consumed to treat ADR Count Percentage
Yes 11 14.86
No 63 85.14
Total 74 100.00
Among the study population, 14.86% of the study subjects are taking medicine for
adverse reactions while 85.14% are not taking any.
Graph-14: Distribution of study subjects based on medication consumed for
adverse drug reactions(n=179)
Table-15: Association between polypharmacy and prescribing person(n=38).
Prescribing person Polypharmacy
NO Polypharmacy
YES Total % of polypharmacy
Government doctor 93 15 108 13.80%
Private doctor 42 22 64 34.37%
RMP 6 1 7 14.28%
In the study population of polypharmacy(n=38),34.37% is prescribed by private
doctor followed by 14.28% by RMP and 13.80% by government doctor.
The chi-square statistic is 5.8423. The p-value is .05387. The result
is not significant at p < .05.
DISCUSSION
In present study, it was observed that the majority(41.90%) of the study
population were 70-74 years age group. A similar observation was made in the
study done by U.Kirchmayer et al.[6] where out of the 1,122,864 elderly
residents, 57.9% were women, and 48.8% aged 75.
In the current study, it was observed that the majority(60.89%) of the study
population were males. A similar observation was made in the study done by
K B Rakesh et al.[7] showed 50.7% were males .
In current study , it was observed that majority (91.62%) of them were seen to
use atleast one medication for a disease. A similar observation was made in
the study done by Alan S.L. Yu MB, BChir, in Brenner and Rector's The
Kidney[8] among the elderly , 87.7% use at least one medication.The
prevalence of polypharmacy among the elderly in the United States is
35.8%. Patients over 65 years of age take on average 2–6 prescribed
Medications.
In current study,majority proportion(26.15%) of them were suffering from
HTN. A similar observation was made in the study done by Alan S.L. Yu MB,
BChir, in Brenner and Rector's The Kidney[9] 44% of older men and 57% of
older women received five or more prescription medications,a finding
typical among those with Cardio vascular diseases.
In current study,21.23% of the study population were seen to be having
polypharmacy. . A similar observation was made in the study done by Dona
Varghese, Cecilia Ishida, Hayas Haseer Koya[10] it was found that 14%
were seen to have polypharmacy. In contrast to the observation made in
another study by Priya S et al.[11] 33.7% were found to have polypharmacy.
In this current study,majority(18.99%) of the study population were found to
Consume Antihypertensives. A similar observation was made in the study
done byColleen J. Maxwell et al.[12] Among both groups, estimates for selected
cardiovascular (statins, angiotensin-converting enzyme (ACE) inhibitors,
beta-blockers) and oral anti-diabetic medications were higher among men
than women (likely reflecting sex differences in the prevalence of related
conditions) whereas women were more often dispensed proton pump
inhibitors (PPIs) and medications for thyroid disease.
In this current study,majority(60.34%) of the study population were
prescribed by Government doctor .
In this current study, 9.50% of the study population were
taking drugs without prescription of which majority of them were seen to
consume Antacids. A similar observation was made in the study
done by Dieu Huyen Thi Bui et al.[13]Mean number of medicines was 7.8%
OTC medicine.
In present study, 12.85% of the study population were taking medication
other than Allopathy of which majority were taking Ayurvedic medicine. In
contrast an observation was made in the study done by Dieu Huyen Thi Bui et
al.[14] 41% were taking herbal and traditional medicine.
In the present study, 6.70% of the study population were seen to have advesre
drug reaction. A similar observation was made in the study done by Dona
Varghese, Cecilia Ishida, Hayas Haseer Koya [15]ADEs are estimated to be
indicated in 5% to 28% of acute geriatric medical admissions. The drug classes
commonly associated with preventable ADEs are cardiovascular drugs,
anticoagulants, hypoglycemics, diuretics, and NSAIDs. Adverse drug effects are
higher in older adults due to metabolic changes .
Strengths:
1.A large amount of data could be captured in very short time using a
cross-sectional study.
2. Exploration of trends in both multimorbidity and polypharmacy.
Limitations:
1.Unable to procure large number of subjects due to restricted time period.
2.Due to lack of prescription with study subjects, we are unable to collect data
on potentially inappropriate medication.
Recommendations:
1. Maintain an accurate medication list and medical history and update whenever possible.
2. Encourage patients to bring all medications including prescription, OTC drugs, supplements, and herbal preparations.
3. Review any changes with patient and caregiver and if possible, provide all the changes in writing.
4. Use the fewest possible number of medications and the simplest possible dosing regimen.
5. Try to link each prescribed medication with its diagnosis.
6. Discontinue all unnecessary medications.
7. Screen for drug-drug and drug-disease interactions.
8. Avoid starting potentially harmful medications.
9. Avoid starting medications to combat the potential side effects of other medications.
SUMMARY AND CONCLUSION
The main essence of the study was to assess the prevalence of polypharmacy
among the geriatric population in the field practice area of urban health
training centre, Peddajalaripeta and to study the pattern of therapy amongst
the Indian system of medicine and study the adverse drugs reactions among
the geriatric population.
It was observed that out of 179 study subjects 38(21.22%) of the study
Population were categorized under polypharmacy and 141(78.77%) were not
under polypharmacy.So this accounts for 21.22% prevalence rate of
polypharmacy in the study population(n=179).
Most of the participants include in the age group of 70-74 years i.e; 41.90%
and majority of them were males(60.89%).
Among the study subjects(n=179),91.62% of them were taking medication for
disease and majority of them are suffering from HTN(26.15%) followed by
DM(24.8%).
Among the study population(n=179),21.23% were consuming more than or
equal to 5 drugs on daily basis and they were categorized under
polypharmacy(21.23%).
Among the study subjects(n=179), majority of them were consuming anti
hypertensives (18.99%) followed by hypoglycemics(18.22%).
Among the study population(n=179), 60.34% were prescribed by government
doctor .
9.50% of the study subjects were taking medication at pharmacy without
doctors prescription of which 19.60% were taking antacids directly.
Among the study population(n=179), 23(12.85%) of them were taking other
than allopathy of which 14(53.85%) were taking Ayurveda and 12(46.15%)
were taking homeopathy medicine.
Lastly,among the study population(n=179), 12(6.7% )of the study subjects
suffered from adverse drug reactions after taking medication.
There was no association found between,polypharmacy and prescribing
doctor among the study subjects.
In conclusion, the prevalence of polypharmacy among the geriatric population
in the field practice area of urban health training centre, Peddajalaripeta was
found to be 21.23%
REFERENCES
1. Priya S , Gupta NL , Chauhan HS ,MPH Scholar, Center for Public Health & Healthcare Administration, Eternal University, Baru Sahib, HP, India ,Associate Professor& HoD, Psychology Department, Eternal University, Baru Sahib, HP, India ,Professor cum Head of Department, Center for Public Health & Healthcare Administration, Eternal University, Baru Sahib, HP, India:
http://gmch.gov.in/sites/default/files/documents/6_POLYPHARMACY_43_52.pdf (accessed on 26 December 2021)
2. Priya S , Gupta NL , Chauhan HS ,MPH Scholar, Center for Public Health & Healthcare Administration, Eternal University, Baru Sahib, HP, India ,Associate Professor& HoD, Psychology Department, Eternal University, Baru Sahib, HP, India ,Professor cum Head of Department, Center for Public Health & Healthcare Administration, Eternal University, Baru Sahib, HP, India:
http://gmch.gov.in/sites/default/files/documents/6_POLYPHARMACY_43_52.pdf (accessed on 26 December 2021)
3. K B Rakesh , Mukta N Chowta , Ashok K Shenoy , Rajeshwari Shastry, Sunil B Pai : https://pubmed.ncbi.nlm.nih.gov/28458417/
(accessed on 26 December 2021)
4. U.KirchmayeraF.MayeraM.BassobR.DeCristofarobN.MorescG.CappaiaN.AgabitiaD.FuscoaM.DavoliaG.Gambassid: https://www.sciencedirect.com/science/article/abs/pii/S1878764916300626 (accessed on 26 December 2021)
5. Colleen J. Maxwell ,Luke Mondor,Anna J. Pefoyo Koné, David B. Hogan,Walter P. Wodchis: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0250567 (accessed on 26 December 2021)
6. U.KirchmayeraF.MayeraM.BassobR.DeCristofarobN.MorescG.CappaiaN.AgabitiaD.FuscoaM.DavoliaG.Gambassid: https://www.sciencedirect.com/science/article/abs/pii/S1878764916300626 (accessed on 26 December 2021)
7. K B Rakesh , Mukta N Chowta , Ashok K Shenoy , Rajeshwari Shastry, Sunil B Pai : https://pubmed.ncbi.nlm.nih.gov/28458417/ (accessed on 26 December 2021)
8. Alan S.L. Yu MB, BChir, in Brenner and Rector's The Kidney:
https://www.sciencedirect.com/topics/medicine-and-dentistry/polypharmacy (accessed on 26 December 2021)
9. Alan S.L. Yu MB, BChir, in Brenner and Rector's The Kidney:
https://www.sciencedirect.com/topics/medicine-and- dentistry/polypharmacy (accessed on 26 December 2021)
10. Priya S , Gupta NL , Chauhan HS ,MPH Scholar, Center for Public Health & Healthcare Administration, Eternal University, Baru Sahib, HP, India ,Associate Professor& HoD, Psychology Department, Eternal University, Baru Sahib, HP, India ,Professor cum Head of Department, Center for Public Health & Healthcare Administration, Eternal University, Baru Sahib, HP, India: http://gmch.gov.in/sites/default/files/documents/6_POLYPHARMACY_43_52.pdf (accessed on 26 December 2021)
11. Dona Varghese, Cecilia Ishida, Hayas Haseer Koya: https://www.statpearls.com/ArticleLibrary/viewarticle/27419 (accessed on 26 December 2021)
12. Colleen J. Maxwell ,Luke Mondor,Anna J. Pefoyo Koné, David B. Hogan,Walter P. Wodchis: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0250567 (accessed on 26 December 2021)
13. Dieu Huyen Thi Bui ,Bai Xuan Nguyen, Dat Cong Truong ,Dan Wolf
Meyrowitsch,Jens Søndergaard , Tine Gammeltoft, Ib Christian
Bygbjer , Nielsen Jannie:
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.024984
(accessed on 26 December 2021)
14.Dieu Huyen Thi Bui ,Bai Xuan Nguyen, Dat Cong Truong ,Dan Wolf
Meyrowitsch,Jens Søndergaard , Tine Gammeltoft, Ib Christian
Bygbjer , Nielsen Jannie:
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.024984
(accessed on 26 December 2021)
15.Dona Varghese, Cecilia Ishida, Hayas Haseer Koya: https://www.statpearls.com/ArticleLibrary/viewarticle/27419 (accessed on 26 December 2021)
ANNEXURE
QUESTIONNAIRE:
PREVALENCE OF POLYPHARMACY IN GERIATRIC PATIENTS.
1.Age group(in years)
a) 65-69
b) 70-74
c) 75-79
d) ≥80
2.Gender
a) Male
b) Female
3.Are you taking any medication for any disease?
a) Yes
b) No
4.If yes,what are the diseases are you suffering from?
Yes No
a) HTN
b) DM
c) Cataract
d) Arthritis
e) Cancer
f) TB
g) Hearing loss
h) Stroke
i) Chronic kidney disease
j) Parkinson’s disease
k) Osteoporosis
l) Asthma
m) Chronic Bronchitis
n) Emphysema
o) CNS impairment
p) Others
5.How many medicines are you consuming on a daily basis?
______________________
6.What are the drugs consumed?
Yes No
a) Antibiotics
b) Antiemetics
c) Antitussives
d) Antispasmodic
e) Anticancer
f) Hypoglycaemic
g) Bronchodilators
h) Anti hypertensives
i) Anti histamines
j) NSAIDs
k) Anti arrhythmic
l) Diuretics
m) Anti helminthic
n) Anti coagulants
o) Anti rheumatic
p) Anti depressants
q) Sedatives
r) Anti epileptics
s) Anti anginal
t) Hypolipidaemic
u) PPI inhibitors
v) Antacids
w) Others
7.Who is prescribing the drugs?
a) Government doctor
b) Private doctor
c) RMP
8.Are you taking any drugs directly from pharmacy without doctors prescription?
a) Yes
b) No
9.If yes what are the drugs consumed?
Yes No
a) Antibiotics
b) Anti emetics
c) Anti tussives
d) Anti spasmodic
e) Anti cancer
f) Hypoglycaemic
g) Bronchodilators
h) Anti hypertensive
i) Anti histamines
j) NSAIDs
k) Anti arrhythmic
l) Diuretics
m) Anti helminthic
n) Anti coagulants
o) Anti rheumatic
p) Anti depressants
q) Sedatives
r) Anti epileptics
s) Anti anginal
t) Hypolipidaemic
u) PPI inhibitors
v) Antacids
w) Others
10.Are you taking any medication other than allopathy?
a) Yes
b) No
11.If yes, which system is he taking from?
Yes No
a) Ayurveda
b) Homeopathy
c) Siddha
d) Yunani
12.Did you suffer from any adverse drug reactions after taking medications?
a) Yes
b) No
13.If yes, did you take any medicine to treat them?
a) Yes
b) No
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