A Prospective Study on Polypharmacy in Tertiary Care Teaching Hospital

Abstract

Background: Polypharmacy, the concurrent use of multiple medications, is increasingly prevalent among middle-aged and geriatric populations due to the rise in chronic comorbid conditions. This study to evaluate the prevalence and patterns of polypharmacy, identify associated comorbidities, assess related risk factors, and estimate survival rates using validated clinical scales in a tertiary care hospital setting. Aims and Objectives: To assess the burden of comorbid illnesses among middle-aged and elderly patients. To study the association between comorbidities and polypharmacy. To identify risk factors contributing to polypharmacy. To promote awareness regarding comorbidity-driven polypharmacy. To evaluate survival outcomes using the Charlson Comorbidity Index (CCI) and Comorbid Polypharmacy Scale (CPS). Materials and Methods: A prospective study was conducted over six months (November 2024–April 2025) in the departments of General Medicine, Surgery, Respiratory Medicine, and Orthopedics at Sri Balaji Medical College Hospital, Tirupati. Of 320 screened patients, 72 met the inclusion criteria. Demographic, clinical, and prescription data were collected and analyzed. The number and types of drugs, associated comorbidities, and scores from CCI and CPS were used to evaluate the extent and impact of polypharmacy. Results: Among the 72 subjects, 61% were male and the majority (37%) were aged between 60–69 years. Hypertension (89%) and diabetes (67%) were the most common comorbidities. Most patients (67%) had three comorbidities, and 32% were taking six different medications. The most commonly prescribed drug classes were anti-hypertensive (89%) and anti-diabetics (74%). Using the Charlson Comorbidity Index, most patients fell under moderate mortality risk (score 3: 25.4%), with estimated survival rates decreasing as scores increased. Based on the Comorbid Polypharmacy Scale, 79% of patients experienced moderate polypharmacy (score 8–14), while 18% had mild and 3% had severe polypharmacy. Conclusion: This study identified a high prevalence of polypharmacy among middle-aged and elderly patients, particularly in males aged 60–69 years. Hypertension and diabetes mellitus were the most common comorbidities contributing to increased medication use. Most patients exhibited moderate polypharmacy and moderate mortality risk based on the Charlson Comorbidity Index and Comorbid Polypharmacy Scale. These findings highlight the importance of regular medication review, rational prescribing, and multidisciplinary involvement to minimize drug-related risks and improve therapeutic outcomes in patients with multiple chronic conditions.