Chronic illnesses and polypharmacy in elderly patients: A hospital-based study in Northern Sri Lanka

Abstract

Population aging and multiple pathology among older people have increased medicines use in elderly. Aim of this study was to evaluate chronic illnesses and polypharmacy and to determine factors associated with polypharmacy among hospitalized elderly at Teaching Hospital-Jaffna. This was a cross sectional, descriptive study. Elderly and polypharmacy were defined as ≥65years and concomitant use of ≥6 medications for ≥1 month respectively. Data were collected from bedhead-tickets of 288 elderly patients using data extraction sheet. Chi-squared and paired t-test were performed to determine the level of significance and unadjusted odd ratios were calculated to determine the association between polypharmacy and common chronic illnesses. A p value <0.05 was set as statistically significance. Mean age was 72 (SD±6.2) and majority were males (53.5%). Relatively higher proportion, 58.7% (n=169) of patients had polypharmacy. Seven chronic illnesses were prevalent in >10% of the patients. Lipid-modifying (80.9%) and antithombotic agents (76.4%) were the top two subgroups prescribed to elderly. Polypharmacy was substantially increased with increasing number of chronic illnesses (p<0.05). Significant association (p<0.05) was found between polypharmacy and coronary heart disease, anaemia, heart failure, asthma and diabetes mellitus. Significantly greater number of medications were prescribed on discharge compared to admission (p<0.05). This study concluded that polypharmacy was common among hospitalized elderly and increases with hospitalization. There was increased tendency to prescribe antithrombotic and lipid-modifying agents. These findings indicate the need for medication reconciliation and review in elderly patient. Further studies targeting wider population are needed to determine the appropriateness of polypharmacy in elderly.