EFFECT OF POLYPHARMACY IN GERIATRICS POPULATION –A PHARMACOVIGILANCE STUDY

Background As per the census of 2001 geriatric population accounts for 7.4% of the total population which increases to 8.2% by 2011 and likely to be 10.7% by 2021. Aging is associated with decreased renal and hepatic clearance of drugs and about one third of the elderly patients are hospitalized due to adverse drug reactions and leading cause were polypharmacy and comorbidities. Objective The objective was to identify and spontaneous reporting of ADR observed in geriatric patients and to assess the influence of polypharmacy and co-morbidities causing ADRs. Methods A six months prospective study was conducted in the geriatric patient of medicine department, Pariyaram Medical College, Kannur (DIST) after obtaining the Ethical Approval. Study was based on the identification, reporting and assessment of ADR according to the inclusion and exclusion criteria. Any reaction noted will be brought into the notice of the physician and filled the notification form. These reports were coordinated during ward rounds and pharmacy practice activities. Informed consent shall be taken from the patient for suspected ADR before documentation. Data of each patient was collected using structured data collection form. The results were statistically analyzed using SPSS version 21. Results and Discussion A total of 203 geriatric patients, 148 patients were monitored during the study period. In 61 ADR reported; 62.29% were female and 37.70% male. Antibiotics were the most ADR causing class of drug and the gastrointestinal system(27.86%) was most affected. Majority of patient had comorbidity condition of diabetes(70.76%) and 93.6% of study population consumes more than 6 drugs. By applying Spearson’,s rho stastical method age was strongly correlated with polypharmacy(p=0.000). Causality assessment according to Naranjos scale observed that 18.03% of ADRs were definite , 52% possible and probable comprises 29.5%. Conclusion Polypharmacy comes with an increased risk for negative health outcomes such as higher healthcare costs, ADEs, drug-interactions, medication non-adherence, decreased functional status and geriatric syndromes. Another reason of ADR is comorbid condition. The available data suggest that a scope of closer pharmacovigilance studies are much needed in the older age group due to co morbidity and polypharmacy which can cause ADR that are preventable.