Drugs are the most common medical interventions for betterment of the patients but they are fatal too. Inappropriate prescription and using of multiple medications can lead to morbidity and mortality. Polypharmacy is an important factor for occurrence of drug related problems like adverse drug reactions and drug-drug interactions, especially in elderly and ICU treated patients. Concomitant use of multiple medications associated with increased risk of hospitalization, increase in economic burden to patient and can potentially leadsto therapeutic failure. The study was aimed to assess the prevalence of polypharmacy and drug-drug interactions. The study was carried out in a 500 bedded tertiary care teaching hospital for a period of four months. About 940 prescriptions were screened for the study, in this male were 50.95 % (n = 479) and female 49.04 % (n = 461). About 51.06 % (n = 480) patients had major poly pharmacy followed by 22.97 % (n = 216) patients with minor polypharmacy and 25.95 % (n = 244) patients with non-poly pharmacy. In present study, majority of thepatients had respiratory followed by cardiovascular diseases. There were 512 (54.46 %) prescriptions which had drug-drug interactions and 420 (45.53 %) prescriptions had no drug-drug interaction. Out of 512 prescriptions there were 734 drug-drug interactions among them 16.75 % (n = 123) were major, 41.82 % (n = 307) were moderate and 41.41 % (n = 304) were minor drug-drug interactions. Poly pharmacy has a very high prevalence among hospitalized patients especially in ICU, resulting in more drug interactions. Physicians should prescribe a rationale combination and pharmacist should provide the pharmaceutical health care to improve the quality of patients.
Poly pharmacy significantly raises the likelihood of adverse reactions to drugs, risk of hospitalization and medical errors related to drugs. It depends on the number of drugs, the diseases, and patient related factors. Poly pharmacy is a risk factor for severe adverse drug reactions (ADRs) and is associated with an increased risk of mortality. The main aim of the study was to assess the poly pharmacy leading to adverse drug reaction. This is a prospective observational study conducted at Basaveshwara Medical College Hospital and Research Center (BMCH and RC), Chitradurga, India for the period of 4 months in the department of Medicine. In this study 601 patients of both genders were included. The identified ADRs are reported to the physician and causality assessment of adverse drug reactions (ADR's) was done by using the Naranjo's scale and Modified Hartwig Seigle scale. About 601 patients screened among them 315 patients were males and 286 were females and average drugs per prescription were 6.17. There are 356 (59.23 %) patients with major poly pharmacy (≥ 6 drugs) and 245 (40.76 %) with minor poly pharmacy (3-5 drugs). During the study 32 ADRs were identified and reported to the Physicians; in this 28 ADRs were accepted. The prevalence of ADRs seen during the study was 5.32 % and in this 3.49 % (n = 21) were seen patients who had major poly pharmacy. Our study showed that females were more prone to develop ADRs compared to the males i.e., 53.12 % (n = 17) of ADRs were identified in female gender and 46.87 % (n = 15) in male gender. Out of 32 ADRs 21 (65.62 %) were identified in patients with major poly pharmacy and 11 (34.37 %) with minor poly pharmacy. There were more ADRs associated with major poly pharmacy and female gender. It is necessary to create the awareness to curb irrational prescription of poly pharmacy which helps in prevention of drug related problems like ADRs.
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