Polypharmacy and Adherence to Medication Among Community Dwelling Elderly in a Rural Area in Bangalore Urban District
Background: India’s population above 60 years is projected to climb from 8% in 2011 to 19% in 2050. Elderly persons are vulnerable to chronic diseases for which they consume multiple medications. This study aims to estimate the prevalence of polypharmacy and adherence to medication among elderly persons and factors associated with it. It also estimates the prevalence of diabetes and hypertension, the prevalence of drug-drug interactions, and costs associated with treatment. Methodology: A cross-sectional study was done from June 2014 to May 2015 among 621 elderly persons selected consecutively, residing in 8 villages in Anekal taluk in Bangalore Urban district. All subjects were administered an interview schedule to assess the presence of chronic disease, polypharmacy, and level of adherence to medication. This was followed by physical examination, glucometry, and sphygmomanometry. Results: The median age of the study population was found to be 66 years (IQR 62–72, Range 60–95 years), with 57.6% being “young old.” The prevalence of polypharmacy was found to be 20.9%. Polypharmacy was found to be significantly associated with persons living with one or more family members and was higher among persons suffering from more than one morbidity with poor adherence to medication. Poor adherence to medication was seen among 47% of the population. Poor adherence was found to be significantly associated with persons who used to procure their medication themselves and who were not employed. The prevalence of hypertension and diabetes was 34.1% and 22.2%, respectively. The prevalence of potential drug interaction was found to be 59.4%. A median amount of 578 INR was spent monthly on the total treatment. Conclusions: Rational prescribing of drugs by the treating physician would help to reduce the burden of polypharmacy and potential drug interaction among the elderly.
Key words: Polypharmacy, Adherence, Elderly, Cost of medication, Diabetes, Hypertension, Drug interaction
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