Prevalence and Interrelationship of Polypharmacy, Potentially Inappropriate Prescribing, and Drug-drug Interactions, in a Tertiary Care Hospital, in Lahore, Pakistan: A Cross-Sectional Study

Abstract

Objective: To determine the prevalence and interrelationship of drug-drug interactions (DDIs) potentially inappropriate prescribing (PIPs) and polypharmacy in admitted patients.
Study Design: Cross-sectional study.
Place and Duration of the Study: Conducted at the Medical Inpatient Department of Combined Military Hospital (CMH), Lahore from 15th January 2024 to 18th May 2024.
Materials and Methods: A total of 180 patients aged 65 years and above, taking at least two medications werei included. Patients with critical illnesses or psychiatric disorders were excluded. Prescriptions were analyzed for DDIs using Medscape's “drug interaction checker” and PIPs were evaluated using the STOPP/START criteria (version 3). Descriptive statistics, including frequencies and percentages, were used to assess the prevalence and association of polypharmacy, DDIs, and PIPs.
Results: Among all prescriptions analyzed, 37.1% included at least one drug identified by the STOPP criteria. DDIs were present in 72.1% of prescriptions, of which 19.7% were minor, 47.5% were significant, and 4.9% were major. Polypharmacy was observed in 67.2% of cases.
Conclusion: Polypharmacy was common among geriatric patients. A moderate proportion of prescriptions exhibited DDIs, out of them the majority classified as significant. Thus, emphasizing the importance of managing complex medication regimens to avoid adverse effects. These findings underline the necessity for vigilant medication review, deep pharmacological knowledge and management to enhance patient safety.