Background:
Medication overload and polypharmacy are increasingly common in older adults, particularly those with chronic conditions such as hypertension, diabetes, and urological disorders. Drug–drug interactions (DDIs) are often underreported but contribute significantly to hospitalizations, adverse drug reactions (ADRs), and treatment failure in this population (1–3). Despite widespread clinical guidelines, inappropriate prescriptions and poorly monitored regimens continue to pose risks (4,5).
Objective:
This study aims to evaluate patterns of medication overload and clinically significant drug–drug interactions among older adults, using both hospital-based data and a community survey. It also seeks to assess contributing risk factors and propose improved strategies for medication safety.
Methods:
A mixed-methods study was conducted using secondary data from published studies, a retrospective review of 115 elderly patient records from a tertiary hospital in Lahore, and a small survey of 50 community-dwelling adults aged ≥65. Key variables included number of medications, DDI risk (based on Micromedex® and Beers Criteria), and clinical outcomes. Data were analyzed descriptively and with logistic regression to identify predictors of DDIs.
Results:
The prevalence of polypharmacy (≥5 drugs) was 68%, with 32% of patients exposed to ≥1 clinically significant DDI. Among hospital patients, 21.7% had recent ADR-related admissions, primarily due to cardiovascular and urological drug combinations. The survey revealed poor awareness of DDI risks (only 16% had received pharmacist counseling). A significant association was found between polypharmacy and DDI risk (p<0.01).
Conclusion:
Older adults face high rates of medication overload and DDI-related harm, particularly those with complex comorbidities. Regular medication reviews, pharmacist-led interventions, and EHR-integrated DDI alerts are critical to reducing avoidable harm. Public education and tailored prescribing policies are urgently needed.
Keywords:
Polypharmacy, Drug–Drug Interactions, Older Adults, Medication Overload, Adverse Drug Reactions, Geriatrics, Clinical Pharmacology.