New Delhi: Twenty-eight out of 100 elderly individuals in India are at risk of consuming potentially inappropriate medications, a new study on polypharmacy—the simultaneous use of multiple medications—and self-medication, has found.
Another major concern highlighted by the report was that at least 19.7 percent of the participants, particularly those who were living alone, were self-medicating, had multiple health conditions, or were recently hospitalised.
The study was conducted by researchers from institutes including the Indian Council of Medical Research Centre for Ageing and Mental Health in Calcutta, the Department of Community Medicine at Government Medical College, Omandurar, and Vardhman Mahavir Medical College and Safdarjung Hospital in New Delhi. It was published in the journal Scientific Reports last week.
The report is the result of a door-to-door survey conducted in six Indian cities, and reveals a concerning prevalence of both inappropriate medication use and missed essential treatments. A total of 100 individuals each, aged 60 and above, were randomly selected from urban areas of Delhi, Kolkata, Chennai, Guwahati, Patna, and Ujjain.
The study analysed 2,741 prescribed medicines (solid oral formulations) and found that 173 out of 600 participants had prescriptions containing potentially inappropriate medications (PIMs)—drugs that may be unnecessary or harmful—while 20.3 percent were missing essential medicines, classified as potential prescribing omissions (PPOs).
According to the World Health Organization (WHO), polypharmacy is defined as “the administration of many drugs at the same time or the administration of an excessive number of drugs, usually five or more medications per day.”
Dr Santanu Tripathi, clinical pharmacologist and co-author of the study, formerly with the Calcutta School of Tropical Medicine, told ThePrint that not all prescribed medications are equally necessary. While a prescription may include five to seven medicines, some could be redundant.
He explained that these unnecessary medications can sometimes lead to complications due to drug interactions. “While they may not provide any real benefit, they have the potential to cause harm. The best approach is to eliminate them.”
The study found that, overall, 33.7 percent of elderly participants were on polypharmacy. This was significantly linked to factors such as having multiple health conditions, recent hospital stays, and transitions in care.
Most commonly prescribed, self-medicated drugs
According to the study, the most commonly prescribed medications were antihypertensives, followed by antidiabetic drugs, cholesterol-lowering medications, calcium supplements, and nonsteroidal anti-inflammatory drugs. The most frequently omitted medicines included anti-clotting therapy for diabetic patients with cardiovascular risk factors, aspirin or clopidogrel for individuals with documented coronary artery disease, and calcium or vitamin D for those with osteoarthritis.
Alarmingly, 65.3 percent of those who self-medicated lacked proper knowledge about it, 50 percent were unaware of the risks involved, and 40.7 percent admitted to unsafe practices.
The most commonly self-medicated drugs were nonsteroidal anti-inflammatory drugs, used by nearly six in ten individuals, followed by paracetamol, taken by about 42 out of every 100, and antibiotics for upper respiratory tract infections and diarrhoea, used by roughly one in three.
Researchers involved in the study noted that this issue is more pronounced among India’s elderly population compared to the general population and Western countries. They attributed this to the lack of guidelines for licensing over-the-counter medicines, the absence of structured support for medication reconciliation, and the widespread practice of unregulated drug dispensing by unqualified practitioners without proper diagnosis.
“This problem appears to have been aggravated following the coronavirus disease 2019 (COVID-19) pandemic,” researchers noted in the study.
The study also found that 27.3 percent of participants were using traditional and complementary medicines, such as Ayurveda, Unani, Siddha, and Homeopathy, often for chronic conditions. Notably, nearly half (48.8 percent) of these individuals took traditional medicine formulations that lacked proper labels or names, raising concerns about safety and regulation.
Among the participating individuals, polypharmacy was most prevalent in Guwahati, where 57 percent of participants were taking multiple medications, while Ujjain had the lowest prevalence at 11.7 percent.
(Edited by Radifah Kabir)
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