The prevalence of self-medication was 19.7%, associated with factors, such as staying alone, multiple comorbidities and recent hospitalisations. Photograph used for representational purposes only
| Photo Credit: Getty Images
A cross-sectional study conducted among 600 older adults across six Indian cities has found that the prevalence of polypharmacy and unsafe self-medication is high in this population. Polypharmacy refers to the intake of five or more medications per day. Among those who self-medicated, a majority lacked knowledge about self-medication, and did not understand the risks associated with it, the study found.
In the study – ‘Polypharmacy and self-medication among older adults in Indian urban communities – a cross-sectional study’ – published in Scientific Reports, researchers Das, S., Gnanavel, P., Smanla, S. et al. from the Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden, the Indian Council of Medical Research – Centre for Aging and Mental Health, Kolkata and a number of medical institutions including the Department of Community Medicine, Government Medical College, Omandurar Government Estate, Chennai, have taken a close look at the medication usage and self-medication practices among older adults in New Delhi, Chennai, Kolkata, Ujjain, Patna and Guwahati.
A total of 100 older adults were recruited in each city. Of the 600, 477 were aged 60 to 80 years and 123 were the age of 80. More than half of them (353), were women. There were three or more co-morbid conditions in 423 of these individuals.
The researchers used an updated screening tool, the Older Persons’ Prescriptions and Screening Tool to Alert to Right Treatment (STOPP-START) criteria to identify potentially inappropriate medications (PIM) and potential prescribing omissions (PPO) respectively.
Polypharmacy rates over 30%
The study found that the prevalence of polypharmacy was 33.7% with significant associations to multiple comorbidities, recent transition of care and recent hospitalisation. A total of 314 individuals were taking one to four oral allopathic medicines (solid formulations) daily.
The highest prevalence of polypharmacy was found in Guwahati (57%), while Ujjain had the lowest prevalence (11.7%). A total of 2,741 medicines were prescribed to all individuals. The most common were antihypertensive medicines followed by antidiabetic medicines, hypolipidemic medicines, calcium supplements and nonsteroidal anti-inflammatory drugs, the study said.
The study found that 25.2% of the individuals used at least one fixed-drug combination (solid oral formulations). The most common combinations were antihypertensive and antidiabetic fixed-drug combinations.
The reaearchers found the proportion of prescriptions with PIM and PPO were 28.8% and 20.3% respectively. The highest prevalence of PIM use – 46.2% – was attributed to medications prescribed without evidence-based clinical indications and those prescribed beyond the recommended duration.
A total of 164 persons were using concomitant traditional and complementary medicines mostly for chronic conditions. Of these, 80 persons used certain traditional and complementary solid oral formulations without names or labels. In fact, the authors observed that the presence of unlabelled solid oral formulations among traditional medications raised concerns regarding patient safety and underlined the importance of regulatory oversight and adherence to quality standards in healthcare delivery.
Nearly 20% of study participants self-medicated
The prevalence of self-medication was 19.7%, associated with factors, such as staying alone, multiple comorbidities and recent hospitalisations. The most common medicines that were self-medicated were nonsteroidal anti-inflammatory drugs (59%) followed by paracetamol (42.4%) and antibiotics for upper respiratory tract infection and diarrhoea (33.9%).
A lack of awareness and unsafe practices were found among self-medicating individuals. Among those who self-medicated, 65.3% lacked knowledge of self-medication, 50% did not comprehend the risks and 40.7% reported unsafe self-medication practices.
These findings emphasise the necessity for interventions to promote safe medication use in older adults, the authors said, stressing the need to address the issue by raising awareness and establishing services for medication reconciliation, review and feedback to improve medication safety and management in them.
Published – March 11, 2025 02:52 pm IST
Leave a Reply