Journal Club- Polypharmacy A Global Risk Factor for Elderly People

World Health Organization has evaluated that in every nine people there is one elderly people, i.e., of age 60 years or older. This value is to be expected to increase to one in five people by 2050 accounting for about half of the total growth of the world population.

Ageing population is not just a concern for high-income countries. The majority of older people already live in low- and middle-income countries, and this is where some of the fastest rates of ageing are occurring. This demographic transition in the elderly population constitutes a significant challenge for health authorities worldwide as with advancing age multiple chronic diseases such as hypertension, diabetes mellitus, arthritis, chronic heart disease, renal diseases, etc. are associated. As a result of which elderly people tend to take multiple medications in a day that can be referred to as polypharmacy.

There is no as such standard definition of polypharmacy. It can be explained as the use of multiple medications generally referred to five or more prescribed drugs per day and/or the administration of more medications than are clinically indicated, representing unnecessary/unwanted drug use.

Polypharmacy is an area of concern for elderly because of several reasons. Elderly people are at a greater risk for adverse drug reactions (ADRs) because of the metabolic changes and reduced drug clearance associated with ageing; this risk is furthermore exacerbated by increasing the number of drugs used. Potential of drug-drug interactions is further increased by use of multiple drugs. In a case–control study carried out among old age people, polypharmacy was found to be an independent risk factor for hip fractures.