Prevalence, Patterns, and Risk Factors of Polypharmacy Among Elderly Patients: A Cross-Sectional Study

Abstract

Polypharmacy is common among older adults because of the increasing prevalence of multimorbidity and chronic diseases requiring long-term pharmacological treatment. Although multiple medicines may be clinically appropriate, increasing medication burden can contribute to medication-related risks and emphasizes the need for regular medication review. The present study assessed the prevalence, patterns, and factors associated with polypharmacy among elderly patients attending a secondary-level hospital. Methods: A hospital-based cross-sectional observational study was conducted among 300 elderly patients aged ≥60 years attending Sub-Divisional Hospital, Dhuri, District Sangrur, Punjab, India, from August 2024 to July 2025. Demographic characteristics, comorbidities, and medication profiles were assessed using patient interviews and clinical/prescription records. Polypharmacy was defined as the concurrent use of ≥5 medications, while hyperpolypharmacy was defined as the use of ≥10 medications. Continuous variables were expressed as mean ± standard deviation and categorical variables as frequency and percentage. Associations between categorical variables were assessed using the chi-square test, continuous variables were compared using appropriate statistical tests, and multivariable logistic regression was performed to identify factors independently associated with polypharmacy. A p-value <0.05 was considered statistically significant. Results: The study included 300 elderly patients with a mean age of 70.13 ± 6.48 years. Males constituted 163 (54.3%) participants and females 137 (45.7%). The mean number of comorbidities was 2.30 ± 1.29, while the mean number of medications was 4.56 ± 1.56. Polypharmacy was present in 150 patients (50.0%; 95% CI: 44.255.8%). No patient received ≥10 medications; therefore, hyperpolypharmacy was not observed. The mean number of comorbidities was significantly higher among patients with polypharmacy than among those without polypharmacy (2.55 ± 1.29 vs 2.05 ± 1.24; p=0.001). Antihypertensive medicines were the most frequently recorded medication class, used by 209 (69.7%) patients, followed by antidiabetic medicines in 144 (48.0%) and proton-pump inhibitors in 128 (42.7%). Age group and sex were not significantly associated with polypharmacy. In multivariable logistic regression, each additional comorbidity was independently associated with increased odds of polypharmacy (adjusted OR 1.40; 95% CI: 1.15–1.69; p<0.001). Conclusion: Polypharmacy was common among elderly patients in the study setting, affecting one-half of the study population. The number of comorbidities was the principal independent factor associated with polypharmacy, whereas age and sex were not independently associated with medication burden. These findings emphasize the need for systematic medication reconciliation and periodic medication review, particularly among elderly patients with multiple chronic conditions, to promote rational and patient-centred pharmacotherapy. Keywords: Polypharmacy; Elderly; Multimorbidity; Medication burden; Comorbidities; Medication review; Older adults.