Polypharmacy and self-medication among older adults in Indian urban communities-a cross-sectional study

Older adults are vulnerable to unsafe medication practices. This cross-sectional study estimated the prevalence and factors of polypharmacy and self-medication among 600 older adults from six Indian cities. The updated Screening Tool of Older Persons' Prescriptions and Screening Tool to Alert to Right Treatment criteria (version 3) were used. Knowledge, attitudes, and reported practices regarding self-medication were assessed. Descriptive statistics, binary logistic regression, and multivariable analysis were used. The prevalence of polypharmacy was 33.7% (95% CI 29.9-37.6%), with significant associations to multiple comorbidities [adjusted odds ratio (aOR) 2.5 (95% CI 1.1-4.1)], recent transition of care [aOR 3.3 (95% CI 1.4-5.7)], and recent hospitalization [aOR 4.6 (95% CI 2-7.7)]. The proportions of prescriptions with potentially inappropriate medications and potential prescribing omissions were 28.8% (95% CI 25.2-32.6%) and 20.3% (95% CI 17.2-23.8%), respectively. The prevalence of self-medication was 19.7% (95% CI 16.6-23.1%), associated with factors, such as staying alone [aOR 4.5 (95% CI 2.4-6.6)], multiple comorbidities [aOR 3 (95% CI 1.4-6.7)], and recent hospitalization [aOR 4.8 (95% CI 1.5-8)]. 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. The findings emphasize interventions' necessity for promoting safe medication use in older adults.