Related Experiment Video
Updated: Jan 13, 2026
06:52
Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
10.4K
A Single-Center Prospective Study on Adverse Drug Reactions Associated With Polypharmacy in Elderly Outpatients
Maria Khurshid1, Ammarah Amjad2, Sundas Qamar3
1Pharmacology, Azad Jammu and Kashmir Medical College, Muzaffarabad, PAK.
Cureus
|January 6, 2026
Summary
Polypharmacy in elderly patients frequently leads to adverse drug reactions (ADRs), impacting outpatient care. This study found over 30% of elderly patients on multiple medications experienced ADRs, particularly those over 80.
Area of Science:
- Geriatric Medicine
- Clinical Pharmacology
- Patient Safety
Background:
- Polypharmacy in elderly individuals elevates the risk of adverse drug reactions (ADRs).
- Managing multiple medications in older adults presents significant challenges for safe outpatient care.
Purpose of the Study:
- To prospectively assess the incidence, characteristics, and clinical consequences of ADRs in elderly outpatients with polypharmacy.
- To identify risk factors associated with ADRs in this population.
Main Methods:
- A prospective observational study involving 246 elderly outpatients (≥60 years) using five or more medications.
- Data collected via medical record review and patient interviews; ADRs classified using the FDA Toxicity Grading Scale.
- Statistical analysis performed using SPSS v25.0, with P < 0.05 considered significant.
Main Results:
- Over 30% (76/246) of patients experienced at least one ADR, with gastrointestinal and dermatological systems most affected.
- ADRs were significantly more prevalent in patients aged ≥80 years, those on ≥9 medications, and those with multiple comorbidities (P < 0.05).
- Common comorbidities included hypertension, type 2 diabetes mellitus, and ischemic heart disease.
Conclusions:
- Polypharmacy in elderly outpatients is strongly linked to clinically significant ADRs.
- Routine medication reviews and diligent pharmacovigilance are crucial for mitigating risks associated with polypharmacy in the elderly.
Related Concept Videos
01:15Drug Dosing: Geriatric Patients
217
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
217
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
182
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
182
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism
192
Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
192
01:22Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption
218
As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
218
01:00Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution
224
Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are...
224
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
229
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
229