Journal of Clinical and Biomedical Sciences
DOI: 10.58739/jcbs/v16i1. 25.217
Year: 2026, Volume: 16, Issue: 1, Pages: 15-20
Original Article
Suchitra Rajeev1, Snigdha Misra2, Rajesh Kumar Suman3*
1Tutor, Department of Pharmacology, MGM Medical College, MGM Institute of Health Sciences, Kamothe, Navi Mumbai, Maharashtra, India.
2Associate Professor, Department of Pharmacology, MGM Medical College, MGM Institute of Health Sciences, Kamothe Navi Mumbai, Maharashtra, India.
3Professor, Department of Pharmacology, Hind Institute of Medical Sciences, Ataria, Sitapur, Uttar Pradesh, India.
*Corresponding Author
Email: [email protected]
Received Date:07 May 2025, Accepted Date:07 August 2025, Published Date:31 March 2026
Introduction: Elderly patients are at a higher risk of polypharmacy and adverse drug reactions (ADRs) due to multiple comorbidities and age-related pharmacokinetic changes. This study aims to evaluate prescribing trends and ADRs among elderly patients in a tertiary care geriatric unit. Materials and Methods: An observational cross-sectional study was conducted on 250 elderly patients. A total of 1824 drugs were prescribed. Prescribing patterns were evaluated using WHO/INRUD indicators, and ADRs were assessed using the WHO causality assessment criteria. Results: Cardiovascular diseases were the most prevalent (24%), followed by endocrine disorders (18.8%). The most commonly prescribed drugs included pantoprazole, aspirin, atorvastatin, telmisartan, and metformin-glimepiride. As per WHO core prescribing indicators, the average number of drugs per prescription was 7.4, with 71.9% prescribed from the essential drug list and 54% by generic names. Injectable drugs were used in 22% of encounters, and the average number of antibiotics per encounter was 2.33. Causality assessment of ADRs classified aspirin, ofloxacin, azithromycin, rifampicin, metronidazole, amoxicillin-clavulanic acid, ceftriaxone, and ciprofloxacin as 'Probable'. Iron sucrose-induced hypersensitivity reactions and orange-colored urine due to rifampicin were classified as 'Certain'. ADRs caused by diclofenac, heparin sodium, valsartan-sacubitril, rifampicin, ethambutol, and nicorandil were classified as 'Possible'. Conclusion: This study highlights the prevalence of polypharmacy and ADRs in elderly patients. The findings underscore the need for rational prescribing practices and enhanced pharmacovigilance to improve drug safety and efficacy in geriatric care.
Keywords: Adverse drug reaction, Drug utilization studies, Geriatric
1. Mangoni AA, Jackson SHD. Age‐related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications. British Journal of Clinical Pharmacology. 2004; 57 (1). Available from: https://doi.org/10.1046/j.1365-2125.2003.02007.x
2. Hilmer SN, McLachlan AJ, Le Couteur DG. Clinical pharmacology in the geriatric patient. Fundamental & Clinical Pharmacology. 2007; 21 (3). Available from: https://doi.org/10.1111/j.1472-8206.2007.00473.x
3. Maher RL, Hanlon J, Hajjar ER. Clinical consequences of polypharmacy in elderly. Expert Opinion on Drug Safety. 2014; 13 (1). Available from: https://doi.org/10.1517/14740338.2013.827660
4. Field TS, Gurwitz JH, Avorn J, McCormick D, Jain S, Eckler M, <I>et al</I>. Risk Factors for Adverse Drug Events Among Nursing Home Residents. Archives of Internal Medicine. 2001; 161 (13). Available from: https://doi.org/10.1001/archinte.161.13.1629
5. O'Mahony D, Gallagher PF. Inappropriate prescribing in the older population: need for new criteria. Age and Ageing. 2008; 37 (2). Available from: https://doi.org/10.1093/ageing/afm189
6. World Health Organization. <I>How to investigate drug use in health facilities: selected drug use indicators</I>. Geneva: WHO; 1993. Available from: https://apps.who.int/iris/handle/10665/60519
7. World Health Organization. <I>Uppsala Monitoring Centre. The use of the WHO–UMC system for standardised case causality assessment</I>. Uppsala: WHO-UMC; 2005 [cited 2025 Apr 20]. Available from: https://www.who-umc.org/media/2768/standardised-case-causality-assessment.
8. Smith A, Johnson P, Davis R. Prevalence and disparity of malnutrition among elderly: A cross-sectional study. Journal of the Indian Academy of Geriatrics. 2020; 16 (4). Available from: https://doi.org/10.4103/jiag.jiag_12_20
9. Kumar R, Gupta N, Patel S. Disease patterns and healthcare challenges in geriatric patients: A comprehensive study. <I>International Journal of Medical Research</I>. 2019;18(2):120-125.
10. Gupta R, Sharma V, Singh P. Prescribing patterns of drugs in elderly patients: A hospital-based study. <I>Journal of Geriatric Pharmacology</I>. 2021;29(2):178-184.
11. Patel R, Desai N, Shah S. Evaluation of drug prescribing patterns in geriatric patients at a tertiary care hospital. <I>Journal of Clinical Pharmacy and Therapeutics</I>. 2020;35(3):275-282.
12. Keenan T, Oltean D, Harrison W, <I>et al</I>. Frequency and types of adverse drug reactions in elderly patients: a systematic review. <I>Drugs Aging</I>. 2020;37(3):177-189.
13. Smith M, Taylor D, Hall B. Diclofenac-induced acute kidney injury: a case report and literature review. <I>Clinical Nephrology</I>. 2019;92(1):43-48.
14. Patel AB, Morrow Y, Begum S, <I>et al</I>. <I>Hyperkalaemia associated with the valsartan-sacubitril combination in elderly patients</I>. <I>Heart Failure Reviews</I>. 2021;26(6):1291-1301.
15. Johnson M, Turner R, Wong T. Critical review of ethambutol-induced optic neuritis. <I>International Journal of Geriatric Psychiatry</I>. 2022;37(5):45-51.
16. Adams R, Bender H, O'Sullivan B. The clinical significance of rifampicin in geriatric care: a review. <I>Geriatrics & Gerontology International</I>. 2018;18(7):1046-1052.
17. Green J, Hobden J, Carter J, <I>et al</I>. <I>Adverse effects of iron sucrose infusion: a focus on geriatric patients</I>. <I>Journal of Geriatric Cardiology</I>. 2017;14(1):48-55.
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Published By Sri Devaraj Urs Academy of Higher Education, Kolar, Karnataka
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