Health ministry asks ICMR to conduct research on impact of Polypharmacy in geriatric population

Thursday, July 27, 2023,

The Union ministry of health and family welfare has said that it has mandated the Indian Council of Medical Research (ICMR), the apex body in the country for formulation, coordination and promotion of biomedical research, to conduct research on the impact of Polypharmacy and others in geriatric population.

The move comes in at a time when the country is experiencing more instances of Polypharmacy, which refers to the concomitant use of five to nine medicines.

The Ministry said that Polypharmacy is prevalent in India and a systematic review published in research publication Frontiers in pharmacology in 2021 found that 49 per cent of older Indian adults, who are aged 60 years and above, were experiencing Polypharmacy.

“Indian Council of Medical Research has mandated to conduct Research/study to assess the impact of Polypharmacy etc., in geriatric population,” said Prof S P Singh Baghel, minister of state in the ministry of health, responding to a question in the Lok Sabha during the current monsoon session.

He added that the training modules for medical officers and chief health officer for elderly care, developed by the National Health System Resource Centre under the Ministry, are comprised of the assessment tool on Polypharmacy by the elderly patients. The module include creating awareness on adverse effects associated with Polypharmacy.

According to the study in the year 2021, ‘Prevalence of Polypharmacy, Hyperpolypharmacy and potentially inappropriate medication (PIM) use in older adults in India: A systematic review and meta-analysis’ by the experts from Charles University, Czechia, and from Universities and pharmacy institutions in India, the prevalence of Polypharmacy was 49 per cent, Hyperpolypharmacy - which is the concomitant use of more than 10 medicines - was 31 per cent and PIM use was 28 per cent among older Indian adults.

Polypharmacy was more prevalent in North India with around 65%, whereas Hyperpolypharmacy was prevalent in south India with around 33 per cent. Prevalence of PIM use was higher in Western part of the country with 33 per cent, followed by 32 per cent in South India, said the study.

The study recommended that appropriate steps are needed to promote rational geriatric prescribing in India.

Older people are more prone to be prescribed with multiple medications for their chronic conditions, resulting in Polypharmacy or Hyperpolypharmacy. They are also considered proxy indicators of potentially inappropriate medication use, added the report.

PIM, when used in older adults, may outweigh the clinical advantages of the drug, such as decline in mental and functional health, apart from adverse drug reactions and drug interactions, unplanned hospitalisation, morbidity and mortality, it added.

The use of multiple drugs are expected to result in outcomes including adverse drug reactions, drug-drug interactions, medication non compliance, multiple geriatric syndromes, among others, according to experts from Chennai-based Kauvery Hospitals.

It said that if an elder consumes around five to nine different drugs, the probability of drug-drug interaction is almost 50 per cent.

In developed countries, steps are taken to ensure prescribing drugs rationally to the older population with focus on preventing PIM use. There are guidelines and other methods developed in some of the countries to prevent Polypharmacy including looking for indications for every drug prescribed and discontinuing certain drugs based on the drug-reaction reports. There are also tools such as Screening Tool to Alert Doctors to Right Treatment (START) and Screening Tool of Older People's Potentially Inappropriate Prescriptions (STOPP) and others to address the issue, says the hospital.

PHARMABIZ.com