OPTIMIZING GERIATRIC MEDICATION MANAGEMENT: INTERPLAY BETWEEN POLYPHARMACY, COMORBIDITY BURDEN, AND PATIENT PERSPECTIVES IN A PAKISTANI TERTIARY-CARE SETTING
Author(s)
Adeel Aslam, PharmD MPhil PhD1, Shazia Jamshed, PhD2, Shazma Shayan, MBBS3, Edit Paulik, MD PhD4, Márió Gajdács, MPH, MSc, PharmD, PhD4.
1Universiti Teknologi MARA (UiTM), Selangor, Malaysia, 2International Islamic University Malaysia, Kuantan, Malaysia, 3Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom, 4Department of Public Health, University of Szeged, Szeged, Hungary.
1Universiti Teknologi MARA (UiTM), Selangor, Malaysia, 2International Islamic University Malaysia, Kuantan, Malaysia, 3Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom, 4Department of Public Health, University of Szeged, Szeged, Hungary.
OBJECTIVES: Polypharmacy (PPh) is key determinant of inappropriate healthcare resource utilization, adverse drug events, reduced quality of life and compromised patient safety. The present study aimed to assess multimorbidity characteristics, the prevalence of PPh and patient perspectives among geriatric patients in a tertiary care hospital in Pakistan.
METHODS: A single-center, retrospective, observational study was conducted among hospitalized patients ≥65 years and presenting with comorbidities, between January-June 2023 at the Jinnah Hospital (Lahore, Pakistan). Data collection was performed for participants’ socio-demographic, clinical and current medication information. Cumulative chronic disease severity was quantified utilizing the Charlson Comorbidity Index (CCI), while Independence in Activities of Daily Living was assessed by the Katz index. Patient-reported perceptions on polypharmacy were captured using a structured, interviewer-administered questionnaire. Statistical analyses (descriptive statistics, χ² tests and nonparamteric tests) were performed using IBM SPSS Statistics 25.0 (α: 0.05; 95% confidence interval [CI]). The study followed the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) guidelines.
RESULTS: According to our inclusion criteria, N=310 patients were considered for analysis; high prevalence of PPh (53.5%) was documented, with 72.2% of patients in the PPh group taking 10-13 medications daily. Mean age of patients in the PPh group was higher (80.64 [95%CI: 79.3-81.9] vs. no PPh: 70.77 [95%CI: 78.5-81.0], p<0.001), while no differences were shown for Katz index (4.1 [95%CI: 3.7-4.4] vs. no PPh: 4.2 [95%CI: 3.7-4.5]. CCI was higher for PPh patients (80.64 [95%CI: 79.3-81.9] vs. no PPh: 70.77 [95%CI: 78.5-81.0], p<0.001). 60.7% of participants felt they were taking too many medications, while 24.5% were willing to discontinue medications (deprescribing) if advised by a healthcare professional.
CONCLUSIONS: PPh is especially prevalent in elderly patients in low and middle income countries, where clinical management frameworks tailored to older adults with complex comorbidity burden remain profoundly underdeveloped.
METHODS: A single-center, retrospective, observational study was conducted among hospitalized patients ≥65 years and presenting with comorbidities, between January-June 2023 at the Jinnah Hospital (Lahore, Pakistan). Data collection was performed for participants’ socio-demographic, clinical and current medication information. Cumulative chronic disease severity was quantified utilizing the Charlson Comorbidity Index (CCI), while Independence in Activities of Daily Living was assessed by the Katz index. Patient-reported perceptions on polypharmacy were captured using a structured, interviewer-administered questionnaire. Statistical analyses (descriptive statistics, χ² tests and nonparamteric tests) were performed using IBM SPSS Statistics 25.0 (α: 0.05; 95% confidence interval [CI]). The study followed the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) guidelines.
RESULTS: According to our inclusion criteria, N=310 patients were considered for analysis; high prevalence of PPh (53.5%) was documented, with 72.2% of patients in the PPh group taking 10-13 medications daily. Mean age of patients in the PPh group was higher (80.64 [95%CI: 79.3-81.9] vs. no PPh: 70.77 [95%CI: 78.5-81.0], p<0.001), while no differences were shown for Katz index (4.1 [95%CI: 3.7-4.4] vs. no PPh: 4.2 [95%CI: 3.7-4.5]. CCI was higher for PPh patients (80.64 [95%CI: 79.3-81.9] vs. no PPh: 70.77 [95%CI: 78.5-81.0], p<0.001). 60.7% of participants felt they were taking too many medications, while 24.5% were willing to discontinue medications (deprescribing) if advised by a healthcare professional.
CONCLUSIONS: PPh is especially prevalent in elderly patients in low and middle income countries, where clinical management frameworks tailored to older adults with complex comorbidity burden remain profoundly underdeveloped.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH17
Topic
Clinical Outcomes, Epidemiology & Public Health, Patient-Centered Research
Topic Subcategory
Public Health
Disease
Personalized & Precision Medicine