A Survey on Polypharmacy and Use of Inappropriate Medications



Adverse drug reactions, clinical survey, inappropriate medication, polypharmacy, preventions


In the past, polypharmacy was referred to the mixing of many drugs in one prescription. Today polypharmacy implies to the prescription of too many medications for an individual patient, with an associated higher risk of adverse drug reactions (ADRs) and interactions. Situations certainly exist where the combination therapy or polytherapy is the used for single disease condition. Polypharmacy is a problem of substantial importance, in terms of both direct medication costs and indirect medication costs resulting from drug-related morbidity. Polypharmacy increases the risk of side effects and interactions. Moreover it is a preventable problem. A retrospective study was carried out at Bhopal district (Capital of Madhya Pradesh, India) in the year of September-November 2009 by collecting prescriptions of consultants at various levels of health care. The tendency of polypharmacy was studied and analyzed under the various heads in the survey. Available data suggests that polypharmacy is a widespread problem, and physician, clinical pharmacists and patients are all responsible. These risks can be minimized through identifying the prevalence of this potential problem in a high-risk population and by increasing awareness among patients and healthcare professionals. Physicians and clinical pharmacists have the potential to combating this problem through a variety of interventions such as reducing the number of medications taken, reducing the number of doses taken, increasing patient adherence, preventing ADRs, improving patient quality of life and decreasing facility and drug costs.


Download data is not yet available.


Zarowitz BJ, Stebelsky LA, Muma BK, Romain TM, Peterson EL. Reduction of high-risk polypharmacy drug combinations in patients in a managed care setting. Pharmacotherapy 2005;25:636-45.

Goh CR. Minimising Polypharmacy – a challenge in palliative care. Singapore Med J 2002;43:273-5.

Nisly NL, Gryzlak BM, Zimmerman MB, Wallace RB. Dietary Supplement Polypharmacy: An Unrecognized Public Health Problem? Evid Based Complement Alternat Med 2010;7:107-13.

Kaufman DW, Kelly JP, Rosenberg L, Anderson TE, Mitchell AA. Recent patterns of medication use in the ambulatory adult population of the United States. The Slone Survey. JAMA 2002;287:337-44.

Nolan L, O'Malley K. Prescribing for the elderly: Part 1. Sensitivity of the elderly to adverse drug reactions. J Am Geriatr Soc 1998;36:142-9.

Lamy PP. adverse drug effects. Clin Geriatr Med 1990;6:293-307.

Montamat SC, Cusack B. Overcoming problems with polypharmacy and drug misuse in the elderly. Clin Geriatr Med 1992;8:143-58.

Williams P, Rush DR. Geriatric polypharmacy. Hosp Pract 1986;21:9-20.

Roenke KL, Pinholt EM. Reducing polypharmacy in the elderly.J Am Geriatr Soc 1990;38:31-6.

Kroenke KL. Polypharmacy. Am J Med 1985;79:149-52.

Stewart RB, Cooper JW. Polypharmacy in the aged. Practical solutions. Drugs Aging 1994;4:449-61.

Gurwitz JH, Field TS, Harrold LR, Rothschild J, Debellis K, Seger AC, et al. Incidence and preventability of adverse drug events among older persons in the ambulatory setting. JAMA 2003;289:1107-16.

Gomez ER, Demoly P. Epidemiology of hypersensitivity drug reactions. Curr Opin Allergy Clin Immunol 2005;5:309-16.

Chumney EC, Robinson LC. The effects of pharmacist interventions on patients with polypharmacy. Pharm Pract 2006;4:103-9.

Aminzadeh F, Dalziel WB. Older adults in the emergency department: A systematic review of patterns of use, adverse outcomes, and effectiveness of interventions. Ann Emerg Med 2002;39:238-47.

Carlson JE. Perils of polypharmacy: 10 steps to prudent prescribing. Geriatrics 1996;51:26-35. Hanlon JT. Drug-related problems update. Am J Geriatr Pharmacother 2004;2:88-90.

Steinman MA, Rosenthal GE, Landefeld CS, Bertenthal D, Sen S, Kaboli PJ. Conflicts and concordance between measures of medication prescribing quality. Med Care 2007;45:95-9.

Veehof L, Stewart R, Haaijer-Ruskamp F, Jong BM. The development of polypharmacy. A Longitudinal study. Fam Pract 2000;17:261-7.

Schaefer K, Maerkedahl H, Birk HO, Henriksen LO. Polypharmacy in general practice. Dan Med Bull 2010;57:A4165.

Gallagher P, Barry P, O'Mahony. Review Article Inappropriate prescribing in the elderly. J Clin Pharm Ther 2007;27:113-21.

Wilcox SM, Himmelstein DU, Wollhander S. Inappropriate drug prescribing for the community-dwelling elderly. JAMA 1994;272:292-6.

Rozenfeld S, Fonseca MJ, Acurcio FA. Drug utilization and polypharmacy among the elderly: A survey in Rio de Janeiro City, Brazil. Rev Panam Salud Publica 2008;23:34-43.

Beers MH, Ouslander JG, Rollingher I, Reuben DB, Brooks J, Beck JC. Explicit criteria for determining inappropriate medication use in nursing home residents. Arch Intern Med 1991;151:1825-32.

Hawkins C, Hanks GW. The gastroduodenal toxicity of nonsteroidal anti-inflammatory drugs. A review of the literature.J Pain Symptom Manage 2000;20:140-51.

Ahmad A, Hugtenburg J, Welschen LM, Dekker JM, Nijpels G. Effect of medication review and cognitive behavior treatment by community pharmacists of patients discharged from the hospital on drug related problems and compliance: Design of a randomized controlled trial. BMC Public Health 2010;10:133.

Kaufman DW, Kelly JP, Rosenberg L, Anderson TE, Mitchell AA. Recent Patterns of Medication Use in the Ambulatory Adult Population of the United States: The Slone Survey. JAMA 2002;287:337-44.

Sarah N Hilmer, The dilemma of polypharmacy. Aust Prescr 2008;31:2-3.

Dutch Working party on infection prevention (WIP): guideline for primary care available from: http://www.wip.nl/free_content/ Richtlijnen/1Huisartsen.pdf, [Last accessed on 2009 May 6].

Pau AK. Polypharmacy problem: Drug interactions in the multidrug therapy of HIV infection, Publish in New York City by The Physician's Research Network, Inc., 2002;7:4-9. Available online, www.PRN.org.

Lin P. The Canadian Alzheimer Disease Review. 2003; September: 10-14.

Bista D, Palaian S, Shankar PR, Prabhu MM, Paudel R, Mishra P. Understanding the essentials of drug interactions: A potentialneed for safe and effective use of drugs. Kathmandu Univ Med J (KUMJ) 2006;4:421-30.



How to Cite

Rambhade, S., Chakarborty, A., Shrivastava, A., Patil, U. K., & Rambhade, A. (2018). A Survey on Polypharmacy and Use of Inappropriate Medications. Toxicology International, 19(1), 68–73. Retrieved from http://informaticsjournals.com/index.php/toxi/article/view/21848



Original Research