Assessment Of Drug To Drug Interactions In Polypharmacy In Patients ≥ 60 Years: A Clinical Audit

Abstract

Background: Polypharmacy is highly prevalent among older adults and significantly increases the risk of drug–drug interactions (DDIs), yet routine medication review and interaction screening are often inadequate in clinical practice. 

Objective: To assess the prevalence, severity, and predictors of DDIs among patients aged 60 years and above and to evaluate compliance with recommended prescribing and monitoring standards.

Methods: This audit reviewed 260 prescriptions of patients aged ≥60 years attending a tertiary care facility. Data collected included demographics, comorbidities, number of medications, and documented interaction screening. DDIs were identified using a standard interaction checker, and severity was categorized as major, moderate, or minor. Results: The mean patient age was 68.7 ± 6.4 years, and the average number of medications per patient was 7.9 ± 2.1. DDIs were found in 198 prescriptions (76.1%), of which 21.2% were major and 58.6% were moderate. Severe polypharmacy (≥10 drugs), chronic kidney disease, and NSAID use were significant predictors of major DDIs. Despite the high DDI burden, compliance with key prescribing standards was poor: medication review was documented in 34.6% of cases, DDI screening in 29.2%, monitoring plans in 27.9%, and appropriate action for major DDIs in 38.1%.

Conclusion: DDIs are highly prevalent among older adults with polypharmacy, and major interactions are common but under-recognized in routine practice.