Polypragmasia and its consequences in elderly patients of the endocrinological hospital

The elderly population consumes a disproportionate share of medicines (medicines) compared to younger people. About 30% of persons aged 65 years and older receive 5 or more medications per day. Polypragmasia in the elderly can lead to multiple drug interactions (DIs), use of potentially not recommended therapy (PNT), and resulting adverse drug reactions (ADRs). Given the increase in endocrine diseases, particularly diabetes mellitus, among the elderly, it is imperative that health care providers are aware of the potential benefits and risks associated with multidrug therapy. 
Aim. To assess the incidence of polypragmasia, potentially irrational therapy according to Beers 2023 criteria and significant drug interactions, and to search for risk factors for polypragmasia among elderly people with endocrine diseases at the inpatient stage of medical care. 
Material and methods. An observational one-stage single-center single-sample uncontrolled study was conducted on the basis of Endocrinology Research Centre. Performed a review of medical records of inpatients aged 65 years and older hospitalized between September and December 2019 for polypragmasy, PNT in accordance with the Beers 2023 criteria and potentially significant drugs using the Drug Interactions Checker online calculator. 
Results. The study included 54 patients aged 65 years and older, the median age of the total group was 69 years [67; 72]. The median number of drugs prescribed to patients was 9 [7; 11]. Polypragmasia (prescription of 5 or more drugs) was observed in 90.74% of cases, and excessive polypragmasia (prescription of 10 or more drugs) — in 42.59%. The frequency of PST was 46.3%. The frequency of potentially significant LS was 40.74%. The chance of prescribing 5 or more LS was significantly higher in individuals with coronary heart disease (CHD). 
Conclusion. Elderly inpatients with endocrine diseases are at high risk of polypragmancy and PST. There is a clear need to audit drug prescriptions in this highly vulnerable patient group using pharmacotherapy optimization tools such as the Beers 2023 criteria and the Drug Interactions Checker online calculator. Elderly endocrine patients with CHD require special attention and monitoring by health care providers due to the high risk of polypragmancy and, as a consequence, the use of PNT and the development of ADRs.

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