Analysis of the incidence of polypharmacy in cases of adverse drug reactions at a Tertiary Care Centre in India

Background: Polypharmacy or the use of multiple medications is one of the most common and significant causes of adverse drug reactions (ADRs). While there are potential risks associated with polypharmacy, there are numerous benefits when drugs are combined to cure and alleviate symptoms, or prevent complications. Balancing the risks and benefits is becoming increasingly difficult, especially with the advent of over-the-counter drugs and alternative medicine. Objectives: To determine the incidence and impact of polypharmacy on ADRs in an inpatient medicine ward of a tertiary care hospital in India. Materials and Methods: This was a hospital-based, prospective, observational, study. The Patients’ data was recorded using a structured ADR reporting form. The baseline parameters, medical history, clinical data, characteristics of ADRs, and details of the medication responsible for ADRs and those used to treat ADRs were recorded. The data was analyzed using descriptive statistics with the Statistical Packages for the Social Sciences version 26.0 software. Results: A total of 164 patients fulfilling the inclusion criteria were admitted during the study period. Of this number with ADR, 95 (57.9%) had polypharmacy while 69 (42.1%) did not have polypharmacy. The observed difference was statistically significant (OR: 1.90; 95% CI: 1.2-2.9; P = 0.004). Conclusion: Polypharmacy is a significant contributor to ADR-related admissions and inpatient ADRs in India. Therefore, there should be careful and adequate consideration before initiating multiple drugs as well as regular follow-up to identify and treat any case of ADR.