Drug Use Patterns among Indian Elderly Outpatients

Objective: Published literature on the characteristics of prescribing medication to the Indian elderly is limited. This study aims to evaluate the prescription pattern among Indian elderly patients using WHO prescribing indicators. Methods: The prescriptions of 4005 outpatients aged sixty and above were evaluated prospectively using WHO prescribing indicators. Results: The average age of patients was 68.28±0.11 (±SEM) years. On an average, each patient had 2.01±0.01 diagnoses and was prescribed 6.45±0.04 drugs. The most common disorder which warranted a prescription was “diseases of circulatory system”. The patients were prescribed an average of 6.45±0.04 medications. Over half of the patients (57.9%) received more than five medications concurrently. Only 0.8% of the prescribed drugs had their generic names. Antibiotics were prescribed in 13% of the prescriptions, while 7.3% of patients were prescribed injections. Sixty six percent of the drugs prescribed were from National List of Essential Medicines 2003. Conclusions: The relatively small amount of prescription of antimicrobials and injections coupled with a higher number of prescriptions from essential drug list is a very positive reflection of rational prescribing among elderly outpatients. However, a high prevalence of polypharmacy, lower number of drugs prescribed by their generic name and from essential drug list indicated that prescribing need requires further refining. This study highlighted the fact that the number of co-morbidities increased with increasing age which resulted in increased number of medications prescribed. This, to the best of our knowledge, is the first set of published results on prescribing in a sample of 4005 Indian outpatients.