abstract

Polypharmacy, defined as the concurrent use of five or more medications, is highly prevalent among elderly patients due to the increasing incidence of chronic illnesses such as hypertension, diabetes, arthritis, and cardiovascular diseases. While necessary for managing multimorbidity, polypharmacy significantly raises the risk of drug-drug interactions (DDIs) and adverse drug reactions (ADRs), thereby compromising patient safety and therapeutic outcomes. This cross-sectional study was conducted among 250 elderly patients in tertiary healthcare settings to investigate the prevalence and clinical impact of DDIs and ADRs. Data were collected using validated tools, including medication review forms, the Naranjo Algorithm for ADR assessment, and drug interaction screening software. Findings revealed that over half of the patients had 3–4 comorbid conditions, and a considerable proportion (20%) were on ten or more medications. Moderate and major DDIs were identified in 50% and 26% of the population, respectively. Gastrointestinal disturbances, dizziness, and hypoglycemia emerged as the most common ADRs. Statistical analysis demonstrated a significant association between the number of medications and ADR occurrence (p = 0.001). Logistic regression identified ≥10 medications, age >75, use of anticoagulants, and >3 comorbidities as strong predictors of ADRs. These findings underscore the urgent need for routine medication review, use of digital interaction tools, and individualized therapeutic strategies to ensure safer pharmacological care for the elderly.