Abstract

POLYPHARMACY AND POTENTIAL DRUG INTERACTIONS AMONG ELDERLY PATIENTS WITH CHRONIC CONDITIONS: A CROSS-SECTIONAL STUDY ON PREVALENCE, PREDICTORS, AND CLINICAL IMPLICATIONS IN DHI QAR

Usama Kadem Radi*

Abstract

Background: For patients who are elderly, chronically ill, and for whom this can cause significant adverse effects and complications, polypharmacy and DDDIs are important issues to watch out for. However, polypharmacy and DDIs data are scant in Iraq, especially in resource-poor places such as Dhi Qar governorate. This article analyses polypharmacy and DDIs, risk factors, and clinical implications of them for chronically ill elderly Iraqi patients. Objectives: To investigate the frequency of polypharmacy and DDIs among elderly chronic-care patients in Dhi Qar governorate, Iraq, and the demographic and clinical predictors of them. Methods: An observational cross-sectional study from February to May 2025 in Dhi Qar governorate involved 397 patients 65 years of age with at least one chronic illness and two or more prescription medications. Demographics, clinical information, and medication information were derived from patient interviews and medical record checks. Polypharmacy was defined as the use of five medications, and DDIs were stratified according to severity by a standard interactionchecking tool. For polypharmacy, DDIs, and independent variables, associations were assessed using descriptive statistics, the chi-square test, the t-test, and logistic regression. Results: Polypharmacy was 60% (n = 238), and 45% (n = 179) of patients were potentially DDIs (12%), moderate interactions (3%) and severe interactions (3%). Longer age (OR=1.05; 95% CI: 1.02-1.08), female gender (OR=1.4; 95% CI: 1.1-1.9), and more chronic diseases (OR=1.6; 95% CI: 1.3-2.0) all increased polypharmacy. DDIs were more prevalent in multiple drug patients (OR = 1.8; 95% CI: 1.5-2.2) and in people with cardiovascular disease (OR = 1.5; 95% CI: 1.1-2.1). Particularly prone to interaction were antihypertensives and NSAIDs, as well as antidiabetics and cardiovascular medication. Conclusion: The prevalence of polypharmacy and DDIs among elderly chronically ill patients in Dhi Qar poses a significant clinical risk. Older age, female gender, and multimorbidity all lead to polypharmacy; cardiovascular disease and high levels of medications exacerbate DDI risk. All these results call for frequent medication audits, targeted interventions, and better prescribing guidelines to ensure that elderly Iraqi patients receive the best medications possible.

Keywords: Polypharmacy, drug-drug interactions, elderly patients, chronic conditions, medication safety.