Drug Prescribing Patterns in Geriatric Patients With Type 2 Diabetes Mellitus at a Tertiary Care Teaching Hospital: A Cross-Sectional Study

TL;DR

This study examines drug prescribing patterns in elderly patients with type 2 diabetes at a hospital in North India, finding high polypharmacy and suboptimal use of essential medicines.

Contribution

The study provides empirical evidence on prescribing practices in geriatric T2DM patients using WHO indicators in a real-world setting.

Findings

Average number of drugs per prescription was 5.22, indicating high polypharmacy.

Only 21% of prescribed drugs were from the National List of Essential Medicines.

Sulfonylureas were the most commonly prescribed antidiabetic drug class.

Abstract

Introduction

Type 2 diabetes mellitus (T2DM) is highly prevalent among elderly individuals and is frequently accompanied by multiple comorbidities, resulting in complex pharmacotherapy and an increased risk of polypharmacy and irrational prescribing. Evaluating real-world prescribing patterns using standardized indicators is essential to promote rational drug use and optimize therapeutic outcomes in geriatric patients with T2DM.

Methods

A hospital-based, cross-sectional observational study was conducted over one year (April 2024 to March 2025) in the outpatient department of a tertiary care teaching hospital in North India. A total of 600 geriatric patients (≥60 years) with T2DM were included. Demographic and clinical data were recorded using a predesigned case record form. Prescriptions were analyzed using World Health Organization (WHO) core prescribing indicators. Polypharmacy was defined as the concurrent use of five or more medications. Descriptive statistics were used to summarize the data.

Results

The mean age of the study population was 66.4 ± 4.8 years, with a male predominance (63%). Hypertension (68%) was the most common comorbidity, followed by chronic kidney disease (35.1%) and dyslipidemia (18.2%). The average number of drugs per prescription was 5.22 ± 1.37, indicating a high prevalence of polypharmacy. Drugs were prescribed by generic name in 57.7% of cases, and injectable medications were used in 24.2% of encounters. The mean number of antibiotics prescribed per encounter was 0.44 ± 0.81. Only 21% of the prescribed drugs were from the National List of Essential Medicines. Sulfonylureas were the most commonly prescribed antidiabetic drug class, and dual antidiabetic therapy was the most frequent regimen (42%).

Conclusion

Geriatric patients with T2DM attending a tertiary care hospital experience a high burden of polypharmacy, reflecting the presence of multiple comorbidities. Although moderate generic prescribing and judicious antibiotic use were observed, adherence to essential medicine prescribing remains suboptimal. Regular prescription audits, rational drug use policies, and periodic medication review are necessary to improve the safety, affordability, and quality of pharmacotherapy in elderly patients with T2DM.

Figures