**Background:** India's elderly population is growing rapidly, with those aged 60+ expected to rise from 101.5 million in 2011 to 227.4 million by 2036. Age-related physiological changes, altered pharmacokinetics and pharmacodynamics, and polypharmacy make drug prescribing in the elderly challenging. Prescription analysis studies are needed to identify irrational drug use and prevent adverse drug interactions. This study aimed to investigate medicine use patterns among geriatric patients attending the Medicine Outpatient Department at a tertiary care teaching hospital in Raipur, Central India.
**Methods:** This cross-sectional observational study included 234 elderly patients aged ≥65 years who were on two or more drugs for chronic diseases. Severely ill patients were excluded. Data were collected from a previously published study (unused earlier) after obtaining written informed consent. Collected data included demographic details, dietary history, personal history, history of constipation and peptic ulcer disease, and drug details (generic name, dose, duration, prescription pattern). The number of drugs per prescription was recorded to calculate polypharmacy incidence. Descriptive statistics (numbers, proportions, mean ± SD) were applied using Microsoft Excel.
**Key Results:** A total of 1298 prescriptions were analyzed. The average number of drugs prescribed per prescription was 5.92 ± 2.31 as single drugs and 2.15 ± 1.41 as fixed-dose combinations. The mean age was 68.70 ± 5.76 years; 141 (60.26%) were male. Among participants, 40 (17.09%) were illiterate, 82 (35.04%) were unemployed, 124 (53%) were retired, and 171 (73.08%) had a monthly income less than Rs. 5,000. Personal history included 18 (7.69%) alcoholics, 56 (23.93%) smokers, 81 (34.62%) with constipation, 25 (10.68%) with peptic ulcer disease, and 62 (26.50%) taking over-the-counter (OTC) herbal medications. Diagnoses included diabetes mellitus alone (21, 8.97%), diabetes with hypertension (64, 27.35%), diabetes with other comorbidities (59, 25.21%), hypertension alone (31, 13.25%), and hypertension with comorbidities (42, 17.95%). For cardiovascular diseases (617 prescriptions), telmisartan alone (58, 9.40%) and telmisartan combinations (82, 13.29%) were most common, followed by calcium channel blockers (78, 12.64%), beta-blockers (42, 6.81%), diuretics (31, 5.02%), and ACE inhibitors (14, 2.27%). Aspirin and statins alone or in combination (172, 27.88%) were most prescribed for cardiovascular prophylaxis. For diabetes (262 prescriptions), metformin (49, 18.70%), glimepiride (29, 11.07%), and their combinations (53, 20.23%) were common, along with teneligliptin (28, 10.69%) and alpha-glucosidase inhibitors (31, 11.83%). For CNS diseases (85 prescriptions), clonazepam (14, 16.47%) was most prescribed, and gabapentin/pregabalin combinations (28, 32.94%) for neuropathies. Pantoprazole alone or with domperidone (82, 64.57%) was most common for acid-peptic disease, thyroxin (26, 100%) for hypothyroidism, and vitamin preparations (118, 62.43%) were widely used.
**Clinical Implications:** This study reveals a high prevalence of polypharmacy (average 5.92 drugs per prescription) in elderly patients, increasing the risk of drug-drug interactions (DDIs). The frequent use of calcium channel blockers (e.g., amlodipine) in patients with constipation (35%) warrants caution, as CCBs may exacerbate constipation. Proton pump inhibitors (PPIs) were prescribed extensively; according to STOPP/START criteria, full-dose PPI therapy beyond eight weeks for uncomplicated peptic ulcer disease should be reconsidered. Benzodiazepines like clonazepam were commonly prescribed, despite known risks of falls and fractures in the elderly. The use of OTC herbal medications by 27% of patients further increases DDI risk. Regular prescription analysis using tools like STOPP/START and Beers criteria is essential to promote rational prescribing, minimize adverse effects, and improve patient safety in this vulnerable population.