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\begin{document}

\title{Economic implications of polypharmacy in Nepal: Multicenter
community-based study}



\author[1]{Binaya Sapkota}%
\author[1]{Suraj  Shakya}%
\author[1]{Saroj  Sah}%
\author[1]{Narendra  Chaudhary}%
\author[1]{Bijendra  Tamang}%
\author[1]{Saugat Singh  Karki}%
\affil[1]{Nobel College Pvt Ltd}%


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  \date{May 25, 2024}


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\begin{abstract}
Aims: Improper management of polypharmacy in community and hospital
pharmacies may lead to adverse effects and drug interactions in patients
of all age groups, especially children and elderly. This study sought to
determine scenario of polypharmacy at multiple communities in Nepal and
costs implicated. Methods: Multi-center community-based cross-sectional
study was conducted to explore scenario of polypharmacy at multiple
communities in Nepal and their cost implications for individual. Total
400 patients of all age groups, who were consuming medicines and
fulfilling inclusion criteria (i.e., prescribed with [?]4 medications)
from May 2017 to August 2018 were recruited. Semi-structured
questionnaire, based on prescription optimization method, was used.
Multinomial logistic regression was performed to analyze statistical
significance of polypharmacy with various predictors, considering
p-value \textless{}0.05 as statistically significant. Results: Overall,
79 (97.5\%) patients aged 22-31 years, 208 (95\%) female, 219 (98.2\%)
illiterate, 202 (99\%) from Siraha district, 113 (97.4\%) taking
medications for common cold, cough, fever problems and 303 (96.5\%)
expending USD 1.01 - 11 experienced moderate polypharmacy. There were
216 patients (54\%) with prescriptions of five medicines (i.e., moderate
polypharmacy), with total number of medicines consumed by 400 patients
2269 (mean = 5.67) and total expenditure USD 3409.54 (mean = 8.66).
Conclusion: The present study analyzed economic aspect of polypharmacy
at multiple communities in Nepal and found that both moderate and severe
polypharmacy were significantly related with almost all age groups,
education levels and total cost of medications. Economic implications
and health consequences of polypharmacy are to be considered to avoid
preventable polypharmacy.%
\end{abstract}%



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