International Journal For Multidisciplinary Research

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The Compounding Effect of Polypharmacy and Comorbidities on Adverse Drug Reaction Severity in Critically Ill Patients

Author(s) Dr. Lokeshwaran Selvam, Dr. Ambai Jeevamani, Dr. Ramkumar R.P
Country India
Abstract Adverse drug reactions (ADRs) present a profound clinical challenge in the intensive care unit (ICU), where multi-organ dysfunction and complex pharmacotherapy are prevalent. This study investigates the compounding effects of polypharmacy and baseline comorbidities on the severity of ADRs in critically ill patients.
Methods: A prospective observational study was conducted over six months in a 1009-bedded multi-speciality tertiary care teaching hospital. A cohort of 174 patients who developed an ADR during ICU admission was evaluated. Severity was assessed using Hartwig's scale, while causality and preventability were measured using the Naranjo and Schumock-Thornton scales, respectively.
Results: Among the 174 patients, 109 (62.64%) presented with pre-existing comorbidities. Polypharmacy was extensive, with 120 patients (68.97%) prescribed 10 or more concurrent medications. Severity assessment revealed 93 (53.44%) mild, 78 (44.82%) moderate, and 3 (1.74%) severe reactions. Antibiotics were the primary causative agents, responsible for 28.16% of incidents.
Conclusion: The convergence of polypharmacy and underlying comorbidities significantly amplifies the complexity of adverse drug events. Strict pharmacovigilance and targeted medication reconciliation are critical for high-risk ICU populations.
Keywords Adverse Drug Reactions (ADRs), Polypharmacy, Comorbidities, Intensive Care Unit (ICU), Critically Ill Patients, Hartwig’s Severity Scale, Naranjo Causality Scale, Schumock-Thornton Preventability Scale, Medication Reconciliation, Pharmacovigilance, Critical Care Pharmacotherapy, Drug-Drug Interactions (DDIs), Antibiotics, Anticoagulants.
Field Medical / Pharmacy
Published In Volume 8, Issue 4, July-August 2026
Published On 2026-07-15
DOI https://doi.org/10.36948/ijfmr.2026.v08i04.83732
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