Geriatric medication safety: Drug interaction medication adherence and adverse drug reaction awareness

Background: Medication safety is a critical concern in the geriatric population due to age-related physiological changes, multiple comorbidities, and polypharmacy. Inappropriate medication use, poor medication adherence, drug interactions, and lack of awareness regarding adverse drug reactions (ADRs) can significantly increase the risk of medication-related problems and negatively impact health outcomes among elderly patients. 
Aim: The study aimed to evaluate and enhance geriatric medication safety by examining drug interactions, medication adherence, and awareness of adverse drug reactions among the geriatric population. 
Methods: A cross-sectional observational study was conducted in a selected FHC Villadom, Thrissur over a period of five months from September 2025 to January 2026. The study included geriatric participants above 65 years and data were collected using a structured and validated questionnaire based on predefined inclusion and exclusion criteria. 
Results: Among the study population, (39%) were males and (61%) were females, with the majority of participants (58.7%) belonging to the 65–70 years age group. Polypharmacy was commonly observed, with (69.6%) of participants. The majority of participants experienced major drug interactions (40.9%), followed by moderate (25.7%) and minor (0.5%) interactions, while (32.8%) showed no evidence of drug interactions. Pharmacodynamic interactions were more prevalent (53.0%) than pharmacokinetic interactions (14.1%). Assessment of medication adherence revealed that (72.5%) of participants had low adherence, while (27.5%) showed medium adherence. Evaluation of ADR knowledge indicated that (67.4%) of participants had poor knowledge during the pre-test, following the distribution of educational leaflets and patient counselling, and marked improvement in ADR knowledge was observed, with only (10.1%) of participants continuing to have poor ADR knowledge in the post-study assessment. 
Conclusion: The study highlights that the geriatric population is highly vulnerable to medication related problems due to polypharmacy, low medication adherence, and inadequate baseline awareness of adverse drug reactions. The findings demonstrate that educational interventions and regular follow-up play a crucial role in improving ADR awareness and promoting safer medication practices. Incorporation of pharmaceutical care services and patient- centered education into routine geriatric healthcare is essential to enhance medication safety, reduce drug-related problems, and improve overall health outcomes among elderly patients.