Elderly prescribed inappropriate meds

February 1, 2002

Pharmaceutical Representative

A new study highlights the problem of inappropriate prescribing in elderly patients in the United States.

A new study from the U.S. Agency for Healthcare Research and Quality highlights the problem of inappropriate prescribing in elderly patients in the United States. The study was based on AHRQ Medical Expenditure Panel Survey data on a national sample of 2,455 community-dwelling elderly persons aged 65 and older in 1996.

According to the findings, about one-fifth of the approximately 32 million elderly Americans not living in nursing homes in 1996 used at least one or more of 33 prescription medicines considered potentially inappropriate. Nearly one million elderly used at least one of 11 medications that a panel of geriatric medicine and pharmacy expert advisors agreed should always be avoided in the elderly, including long-acting benzodiazapines, sedative or hypnotic agents, long-acting oral hypoglycemics, analgesics, antiemetics and gastrointestinal antispasmodics.

"This important research indicates that patient safety issues can occur outside hospitals, nursing homes and institutional settings, and among any patient population," said AHRQ Director John M. Eisenberg. "This study highlights the need to develop evidence-based programs and ways to improve prescribing practices in the United States."

Could be higher

According to lead author Chunliu Zhan, the actual extent of inappropriate medication prescribing may be much higher than the estimates because of the conservative criteria the researchers used and because of the rate of introduction of new pharmaceutical agents into the market. Furthermore, inappropriate medication use in the elderly is a component of the even larger problem of suboptimal prescribing (underuse of effective medications, inappropriate dosing, inappropriate combination use of drugs and other prescription errors).

Not all physicians agree about the appropriateness of specific drugs for the elderly. This lack of consensus stems in part from the limited amount of evidence of risks and benefits for some medications, because older patients are often excluded from clinical trials. PR

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