Study examines inappropriate medication prescribing for elderly patients

February 09, 2004

CHICAGO - Medications considered "inappropriate" were prescribed at approximately eight percent of outpatient visits by elderly patients, with pain relievers and central nervous system drugs accounting for a large share, according to an article in the February 9 issue of The Archives of Internal Medicine, one of the JAMA/Archives journals.

According to the article, inappropriate medication use in patients 65 or older has been linked to many adverse drug reactions, poor physical functioning, and excess health care utilization.

Margie Rauch Goulding, Ph.D., of the Centers for Disease Control and Prevention, Hyattsville, Md., examined trends in the prevalence of potentially inappropriate drug prescribing at ambulatory care visits (physician's office and hospital outpatient visits) by older persons from 1995 to 2000. Dr. Goulding studied data from office-based physicians and hospital outpatient departments in the National Ambulatory Medical Care Survey.

Dr. Goluding found that in 1995 and 2000, at least one drug considered inappropriate by experts was prescribed at 7.8 percent of ambulatory care visits by elderly patients, and at least one drug classified as "never or rarely appropriate" was prescribed at 3.7 percent and 3.8 percent of these visits in 1995 and 2000, respectively. Pain relievers and central nervous system drugs made up most of the inappropriate prescriptions.

Dr. Goulding also found that the odds of inappropriate prescriptions were higher for patients with multiple prescriptions, and were double for women.

"Potentially inappropriate prescribing at ambulatory care visits by elderly patients, particularly women, remains a substantial problem," Dr. Goulding writes. "Interventions could target more appropriate drug selection by physicians when prescribing pain relievers, antianxiety agents, sedatives, and antidepressants to elderly patients. Such behavior could eliminate a large portion of inappropriate prescribing for elderly patients and reduce its higher risk for women."
-end-
(Arch Intern Med. 2004;164:305-312. Available post-embargo at archinternmed.com)

To contact Margie Rauch Goulding, Ph.D., call Sandra Smith at 301-458-4800.
For more information, contact JAMA/Archives Media Relations at 312-464-JAMA (5262) or e-mail mediarelations@jama-archives.org.

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