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Use Of Inappropriate Prescription Drugs By Older People

J. Hanlon, K. Schmader, C. Boult, M. Artz, C. Gross, G. Fillenbaum, C. Ruby, J. Garrard
Published 2002 · Medicine

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OBJECTIVES To determine the prevalence and predictors of inappropriate drug prescribing defined by expert national consensus panel drug utilization review criteria for community-dwelling older people. DESIGN Survey. SETTING Five adjacent urban and rural counties in the Piedmont area of North Carolina. PARTICIPANTS A stratified random sample of participants from the fourth (n = 3,234) and seventh (n = 2,508) waves of the Duke Established Populations for Epidemiological Studies of the Elderly. MEASUREMENTS The prescribing appropriateness for digoxin, calcium channel blockers, angiotensin-converting enzyme inhibitors, histamine(2) receptor antagonists, nonsteroidal antiinflammatory drugs (NSAIDs), benzodiazepines, antipsychotics, and antidepressants as determined by explicit criteria (through Health Care Financing Administration expert consensus panel drug utilization review criteria for dosage, duplication, drug-drug interactions and duration, and U.S. and Canadian expert consensus panel criteria for drug-disease interactions). Multivariable analyses, using weighted data adjusted for sampling design, were conducted to assess the association between inappropriate prescribing and demographic, health-status, and access-to-healthcare factors cross-sectionally and longitudinally. RESULTS We found that 21.0 of the fourth wave and 19.2 of the seventh wave participants who used one or more agents from the eight drug classes had one or more elements identified as inappropriate. The therapeutic classes with the most problems were benzodiazepines and NSAIDs. The most common problems were with drug-disease interactions and duration of use. Longitudinal multivariable analyses found that participants who were white (adjusted odds ratio (AOR) = 1.67, 95 confidence interval (CI) = 1.28-2.17), were married (AOR = 1.40, 95% CI = 1.01-1.93), had arthritis (AOR = 1.74, 95% CI = 1.27-2.38), had one or more physical function disabilities (AOR = 1.42, 95% CI = 1.02-1.96), and had inappropriate drugs prescribed at wave 4 (AOR = 6.87, 95% CI = 5.11-9.22) were more likely to have inappropriate prescribing at wave 7. CONCLUSION These results indicate that inappropriate prescribing is common among community-dwelling older people and persists over time. Longitudinal studies in older people are needed to examine the impact of inappropriate drug prescribing on health-related outcomes.
This paper references
10.1093/GERONJ/21.4.556
A Guttman health scale for the aged.
I. Rosow (1966)
10.1111/J.1532-5415.1975.TB00927.X
A Short Portable Mental Status Questionnaire for the Assessment of Organic Brain Deficit in Elderly Patients †
E. Pfeiffer (1975)
10.2190/UURL-2RYU-WRYD-EY3K
A Measure of Primary Sociobiological Functions
S. Katz (1976)
10.1007/springerreference_61216
Adverse drug reactions.
S. R. Fine (1976)
A measure of primary sociobiologic functions
S Katz (1976)
10.1093/AJHP/35.1.76
Drug use review: operational definitions.
M. Stolar (1978)
Framework and development of a comprehensive drug product coding system.
C. A. Devito (1979)
10.2307/2531133
Epidemiologic Research: Principles and Quantitative Methods.
S. Pocock (1982)
10.1111/J.1532-5415.1985.TB01779.X
Screening the Elderly
G. Fillenbaum (1985)
Screening the elderly: A brief instrumental ADL measure
GG Fillenbaum (1985)
10.1007/3-540-29832-0_1147
Non steroidal anti-inflammatory drugs.
R. Day (1987)
Methodologies for drug use review in geriatric therapy
FB Palumbo (1987)
10.2307/2532419
Applied Logistic Regression
D. Hosmer (1989)
A nomogram for computing body mass index. Diet Curr 1989;16:5–12
ML Rowland (1989)
10.1016/S0749-3797(18)31026-2
Demographic and health characteristics of elderly smokers: results from established populations for epidemiologic studies of the elderly.
P. Colsher (1990)
10.1016/S0749-0690(18)30623-2
Nonsteroidal anti-inflammatory drugs.
M. Murray (1990)
10.1111/j.1532-5415.1990.tb04419.x
Prevalence and Characteristics of Multiple Analgesic Drug Use in an Elderly Study Group
E. Chrischilles (1990)
10.1038/CLPT.1991.189
Development of criteria for drug utilization review
D. A. Knapp (1991)
10.2105/AJPH.81.12.1630
The importance of assessing the fit of logistic regression models: a case study.
D. Hosmer (1991)
10.1080/00224065.1991.11979294
Applied Linear Regression Models
L. Leemis (1991)
10.1016/0895-4356(92)90144-C
A method for assessing drug therapy appropriateness.
J. Hanlon (1992)
10.1177/106002809202600514
Drug-Use Patterns among Black and Nonblack Community-Dwelling Elderly
J. Hanlon (1992)
Ominibus Budget Reconciliation Act of 1990 , Section 4401
RM Tamblyn (1992)
Screening criteria for outpatient drug use review: Final report to HCFA
D Knapp (1992)
10.2105/AJPH.83.11.1577
Prescription and nonprescription drug use among black and white community-residing elderly.
G. Fillenbaum (1993)
10.1097/00005650-199312000-00001
Drug Utilization Review in Ambulatory Settings: State of the Science and Directions for Outcomes Research
H. L. Lipton (1993)
Questionable prescribing for elderly patients in Quebec.
R. Tamblyn (1994)
10.1001/ARCHINTE.1995.00430160149015
Benzodiazepines and the risk of falling leading to femur fractures. Dosage more important than elimination half-life.
R. Herings (1995)
10.1300/J089V09N04_04
Evaluating Variables Associated with Potential Drug-Related Problems in an Older Population
D. Kirking (1995)
10.2307/2137284
Revisiting the behavioral model and access to medical care: does it matter?
R. Andersen (1995)
10.1016/S0277-9536(96)00342-5
Appropriateness in health care: application to prescribing.
S. Buetow (1997)
10.1001/ARCHINTE.1997.00440350031003
Explicit criteria for determining potentially inappropriate medication use by the elderly. An update.
M. Beers (1997)
Defining inappropriate practices in prescribing for elderly people: a national consensus panel.
P. McLeod (1997)
Explicit criteria for determining potentially inappropriate medication by the elderly
MH Beers (1997)
Prescription medication use in older Americans: a national report card on prescribing.
S. Rathore (1998)
10.1016/S0009-9236(98)90059-5
Benzodiazepine use and cognitive function among community‐dwelling elderly
J. Hanlon (1998)
10.1377/HLTHAFF.17.6.99
National health expenditures in 1997: more slow growth.
K. Levit (1998)
10.1007/BF03339886
Developing a summary measure of medical status
G. Fillenbaum (1998)
A nomogram for computing body mass index
ML Rowland (1998)
10.1016/S0149-2918(00)87245-8
Drug use and prescribing problems in the community-dwelling elderly: a study of three state Medicaid programs.
B. Briesacher (1999)
10.1111/J.1553-2712.1999.TB00139.X
Appropriateness of medication selection for older persons in an urban academic emergency department.
M. H. Chin (1999)
10.4065/77.3.255
Diagnosis and treatment of migraine.
R. Cady (1999)
SAS/STAT User’s Guide
SAS Institute Inc (1999)
SUDAAN: Professional software for survey data analysis
(1999)
10.1176/APPI.AJP.157.7.1089
Marked differences in antidepressant use by race in an elderly community sample: 1986-1996.
D. Blazer (2000)
10.1136/bmj.320.7241.1058
Non-steroidal anti-inflammatory drugs
P. Gøtzsche (2000)
10.1111/j.1532-5415.2000.tb04729.x
Benzodiazepines and the Risk of Falls in Nursing Home Residents
W. Ray (2000)
Pain in nursing home residents — Management strategies
DK Weiner (2001)
Pain in nursing home residents—Management strategies. Drugs Aging 2001;18:13–29
DK Weiner (2001)



This paper is referenced by
10.1007/978-3-030-61721-9_19
From Benzodiazepine Prescription to Dependence: Learning Processes Involved
Emilce Artur de la Villarmois (2021)
10.1186/s12889-020-08984-z
Trends in the consumption rates of benzodiazepines and benzodiazepine-related drugs in the health region of Lleida from 2002 to 2015
F. Torres-Bondia (2020)
10.18549/PharmPract.2019.2.1439
Potentially inappropriate medications prescribing according to Beers criteria among elderly outpatients in Jordan: a cross sectional study
Ahmad Al-Azayzih (2019)
10.1016/j.jgo.2017.07.015
Polypharmacy, potentially inappropriate medications and drug-drug interactions in geriatric patients with hematologic malignancy: Observational single-center study of 122 patients.
D. Léger (2018)
10.1016/J.IJGE.2018.05.006
Polypharmacy and Willingness to Deprescribe Among Elderly with Chronic Diseases
Lim Jia Hao (2018)
10.12816/EJHM.2018.9797
Association between Potentially Inappropriate Prescription (PIP) and Health Outcome Among Geriatric Home Residents
A. Saeed (2018)
10.5530/IJOPP.11.2.17
Evaluation of Potentially Inappropriate Medication Use and Risk of Adverse Drug Reactions in Hospitalized Older Adults: An Observational Study in a Tertiary Care Hospital
Rohit Rawat (2018)
10.1017/S1463423618000142
Evaluation of community pharmacists’ roles in screening and communication of risks about non-steroidal anti-inflammatory drugs in Thailand
Pacharaporn Phueanpinit (2018)
10.1007/s40266-018-0554-2
International Group for Reducing Inappropriate Medication Use & Polypharmacy (IGRIMUP): Position Statement and 10 Recommendations for Action
D. Mangin (2018)
10.1111/bcp.13598
Reducing potentially inappropriate drug prescribing in nursing home residents: effectiveness of a geriatric intervention
C. Cool (2018)
A Pharmacoeconomic Study of Consequences, Continuity & Adherence of Polypharmacy in Elderly Patients
Dr. Anusha Joel (2017)
Impact of Medicare Reimbursement Policy Change on the Utilization, Risks, and Costs Associated with Erythropoiesis-Stimulating Agents in Cancer Patients with Chemotherapy-Induced Anemia
M. Li (2017)
10.17077/etd.4c29spiy
Understanding Medicare part D beneficiaries’ decision making for using comprehensive medication review service
Yiran Zhang (2017)
10.1080/07853890.2016.1252053
Drug Burden Index and change in cognition over time in community-dwelling older men: the CHAMP study
Kris M. Jamsen (2017)
Polifarmacia y prescripción de medicamentos potencialmente no apropiados en ancianos
J. Castro-Rodriguez (2015)
10.1016/J.SEMERG.2014.10.004
Analisis de la prescripción farmacológica en pacientes institucionalizados
Álvaro Sicilia (2015)
10.1331/JAPhA.2015.15506
Keeping kidneys safe: the pharmacist's role in NSAID avoidance in high-risk patients.
A. Pai (2015)
10.1111/jcpt.12246
Conceptualizing and measuring potentially inappropriate drug therapy
A. Santos (2015)
A Polypharmacy Model and the Association of Polypharmacy with All-Cause Mortality and Incident Cognitive Impairment in the REGARDS Cohort
Winn T. Cashion (2015)
10.1001/jamapsychiatry.2014.1763
Benzodiazepine use in the United States.
M. Olfson (2015)
10.1016/j.jamda.2014.04.010
An educational intervention on drug use in nursing homes improves health outcomes resource utilization and reduces inappropriate drug prescription.
F. García-Gollarte (2014)
PREVENTING CHRONIC DISEASE
Swasey (2014)
10.1097/JAC.0000000000000033
The Medication Minefield: Using Computerized Decision Support Systems to Reduce Preventable Adverse Drug Events and Hospitalizations
R. Bernstein (2014)
Medication Safety In Children
L. Reddenna (2014)
10.1007/978-1-4939-0268-2_8
Polypharmacy and Adverse Drug Reactions in the Aging Population with Heart Failure
M. Rich (2014)
10.1016/j.jamda.2014.08.003
Potentially inappropriate drug prescribing and associated factors in nursing homes.
C. Cool (2014)
10.1371/journal.pone.0105425
Potentially Inappropriate Medication Use in Older Patients in Swiss Managed Care Plans: Prevalence, Determinants and Association with Hospitalization
O. Reich (2014)
Lääkkeiden käyttö ja vältettävien lääkkeiden yleisyys 90-vuotiailla tamperelaisilla
Tytti Salonranta (2014)
10.5888/pcd11.140298
NSAID-Avoidance Education in Community Pharmacies for Patients at High Risk for Acute Kidney Injury, Upstate New York, 2011
S. Jang (2014)
10.1093/intqhc/mzt089
Quality of prescribing in Belgian nursing homes: an electronic assessment of the medication chart.
M. Elseviers (2014)
Éthique des soins aux personnes âgées : la capacité à consentir et traitement involontaire
Astrid Lhermite (2014)
10.1111/jgs.12253
Association Between Sedating Medications and Delirium in Older Inpatients
M. Rothberg (2013)
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