engleski

Potentially inappropriate prescribing in elderly outpatients in Croatia

Inappropriate prescribing to elderly patients poses a risk of drug related morbidity and mortality. It includes prescribing medications with a potential for serious drug-drug interactions, underuse, overuse and misuse. Misuse encompasses using potentially inappropriate medications (PIMs), inappropriate dose or duration of treatment. PIMs are defined as drugs with potential risk higher than their potential benefit to the patient, particulary where safer alternative therapies exist. For detecting potentially inappropriate medications in the elderly, several screening tools exist. The purpose of this study was to determine the prevalence of inappropriate prescribing to the elderly and to identify possible gender-related differences in prescribing PIMs to outpatients by using large administrative prescription database. The prevalence of PIMs prescribed to the elderly was assessed using a new protocol developed by Croatian authors. Medications prescribed to elderly outpatients (≥ 65 years) in Primorsko-goranska county, Croatia, who have received ≥ 5 different drugs simultaneously in the year 2010, were analyzed. A total of 62.4% of patients received at least one medication with unfavorable benefit/risk ratio. Female patients were given PIMs in a significantly higher percentage than men (69.3% vs. 50.5% ; p < 0.001). The average number of prescriptions for PIMs that should have been avoided with certain diseases or conditions was 0.88 per patient in the survey. The most common drug combination potentially leading to serious drug-drug interactions was angiotensin-converting enzyme inhibitor and potassium supplement. The study has shown that every tenth medication prescribed to patients older than 65 years and receiving ≥ 5 drugs was potentially inappropriate. Elderly women were prescribed PIMs more often than men. Drugs of concern in female patients were benzodiazepines, antidepressants and non-steroidal anti-inflammatory drugs. In male patients, there was significantly higher proportion of possible interactions with warfarine, theophylline and medications affecting cardiovascular system (ACE inhibitors, amiodarone).

prescribing; elderly; qulaity

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