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Inappropriate medication prescribing for elderly ambulatory care patients.
Arch Intern Med. 2004 Feb 09; 164(3):305-12.AI

Abstract

BACKGROUND

Inappropriate medication use in elderly patients has been linked to a large share of adverse drug reactions and to excess health care utilization.

METHODS

Trends in the prevalence of potentially inappropriate drug prescribing at ambulatory care visits by elderly persons from 1995 to 2000 were examined with data from office-based physicians in the National Ambulatory Medical Care Survey and from hospital outpatient departments in the National Hospital Ambulatory Medical Care Survey. Explicit criteria were used to identify potentially inappropriate prescribing. Multivariate regression was used to identify related factors.

RESULTS

In 1995 and 2000, at least 1 drug considered inappropriate by the Beers expert panel was prescribed at 7.8% of ambulatory care visits by elderly patients. At least 1 drug classified as never or rarely appropriate by the Zhan expert panel was prescribed at 3.7% and 3.8% of these visits in 1995 and 2000, respectively. Pain relievers and central nervous system drugs were a large share of the problem. The odds of potentially inappropriate prescribing were higher for visits with multiple drugs and double for female visits. The latter was due to more prescribing of potentially inappropriate pain relievers and central nervous system drugs.

CONCLUSIONS

Potentially inappropriate prescribing at ambulatory care visits by elderly patients, particularly women, remains a substantial problem. 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.

Authors+Show Affiliations

Office of Analysis, Epidemiology, and Health Promotion at the National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782, USA. mgoulding@cdc.gov

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

14769626

Citation

Goulding, Margie Rauch. "Inappropriate Medication Prescribing for Elderly Ambulatory Care Patients." Archives of Internal Medicine, vol. 164, no. 3, 2004, pp. 305-12.
Goulding MR. Inappropriate medication prescribing for elderly ambulatory care patients. Arch Intern Med. 2004;164(3):305-12.
Goulding, M. R. (2004). Inappropriate medication prescribing for elderly ambulatory care patients. Archives of Internal Medicine, 164(3), 305-12.
Goulding MR. Inappropriate Medication Prescribing for Elderly Ambulatory Care Patients. Arch Intern Med. 2004 Feb 9;164(3):305-12. PubMed PMID: 14769626.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Inappropriate medication prescribing for elderly ambulatory care patients. A1 - Goulding,Margie Rauch, PY - 2004/2/11/pubmed PY - 2004/3/16/medline PY - 2004/2/11/entrez SP - 305 EP - 12 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 164 IS - 3 N2 - BACKGROUND: Inappropriate medication use in elderly patients has been linked to a large share of adverse drug reactions and to excess health care utilization. METHODS: Trends in the prevalence of potentially inappropriate drug prescribing at ambulatory care visits by elderly persons from 1995 to 2000 were examined with data from office-based physicians in the National Ambulatory Medical Care Survey and from hospital outpatient departments in the National Hospital Ambulatory Medical Care Survey. Explicit criteria were used to identify potentially inappropriate prescribing. Multivariate regression was used to identify related factors. RESULTS: In 1995 and 2000, at least 1 drug considered inappropriate by the Beers expert panel was prescribed at 7.8% of ambulatory care visits by elderly patients. At least 1 drug classified as never or rarely appropriate by the Zhan expert panel was prescribed at 3.7% and 3.8% of these visits in 1995 and 2000, respectively. Pain relievers and central nervous system drugs were a large share of the problem. The odds of potentially inappropriate prescribing were higher for visits with multiple drugs and double for female visits. The latter was due to more prescribing of potentially inappropriate pain relievers and central nervous system drugs. CONCLUSIONS: Potentially inappropriate prescribing at ambulatory care visits by elderly patients, particularly women, remains a substantial problem. 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. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/14769626/Inappropriate_medication_prescribing_for_elderly_ambulatory_care_patients_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinte.164.3.305 DB - PRIME DP - Unbound Medicine ER -