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Inappropriate prescribing for elderly outpatients.

R R Aparasu1, S J Sitzman

  • 1College of Pharmacy, South Dakota State University, Brookings 57007, USA. aparasur@mg.sdstate.edu

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
|March 30, 1999
PubMed
Summary

Potentially inappropriate medications were prescribed in 4.45% of elderly outpatient visits. Factors like referrals and multiple prescriptions increased the risk of receiving these harmful drugs.

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Area of Science:

  • Geriatric Medicine
  • Pharmacology
  • Health Services Research

Background:

  • Elderly outpatients are vulnerable to adverse drug events.
  • Potentially inappropriate medications (PIMs) pose significant risks to older adults.
  • Understanding prescribing patterns is crucial for patient safety.

Purpose of the Study:

  • To determine the frequency of PIMs in elderly outpatients.
  • To identify factors associated with PIM prescribing in this population.
  • To inform interventions aimed at reducing PIM use.

Main Methods:

  • A panel of geriatric medicine and pharmacology experts identified 20 PIMs.
  • Data from the 1994 National Hospital Ambulatory Medical Care Survey (NHAMCS) were analyzed.
  • Prescribing of PIMs in outpatients aged 65+ was examined.

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Main Results:

  • PIMs were prescribed in 4.45% of elderly outpatient visits involving medications.
  • An estimated 319,302 visits involved PIMs.
  • Diazepam, propoxyphene, dipyridamole, amitriptyline, and chlordiazepoxide were the most frequent PIMs.

Conclusions:

  • PIM prescribing is a notable issue in elderly outpatient care.
  • Referrals, polypharmacy, and specific drug classes predict PIM use.
  • Patient and provider characteristics can help predict inappropriate prescribing.