Inappropriate drug use among community-dwelling elderly

Area of Science:

• Gerontology
• Pharmacoepidemiology
• Public Health

Background:

• Elderly populations often experience polypharmacy, increasing the risk of inappropriate drug use.
• Updated criteria are essential for accurately assessing medication appropriateness in older adults.
• The Duke Established Populations for Epidemiologic Studies of the Elderly (EPESE) provides a valuable cohort for examining health trends in aging populations.

Purpose of the Study:

• To evaluate the prevalence of inappropriate drug use among community-dwelling elderly using updated criteria.
• To identify factors associated with inappropriate medication prescribing in older adults.
• To inform interventions aimed at improving medication safety in the elderly.

Main Methods:

• Cross-sectional analysis of data from the second and third in-person waves of the Duke EPESE.
• In-home interviews to collect information on sociodemographics, health status, healthcare access, and drug use.
• Application of explicit criteria to code drug use by therapeutic class and appropriateness.

Main Results:

• Prevalence of inappropriate drug use was 27% in the second wave and 22.5% in the third wave.
• Most commonly misused drug classes included central nervous system and cardiovascular agents.
• Factors associated with inappropriate drug use included polypharmacy, lack of care continuity, prior inappropriate drug use, and frequent healthcare visits.

Conclusions:

• Inappropriate drug use is a significant issue among community-dwelling elderly.
• Specific patient characteristics and healthcare utilization patterns are linked to higher risks of inappropriate medication use.
• Findings underscore the need for ongoing medication review and management strategies for older adults.