Prescription patterns in the elderly population--"new" versus "old" medical card holders

In July 2001, the GMS Scheme was extended to the whole elderly population aged 70 and over, permitting access to medical care services free of charge. We undertook a study to compare prescribing patterns between those relatively affluent people referred to as "new" over 70s with those relatively deprived people referred to as "old" over 70's, over the 18 months since the introduction of the scheme. Patients who had received a prescription for antibacterials, diuretics, psycholeptics, psychoanaleptics, statins, b-blockers, antithrombolytics, antianaemic drugs and drugs for obstructive airway diseases, were identified over the 18 month period using the GMS database. We also compared the average defined daily dose (DDD) received per month for each of the therapies above.

All therapies directed at treatment were significantly more likely to be prescribed to the old over 70's, such as the vasodilators (OR=1.59, 1.51-1.67), peptic ulcer drugs (OR=1.37, 1.33-1.43) and the antibacterials (OR=1.37, 1.33-1.41) with the exception of those associated with cardiovascular prevention; statins (OR=0.88, 0.85-0.92), beta-blockers (OR=0.95, 0.92-0.98) and antithrombolytics (OR=0.96, 0.93-0.99). The old over 70's received more prescriptions with a higher than the average DDD per month for vasodilators, diuretics, and drugs for obstructive airway disease. This study highlights a potential inequality in prescribing in primary care, evident following a change in the health policy in Ireland. These results suggest that differences in socio-economic status (such as income) and morbidity may be associated with differences in prescribing by GPs.