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Sex differences in inappropriate prescribing among elderly veterans
Arlene S Bierman1, Mary Jo V Pugh, Irfan Dhalla
1Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada. arlene.bierman@utoronto.ca
The American Journal of Geriatric Pharmacotherapy
|August 28, 2007
Summary
Older women receive more inappropriate prescriptions than older men, particularly analgesics and psychotropic drugs. Targeted interventions for women are needed to reduce this prescribing gap.
Area of Science:
- Geriatric Pharmacy
- Pharmacology
- Health Services Research
Background:
- Previous research indicates older women may receive more potentially inappropriate prescriptions than older men.
- Understanding sex differences in inappropriate prescribing is crucial for developing targeted interventions.
Purpose of the Study:
- To assess sex differences in inappropriate prescribing rates before and after considering appropriate indications.
- To examine predictors of inappropriate drug use, stratified by sex.
Main Methods:
- Retrospective cohort study using Veterans Health Administration (VA) administrative data.
- Included veterans aged 65 years or older with outpatient visits in fiscal years 1999 and 2000.
- Assessed diagnosis-adjusted prevalence of 33 potentially inappropriate medications using Beers criteria.
Main Results:
- Women were more likely than men to receive inappropriate medications overall and in all assessed categories, even after adjusting for diagnoses.
- Women were more likely to receive analgesics, psychotropic drugs, and anticholinergic agents.
- Psychiatric comorbidity predicted inappropriate prescribing in men but not in women.
Conclusions:
- Higher rates of inappropriate drug use in older women were linked to analgesics, psychotropics, and anticholinergics.
- Interventions focusing on avoiding these specific medications in older women could reduce overall inappropriate prescribing.
- Sex-stratified quality indicators are essential for monitoring improvements in prescribing for community-dwelling elders.
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