[Polypharmacy in patients of a geriatric department of a general hospital]

At three somato-geriatric and one psychogeriatric units in the Amsterdam 'Slotervaartziekenhuis', retrospective research into the use of drugs by all patients admitted in 1985 (n = 724) was conducted. The main aim was to answer the question whether geriatric treatment can reduce the hitherto frequently described polypharmacy of the elderly. For that purpose the medication of all patients is registered as from their admission into hospital until the time of discharge from hospital. The average number of drugs used in the hospital appeared to have increased from 2.8 on admission to 3.8 on discharge. Geriatricians in Amsterdam were unable to reduce polypharmacy, probably because of the multiple pathology of their patients (4.4 diagnoses on discharge per patient). Yet, they prescribed only 0.86 drug per diagnosis on average. The most frequently prescribed drugs were vitamins, laxatives, diuretics, analgetics, sedatives/hypnotics and cardiovascular drugs. Antibiotics were used by a large percentage (46%) of the patients. On admission clearly fewer drugs (2.4) were used by patients who lived independently than by patients from residential and nursing homes (respectively 4.1 and 3.6). Eight percent of the patients was admitted because of adverse drug reactions or intoxications. On admission they used an average number of 4.1 drugs daily, which is considerably more than the number (2.7) used by other patients. Their drug use of course was reconsidered during their stay at the geriatric department.