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Potentially inappropriate prescribing to older patients receiving multidose drug dispensing

Anette Vik Josendal1,2, Trine Strand Bergmo3, Anne Gerd Granas3,4

  • 1Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway. anette.vik.josendal@ehealthresearch.no.

BMC Geriatrics
|August 8, 2020
PubMed
Abstract

Insights

Multidose drug dispensing (MDD) in elderly Norwegians is linked to high rates of potentially inappropriate medications (PIMs) and drug-drug interactions (DDIs). Over a quarter of patients received PIMs, and more than half experienced DDIs, highlighting prescribing quality concerns.

Area of Science:

  • Geriatric Medicine
  • Pharmacology
  • Public Health

Background:

  • Multidose drug dispensing (MDD) is a medication management strategy for improving adherence.
  • Previous research suggests potential prescribing quality issues in patients using MDD.
  • This study focuses on Norwegian elderly home care patients utilizing MDD.

Purpose of the Study:

  • To evaluate the quality of prescribing in elderly Norwegian home care patients receiving MDD.
  • To identify the prevalence of potentially inappropriate medications (PIMs) and drug-drug interactions (DDIs) in this population.

Main Methods:

  • A cross-sectional study involving 45,593 elderly MDD patients (≥70 years).
  • Assessment of PIMs using Norwegian General Practice Criteria.
  • Investigation of DDIs using the Norwegian Medicines Agency database.

Main Results:

  • Average medication use was 10.6 drugs per patient, with 6.1 dispensed via MDD.
  • Twenty-seven percent of patients were prescribed at least one PIM; common issues included psychotropic drug use and diazepam.
  • Fifty-nine percent experienced DDIs, though only 2.7% had serious interactions. Women showed higher exposure to PIMs and DDIs.

Conclusions:

  • Polypharmacy is prevalent among elderly Norwegian MDD users.
  • Approximately one-fourth of patients were exposed to PIMs, and over half encountered DDIs.
  • Findings indicate a need to address prescribing quality in elderly MDD patients.
Keywords:
Drug-drug interactionsElderlyHome care servicesInappropriate prescribingMultidose drug dispensingNorway

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