Claudine Laurier1, Yola Moride, Wendy A Kennedy. 1. Policy and Outcomes at the Faculty of Pharmacy, Université de Montréal, Québec, Canada. claudine.laurier@umontreal.ca
Abstract
BACKGROUND: Studies have suggested that elderly patients do not always use medications appropriately. Investigations that have relied on prescription claim databases or clinical records focus on acquisition or prescription, and hypotheses must be made to assess actual consumption. Population survey data constitute an altemative way to study inappropriate use. OBJECTIVE: To estimate the prevalence of potentially inappropriate use of medications in elderly patients in Québec based on self-reported use. METHODS: Using a cross-sectional, general population, health survey in which self-reported medication use in the 2 days prior to the survey was recorded, we estimated the prevalence of inappropriate medication use in elderly patients (> or =65 y old) who responded. Two sets of published criteria were used to define inappropriate use: one to assess use of inappropriate drugs, and another to assess concomitant duplications and potential interactions. RESULTS: Of the 3400 patients surveyed, 6.5% had used > or =1 inappropriate drugs, 2.5% had > or =1 occurrences of potentially inappropriate duplication of medications, and 2.7% had > or =1 potential medication interactions. Concomitant use of at least 2 benzodiazepines was reported by 8.5% of respondents using these drugs. Use of > or =1 long-acting benzodiazepines was reported by 4.2% of the sample. CONCLUSIONS: Population health surveys are a useful tool for detecting potentially inappropriate medication use in the elderly. In particular, the high prevalence of inappropriate use of benzodiazepines signals a need for improved detection and intervention in this group.
BACKGROUND: Studies have suggested that elderly patients do not always use medications appropriately. Investigations that have relied on prescription claim databases or clinical records focus on acquisition or prescription, and hypotheses must be made to assess actual consumption. Population survey data constitute an altemative way to study inappropriate use. OBJECTIVE: To estimate the prevalence of potentially inappropriate use of medications in elderly patients in Québec based on self-reported use. METHODS: Using a cross-sectional, general population, health survey in which self-reported medication use in the 2 days prior to the survey was recorded, we estimated the prevalence of inappropriate medication use in elderly patients (> or =65 y old) who responded. Two sets of published criteria were used to define inappropriate use: one to assess use of inappropriate drugs, and another to assess concomitant duplications and potential interactions. RESULTS: Of the 3400 patients surveyed, 6.5% had used > or =1 inappropriate drugs, 2.5% had > or =1 occurrences of potentially inappropriate duplication of medications, and 2.7% had > or =1 potential medication interactions. Concomitant use of at least 2 benzodiazepines was reported by 8.5% of respondents using these drugs. Use of > or =1 long-acting benzodiazepines was reported by 4.2% of the sample. CONCLUSIONS: Population health surveys are a useful tool for detecting potentially inappropriate medication use in the elderly. In particular, the high prevalence of inappropriate use of benzodiazepines signals a need for improved detection and intervention in this group.