Inappropriate medication use in community-residing older persons.
BACKGROUND
Elderly patients taking inappropriate drugs are at increased risk for adverse outcomes. We investigated the prevalence of inappropriate drug use and its predisposing factors in community-residing older persons.


METHODS
We conducted in-home interviews with 414 subjects aged 75 years and older living in the community of Santa Monica, Calif. Inappropriate medication use was evaluated using explicit criteria developed through a modified Delphi consensus process. These criteria identified drugs that should generally be avoided in elderly community-residing subjects regardless of dosage, duration of therapy, or clinical circumstances.


RESULTS
Based on these conservative criteria, 14.0% of the subjects were using at least one inappropriate drug. The most common examples were long-acting benzodiazepines, persantine, amitriptyline, and chlorpropamide. Subjects using three or more prescription drugs, compared with one or two, were more likely to be taking an inappropriate medication (odds ratio, 3.9; 95% confidence interval, 1.9 to 7.9). Furthermore, subjects with depressive symptoms had a higher risk of receiving inappropriate medications than nondepressive subjects (odds ratio, 2.2; 95% confidence interval, 1.1 to 4.1).


CONCLUSIONS
Inappropriate drug use is a common problem in community-residing older persons. The risk of inappropriate drug use is increased in patients taking multiple medications and in patients with depressive symptoms.
Stuck
A E
AE
Department of Geriatrics and Rehabilitation, Zieglerspital, Bern, Switzerland.
Beers
M H
MH
Steiner
A
A
Aronow
H U
HU
Rubenstein
L Z
LZ
Beck
J C
JC
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002140:California; D015984:Causality; D016001:Confidence Intervals; D003625:Data Collection; D003697:Delphi Technique; D003866:Depressive Disorder / Q000188:drug therapy / Q000523:psychology; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D004366:Nonprescription Drugs / Q000627:therapeutic use; D016017:Odds Ratio; D015995:Prevalence; D012646:Self Administration / Q000706:statistics & numerical data*; D012651:Self Medication / Q000706:statistics & numerical data*; D016896:Treatment Outcome
D004366:Nonprescription Drugs