Medication use characteristics in an ambulatory elderly population in Taiwan.
OBJECTIVE
To compare prescribing patterns between the elderly and nonelderly in 1994, to disclose prescribing trends in the elderly-between 1992 and 1994, to explore whether drug utilization is in agreement with disease prevalence, and to identify suboptimal prescribing by drug category for ambulatory elderly patients.


METHODS
Cross-sectional survey at two separate time intervals.


METHODS
All public group practice centers (GPCs) in Taiwan.


METHODS
Ambulatory adults who visited GPCs during 1 random week. Those 65 years or over were classified as the elderly group, and those 20-64 years were the nonelderly group.


METHODS
Mean diagnosis, drug use, and expenditure; frequency of diagnosis; and prescribing by therapeutic category.


RESULTS
Data on 30777 elderly and 38184 nonelderly patients were collected in 1994. There was widespread use of antacids. Compared with nonelderly adults, the elderly were diagnosed with more diseases (1.3 vs. 1.2, respectively; p < 0.01), received more medications (4.7 vs. 4.1, respectively; p < 0.01), and had higher drug expenditures (5.4 vs. 4.6, respectively; p < 0.01). Chronic illness was more prevalent in the elderly, which accounted for the extensive use of cardiovascular drugs (32.1%), nonsteroidal antiinflammatory drugs (25.9%), and anxiolytics (15.9%). The upward trend in the elderly from 1992 to 1994 with hypertension (18.6% vs. 20.0%) or diabetes (9.2% vs. 10.9%) did not result in more cases of cerebrovascular disease (7.1% vs. 4.9%). There was a substantial increase in use of antispasmodic and gastroprokinetic agents (4.5% to 10.7%); the use of antacids decreased (73.6% to 63.4%) in the elderly.


CONCLUSIONS
Compared with the prevalence of disease, there was extensive nonspecific use of anxiolytics and antacids. However, lessened use of antidepressants and postmenopausal hormone replacement may have an impact on morbidity and mortality and deserves particular attention.
Hsu
R Y
RY
Department of Pharmacy, Veterans General Hospital-Taipei, Taiwan.
Lin
M S
MS
Chou
M H
MH
Lin
M F
MF
D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D002908:Chronic Disease; D016527:Drug Costs; D011307:Drug Prescriptions / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D012424:Rural Population; D013624:Taiwan