title: Drug use by the elderly in Italy.
abstract: OBJECTIVE
  To evaluate drug consumption in the elderly aged 75 years or more living at home.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Old-old (i.e., > or = 75 y) people living in central Turin, a city in northern Italy.
  
  
  METHODS
  Thirty-four general practitioners (GPs), with 50 or more old-old people in their patient list, randomly chosen among the GPs working in the Unità Socio-Sanitaria Locale I (Local Health Unit I) of Turin; 261 old-old people (135 men and 126 women) randomly selected from the practice records.
  
  
  METHODS
  Data were collected by the GP through a structured questionnaire during an office visit and by a social worker in a home interview within 14 days of the GP visit. GPs were asked to record every diagnosis and drug currently taken by the patient; social workers were trained in the administration of a structured questionnaire exploring sociodemographic variables, drug use (following the medication inventory strategy), disability, cognitive functions, and depressive symptoms.
  
  
  RESULTS
  Nearly all subjects (95% of the women and 91% of the men) were taking at least 1 drug. The overall number of drugs recorded was 917 (47.1% for men and 52.9% for women), of which 172 (18.8%) were not reported by the GP but were recorded during the social worker's visit. The mean number of drugs was 3.2 for men and 3.8 for women, with a statistically significant difference (p = 0.02), while the mean number of diagnoses was 2.3 and 2.6, respectively. The study of correlates of drug consumption showed a strong association with number of diagnoses at univariate analysis (p < 0.0001, with a linear correlation coefficient of 0.64). No multivariate model showed a clear superiority over the simple one containing only the number of diagnoses in predicting the total number of drugs taken. Cardiovascular, nervous system, and alimentary tract drugs were the most frequently used. A total of 107 subjects (41%) were taking at least 1 unreported drug.
  
  
  CONCLUSIONS
  Our study shows high drug consumption among old-old people, with nearly 20% of drugs taken not reported by the GP. These results emphasize the need for an essential therapeutic approach in old-old people, prescribing only drugs of scientifically proven efficacy. Furthermore, the GP must make more effort when collecting a drug history from old-old patients.
authors.affiliation: Laboratorio di Neuropsichiatria Geriatrica, Istituto di Ricerche Farmacologiche M. Negri, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Nobili
authors.forename: M
authors.initials: M
authors.lastname: Tettamanti
authors.forename: L
authors.initials: L
authors.lastname: Frattura
authors.forename: A
authors.initials: A
authors.lastname: Spagnoli
authors.forename: L
authors.initials: L
authors.lastname: Ferraro
authors.forename: E
authors.initials: E
authors.lastname: Marrazzo
authors.forename: G
authors.initials: G
authors.lastname: Ostino
authors.forename: M
authors.initials: M
authors.lastname: Comelli
mesh_terms: D000368:Aged / Q000523:psychology; D000369:Aged, 80 and over / Q000523:psychology; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005194:Family Practice; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D004366:Nonprescription Drugs / Q000627:therapeutic use; D019338:Polypharmacy
chemical_list: D004366:Nonprescription Drugs