Predictors of medication use, compliance and symptoms of hypotension in a community-based sample of elderly men and women.
OBJECTIVE
To investigate use of prescription and non-prescription drugs, predictors of drug use and symptoms of postprandial and postural hypotension were examined in 765 men and 846 women.


METHODS
A questionnaire mailed to 6324 subjects randomly chosen from the electoral roll.


RESULTS
Drug use, both prescription and non-prescription, was greater (P < 0.0001) in women (mean 4.1 total drugs, CI 3.9, 4.3) than in men (3.5 drugs, CI 3.3, 3.7); 41% of women and 36% of men used at least four drugs. Total drugs used were significantly greater in women (standardized regression coefficient (b) = 0.101, P < 0.0001), and increased with the number of diagnoses (b = 0.461, P < 0.0001) and taking antidepressants (b = 0.160, P < 0.0001). Use of non-prescription drugs was also greater in women (b = 0.094, P < 0.0001) and in association with arthritis (b = 0.053, P = 0.036) but decreased with age (b = -0.013, P < 0.0001). Potentially important drug interactions occurred in 10% of subjects and included hypoglycaemic agents with b-blockers and asthma with b-blockers. Symptoms of postprandial hypotension, reported in 2.6% of subjects, increased with the number of drugs used (OR 1.17, CI 1.05, 1.31) and with diabetes (OR 2.27, CI 1.05, 4.89). Symptomatic postural hypotension, recorded by 13% of subjects, related significantly to age (OR 1.04, CI 1.02, 1.06), tranquillisers (OR 1.98, CI 1.11, 3.54), antidepressants (OR 2.23, CI 1.30, 3.84) and ACE inhibitors (OR 2.14, CI 1.42, 3.22).


CONCLUSIONS
Reduction in the number and frequency of drug doses and better knowledge about drugs may improve compliance. Observed associations with polypharmacy or hypotension suggest possible approaches to decreasing drug-related illness and limiting the adverse effects of hypotension in the elderly.
University Department of Medicine, Royal Perth Hospital and West Australian Heart Research Institute, Australia. vburke@cyllene.uwa.edu.au
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D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000009:adverse effects; D003153:Community Health Services; D004347:Drug Interactions; D011307:Drug Prescriptions; D004356:Drug Storage; D004363:Drug Utilization; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007024:Hypotension, Orthostatic / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000009:adverse effects; D010349:Patient Compliance; D011795:Surveys and Questionnaires
D000928:Antidepressive Agents; D004366:Nonprescription Drugs