title: Prescribing behavior for the elderly in the United Arab Emirates: psychotropic medication use remains low despite rising overall appropriate and inappropriate medication use.
abstract: Inappropriate prescribing, especially for psychotropic agents, is a common and significant cause of morbidity in older people. This cross sectional survey was conducted in the United Arab Emirates (UAE), a country with a rapidly developing economy. Prescribing behavior for people aged 65+ years acutely admitted via a university teaching hospital was examined for 1994 and 1999. All 474 patients (which resulted in 627 acute admissions; 194 in 1994 and 433 in 1999) were included. The patients had a mean age of 74.1 +/- 7.6, mean annual admission rate of 1.3 +/- 0.8 and a female:male ratio of 0.46 in 1994 rising to 0.73 in 1999 (P=0.04). Pre-admission use of five or more medications as recorded in the admission notes increased from 12% in 1994 to 23% in 1999 (P=0.001), while on discharge rose from 26 to 45% (P<0.001). There was a rise in low dose aspirin use, an indicator of appropriate prescribing, both pre-hospital (13-21%, P=0.03) and on discharge (19-29%, P=0.007). There was also a significant rise in pre-hospital inappropriate prescribing from 5 to 13% of patients demonstrating at least 1 of 144 inappropriate medications or combinations looked for (P=0.002) and at discharge from 9 to 19% (P=0.001). The rate of psychotropic medication usage (pre-hospital 0.1 per person: at discharge 0.25) was low compared to western countries and showed no significant change over time. These findings show rises in both appropriate and inappropriate prescribing with the exception of psychotropic medications during a 5-year period, which corresponded to rapid development in the health care system.
authors.affiliation: Faculty of Medicine, Department of Family Medicine, United Arab Emirates University PO Box 17666 Al Ain United Arab Emirates. margolis@uaeu.ac.ae
authors.forename: Stephen Andrew
authors.initials: SA
authors.lastname: Margolis
authors.forename: Tom
authors.initials: T
authors.lastname: Carter
authors.forename: Richard Lewis
authors.initials: RL
authors.lastname: Reed