Quality of prescribing for the elderly in Croatia-computerized pharmacy data can be used to screen for potentially inappropriate prescribing.
OBJECTIVE
The quality of medication use by the elderly is a major safety concern because of an increasing number of people in this segment of the population and the fact that they are major drug consumers. The objective of this study was to test whether administrative computerized pharmacy prescription data could be used to assess the prevalence of potentially inappropriate medication use by the elderly in Rijeka, Croatia, using two sets of explicit criteria data.


METHODS
In 2002, the prevalence of potentially inappropriate medication use in the elderly aged 70 years or over was evaluated using Beers' criteria. Inappropriate co-prescribing was evaluated using a list of eight potentially harmful drug combinations. Information on the use of drugs was collected from a computerized pharmacy record of all prescriptions dispensed in the "Jadran Pharmacies" in Rijeka.


RESULTS
Five computerized pharmacies dispensed 306,000 (65% of all prescriptions in Rijeka); 78,000 were for those aged 70 years and over. Among these elderly, the prevalence of inappropriate choice of drugs was 2.2% and inadequate co-prescribing 1.9%. The most common inappropriate drug was a long-acting benzodiazepine, diazepam. Mostly used potentially harmful combinations were a non-steroidal anti-inflammatory drug (NSAID) co-prescribed with a diuretic, and two benzodiazepines co-prescribed.


CONCLUSIONS
We found that computerized pharmacy data can be used as a screening tool in efforts to improve the quality of drug prescribing in Rijeka. Explicit criteria for assessing inappropriate prescribing for the elderly can easily be applied to population based surveys. This study suggests a low rate of potentially inappropriate prescribing for the elderly in Rijeka.
Vlahović-Palcevski
Vera
V
Unit of Clinical Pharmacology, University Hospital Centre Rijeka, University of Rijeka Medical School, Kresimirova 42, 51000 Rijeka, Croatia. vvlahovic@inet.hr
Bergman
Ulf
U
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D016303:Clinical Pharmacy Information Systems / Q000706:statistics & numerical data*; D017523:Croatia; D003625:Data Collection / Q000379:methods / Q000706:statistics & numerical data*; D019992:Databases as Topic; D003692:Delayed-Action Preparations / Q000627:therapeutic use; D003975:Diazepam / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D011307:Drug Prescriptions / Q000592:standards / Q000706:statistics & numerical data; D004359:Drug Therapy, Combination; D017723:Drug Utilization Review; D006801:Humans; D008508:Medication Errors / Q000145:classification / Q000706:statistics & numerical data*; D017891:Pharmacoepidemiology / Q000379:methods; D010818:Practice Patterns, Physicians' / Q000592:standards*; D015995:Prevalence
D000894:Anti-Inflammatory Agents, Non-Steroidal; D003692:Delayed-Action Preparations; D004232:Diuretics; D001569:Benzodiazepines; D003975:Diazepam