title: Trends in the prescription of inappropriate drugs for the elderly between 1995 and 1999.
abstract: BACKGROUND
  Using criteria developed by Beers et al between 1991 and 1997, previous studies have reported high levels of inappropriate drug prescribing for community-dwelling elderly patients (age>or=65 years). However, it is not known whether the Beers criteria have had a beneficial effect on prescribing practices.
  
  
  OBJECTIVE
  The aims of this study were to compare the prevalence of potentially inappropriate drug use (based on the Beers list) among older Americans between 1995 and 1999; to determine whether any decreases in such use were more likely to be the result of improved adherence to guidelines or of replacement of older medications by newer drugs; and to examine individual characteristics that place elderly patients at increased risk for inappropriate drug use.
  
  
  METHODS
  This was a panel study involving nationally representative samples of community-dwelling elderly persons from the 1995 and 1999 Medicare Current Beneficiary Surveys (MCBS). For comparison, data were analyzed from samples of disabled Medicare beneficiaries aged <65 years for the same periods. The samples were assessed for the use of 36 individual drugs, drug classes, and combinations carrying a risk for adverse out comes in the elderly based on the 1997 Beers criteria for drugs to be avoided in this population.
  
  
  RESULTS
  The study samples contained 7628 community-dwelling elderly persons from the 1995 MCBS and 8902 from the 1999 MCBS, and 1863 and 1851 disabled Medicare beneficiaries aged <65 years for the respective survey years. The proportion of elderly patients taking >or=1 drug on the Beers list declined from 24.8% in 1995 to 21.3% in 1999 (P<0.05). There was a nonsignificant increase in the proportion of disabled Medicare beneficiaries taking >or=1 drug on the Beers list from 31.1% in 1995 to 31.5% in 1999.
  
  
  CONCLUSIONS
  There was a significant decline in the use of potentially inappropriate drugs by elderly patients between 1995 and 1999, particularly in the use of those drugs linked to the most severe outcomes. However, approximately 7 million elderly patients still received potentially inappropriate drugs in 1999, underscoring the continued need for effective interventions to improve prescribing for this vulnerable population.
authors.affiliation: School of Pharmacy, University of Maryland, Baltimore, Maryland 21201, USA. bstuart@rx.umaryland.edu
authors.forename: Bruce
authors.initials: B
authors.lastname: Stuart
authors.forename: Sachin
authors.initials: S
authors.lastname: Kamal-Bahl
authors.forename: Becky
authors.initials: B
authors.lastname: Briesacher
authors.forename: Euni
authors.initials: E
authors.lastname: Lee
authors.forename: Jalpa
authors.initials: J
authors.lastname: Doshi
authors.forename: Ilene H
authors.initials: IH
authors.lastname: Zuckerman
authors.forename: Ilene
authors.initials: I
authors.lastname: Verovsky
authors.forename: Mark H
authors.initials: MH
authors.lastname: Beers
authors.forename: Gary
authors.initials: G
authors.lastname: Erwin
authors.forename: Nancy
authors.initials: N
authors.lastname: Friedley
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000075202:Contraindications; D004363:Drug Utilization / Q000706:statistics & numerical data / Q000639:trends*; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008508:Medication Errors / Q000706:statistics & numerical data*; D004364:Pharmaceutical Preparations; D014481:United States
chemical_list: D004364:Pharmaceutical Preparations