title: Inappropriate medication prescribing in community-dwelling elderly people living in Iran.
abstract: OBJECTIVE
  To determine the prevalence of inappropriate medication prescribing in Middle Eastern community-dwelling elderly persons, and to determine factors associated with inappropriate prescribing.
  
  
  METHODS
  Prescriptions from 3,000 elderly-patient visits (> or =65 years) to physicians in Isfahan, Iran were collected between September and December 2002; only the first patient visit was considered in the study. Inappropriate prescriptions were defined according to Beers' explicit criteria (1997). The presence of at least one drug-drug interaction (DDI) and at least one drug-class duplication within each patient visit was also determined. Multivariate analyses were performed to determine factors associated with receiving at least one inappropriate medication. These factors included age, gender, number of prescribed medications per visit, DDIs, duplications, and physician's number of years of experience. Similar analyses were performed to determine whether these factors were associated with a composite index (defined as having at least one of the following: receiving at least one inappropriate prescription, DDI, or duplication).
  
  
  RESULTS
  The mean age of our cohort was 72.6 (+/-5.7) years, and 1,735 (57.8%) were females. A total of 829 (27.6%) patients received at least one inappropriate prescription, 285 (9.5%) had at least one DDI during the visit, and 746 (24.9%) had at least one duplication during the visit. The three most inappropriately prescribed medication classes were antihistamines (29%), non-steroidal anti-inflammatory agents (23%) and benzodiazepines (16%). In multivariate analyses, the number of prescribed medications per visit was the only factor significantly associated with receiving at least one inappropriate prescription (OR 1.24; 95%CI: 1.16-1.32); analyses using the composite index as outcome gave similar results (OR: 1.70; 95%CI: 1.60-1.80).
  
  
  CONCLUSIONS
  Our findings indicate a high prevalence of inappropriate prescribing in elderly patients. Given the potential severity of this problem, further steps need to be implemented to prevent this occurrence.
authors.affiliation: Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Laurent
authors.initials: L
authors.lastname: Azoulay
authors.forename: Amir
authors.initials: A
authors.lastname: Zargarzadeh
authors.forename: Zeinab
authors.initials: Z
authors.lastname: Salahshouri
authors.forename: Driss
authors.initials: D
authors.lastname: Oraichi
authors.forename: Anick
authors.initials: A
authors.lastname: Bérard
mesh_terms: D000368:Aged; D004347:Drug Interactions; D005260:Female; D005853:Geriatrics; D006801:Humans; D007492:Iran; D008297:Male; D008508:Medication Errors / Q000706:statistics & numerical data*; D017891:Pharmacoepidemiology; D015995:Prevalence; D012111:Residence Characteristics