title: Patterns of drug prescription in a geriatric evaluation and management unit as compared with the general medical wards: a randomised study.
abstract: OBJECTIVE
  This study's objective was to determine whether patients treated in a geriatric evaluation and management unit (GEMU) had a more appropriate drug profile than patients treated in the general medical wards (MW).
  
  
  METHODS
  Frail elderly patients admitted as emergencies to the medical department were randomised to treatment in the GEMU (n=127) or MW (n=127). Drugs used at inclusion and discharge were registered retrospectively and analysed with regard to polypharmacy, number of drugs withdrawn or started, potential drug-drug interactions (DDIs), number of anticholinergic drugs prescribed, and the number of inappropriate drug prescriptions according to Beers' criteria. Utilisation of psychotropic and cardiovascular drugs was compared in detail according to prespecified hypotheses.
  
  
  RESULTS
  The number of patients with polypharmacy did not differ significantly between the GEMU and MW. The median number of scheduled drugs withdrawn per patient was higher in the GEMU than in the MW (p=0.005). Drugs with anticholinergic effects (p=0.003); cardiovascular drugs (p<0.001), particularly digitalis glycosides (p<0.001); and antipsychotic drugs (p=0.009) were withdrawn more often in the GEMU. The median number of scheduled drugs started was higher in the GEMU than in the MW (p=0.03). In particular, antidepressants (p<0.001) and estriol (p=0.001) were started more often in the GEMU than in the MW. Fewer GEMU than MW patients had potential DDIs at discharge (p=0.009).
  
  
  CONCLUSIONS
  Drug treatment in the GEMU as compared with the MW was more appropriate in terms of prescription of fewer drugs with anticholinergic effects and fewer potential DDIs. There were distinct differences in treatment patterns of cardiovascular and psychotropic drugs.
authors.affiliation: Section of Geriatrics, Division of Medicine, St. Olavs University Hospital, Trondheim, Norway. Ingvild.Saltvedt@medisin.ntnu.no
authors.forename: Ingvild
authors.initials: I
authors.lastname: Saltvedt
authors.forename: Olav
authors.initials: O
authors.lastname: Spigset
authors.forename: Sabine
authors.initials: S
authors.lastname: Ruths
authors.forename: Peter
authors.initials: P
authors.lastname: Fayers
authors.forename: Stein
authors.initials: S
authors.lastname: Kaasa
authors.forename: Olav
authors.initials: O
authors.lastname: Sletvold
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004347:Drug Interactions; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods*; D006748:Hospital Departments; D006801:Humans; D008297:Male; D009664:Norway; D017891:Pharmacoepidemiology / Q000706:statistics & numerical data*