Rural residence and prescription medication use by community-dwelling older adults: a review of the literature.
BACKGROUND
Due to various barriers to health care access in the rural setting, there is concern that rural older adults might have lower access to prescribed medications than their urban counterparts.


OBJECTIVE
To review published research reports to determine prevalence and mean medication use in rural, noninstitutionalized older adults and assess whether rural-urban differences exist.


METHODS
PubMed, Ageline, Cinahl, PsycInfo, International Pharmaceutical Abstracts, Agricola, and Institute for Scientific Information Web of Science - Social Science Index were searched. English-language articles through May 2005 involving a sample of rural, noninstitutionalized older adults and analyses of overall medication prevalence and/or intensity were included. Review articles, conference abstracts, dissertations, books, and articles targeting nonprescription or specific therapeutic categories were excluded. A total of 206 citations were identified and 26 met the inclusion criteria.


RESULTS
Reported prevalence of prescription medication use by rural older adults varied between 62% and 96%, with 2-6 prescriptions per person. Multivariate analyses results were equally inconsistent. Controlling for insurance, most US studies suggest there is no rural-urban difference in access to prescribed medications. However, this finding may not be generalizable across all regions in the United States or other countries.


CONCLUSIONS
Geographic location may not be as important a variable for medication usage as for other health services utilization.
Grymonpre
Ruby E
RE
Faculty of Pharmacy, University of Manitoba, Winnipeg, Manitoba, Canada. grymonpr@ms.umanitoba.ca
Hawranik
Pamela G
PG
D000368:Aged; D004363:Drug Utilization; D006801:Humans; D008875:Middle Aged; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data*
D004364:Pharmaceutical Preparations