Multi-dose drug dispensing and inappropriate drug use: A nationwide register-based study of over 700,000 elderly.
OBJECTIVE
To investigate whether the use of multi-dose drug dispensing is associated with potentially inappropriate drug use (IDU).


METHODS
Cross-sectional nationwide register-based study.


METHODS
Sweden.


METHODS
People aged >or=75 years registered in the Swedish Prescribed Drug Register during October-December 2005.


METHODS
Potentially IDU, i.e. anticholinergic drugs, long-acting benzodiazepines, concurrent use of three or more psychotropic drugs, and combinations of drugs that may lead to potentially serious drug-drug interactions (DDIs).


RESULTS
After adjustment for age and number of dispensed drugs, any IDU, anticholinergic drugs, and three or more psychotropic drugs were associated with multi-dose drug dispensing, whereas the opposite relationship prevailed for long-acting benzodiazepines among women and potentially serious DDIs in both men and women. Among the subjects aged 75-79 years, multi-dose drug dispensing was even more strongly associated with any IDU, anticholinergic drugs, three or more psychotropic drugs in both men and women, and long-acting benzodiazepines among men.


CONCLUSIONS
Our results indicate that multi-dose users may be more exposed to potential IDU. However, multi-dose users seem to have a lower probability of potentially serious DDIs. Future research on multi-dose drug dispensing is necessary to ensure a high quality of drug therapy within this system.
Aging Research Center, Karolinska Institutet, Stockholm, Sweden. Kristina.Johnell@ki.se
Kristina
K
Johnell
Johan
J
Fastbom
D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004347:Drug Interactions; D004349:Drug Packaging; D011307:Drug Prescriptions; D017723:Drug Utilization Review; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000517:prevention & control; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D019338:Polypharmacy; D010818:Practice Patterns, Physicians'; D012307:Risk Factors; D013548:Sweden
D004364:Pharmaceutical Preparations