Potentially inappropriate drug use among older persons in Finland: application of a new national categorization.
OBJECTIVE
The Finnish Medicines Agency published a new consensus categorization for potentially inappropriate drug (PID) use among persons aged 75 years and older (A = suitable, B = limited evidence, C = suitable for use under certain conditions only, D = inappropriate) in 2010. We investigated factors associated with use of one or more Category D drugs.


METHODS
Cross-sectional analyses were conducted using baseline data from the Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) Study collected in Kuopio, Finland, in 2004. From a random sample of 1000 persons aged 75 years and older, 781 persons provided consent to participate. Logistic regression was used to compute unadjusted and adjusted odds ratios (ORs) and 95 % confidence intervals (95 % CIs) for factors associated with PID use.


RESULTS
PIDs were used by 30 % (n = 234) of all participants on a regular or as-needed basis. Among the 764 persons (98 %) who used prescription or non-prescription drugs, PID use was associated with the number of drugs in use (adjusted OR 1.20; 95 % CI 1.13-1.28) and moderate self-rated health compared to good self-rated health (adjusted OR 1.74; 95 % CI 1.19-2.55). PID use was associated with poor maximum walking speed (adjusted OR 1.64; 95 % CI 1.10-2.45), poor Timed Up and Go (TUG) test scores (adjusted OR 1.66; 95 % CI 1.11-2.47), impaired instrumental activities of daily living (adjusted OR 1.50; 95 % CI 1.06-2.12) and Mini Mental State Examination scores <18 (adjusted OR 2.27; 95 % CI 1.41-3.65).


CONCLUSIONS
PID use was highly prevalent and associated with impaired functional outcomes. This highlights the importance of clinicians conducting regular reviews of drug therapy.
Kuopio Research Centre of Geriatric Care, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland. simon.bell@uef.fi
J Simon
JS
Bell
Jouni
J
Ahonen
Piia
P
Lavikainen
Sirpa
S
Hartikainen
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004363:Drug Utilization; D017723:Drug Utilization Review; D005260:Female; D005387:Finland; D015577:Geriatric Assessment; D019538:Health Care Surveys; D006801:Humans; D057970:Inappropriate Prescribing; D016015:Logistic Models; D008297:Male; D004366:Nonprescription Drugs / Q000009:adverse effects*; D016017:Odds Ratio; D019338:Polypharmacy; D010818:Practice Patterns, Physicians'; D055553:Prescription Drugs / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors
D004366:Nonprescription Drugs; D055553:Prescription Drugs