title: Drug prescriptions unadapted to the renal function in patients aged 80 years and older.
abstract: BACKGROUND
  Drug-related problems are common in older people. Often they are related to low estimated glomerular filtration rate (eGFR), which has a high prevalence among older adults.
  
  
  OBJECTIVE
  The aim of this study was to investigate inappropriate drug prescriptions and dose adaptations in a very old population and their relationship with the eGFR.
  
  
  METHODS
  
  
  
  METHODS
  A cross-sectional study within a Belgian prospective population-based cohort study (the BELFRAIL study) of 539 participants aged 80 years and older (mean age 85 years). Drug prescriptions at inclusion were reported by the participant's responsible general practitioner. The eGFR was estimated using the MDRD equation. Based on their eGFR, the participants were divided in three groups: > 50, 30-50 and < 30 ml/min/1.73 m², respectively. Drug prescriptions were analysed in different eGFR groups. The prevalence and odds ratios of inappropriate drugs and the unadjusted defined daily doses (DDD) of the participant eGFRs were calculated.
  
  
  RESULTS
  Thirty-six (of 111) and eight (of 31) of the participants with an eGFR between 30-50 and < 30 ml/min/1.73 m², respectively, had at least one inappropriate drug prescribed. No decrease in mean DDD, was observed in any prescribed drug in both lower eGFR groups. Participants with a lower eGFR were at higher risk of receiving gliclazide (OR: 4.51; 95% CI: 1.45-14.02) or unadjusted doses of allopurinol (OR: 3.48; 95% CI: 1.26-9.61).
  
  
  CONCLUSIONS
  Drug prescriptions inappropriate for patient eGFR are common in subjects aged 80 years and older, despite automatic eGFR reporting.
authors.affiliation: Department of Public Health and Primary Care, KU Leuven , Leuven Belgium.
authors.forename: Gijs
authors.initials: G
authors.lastname: Van Pottelbergh
authors.forename: An
authors.initials: A
authors.lastname: Mertens
authors.forename: Majda
authors.initials: M
authors.lastname: Azermai
authors.forename: Bert
authors.initials: B
authors.lastname: Vaes
authors.forename: Wim
authors.initials: W
authors.lastname: Adriaensen
authors.forename: Cathy
authors.initials: C
authors.lastname: Matheï
authors.forename: Pierre
authors.initials: P
authors.lastname: Wallemacq
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Degryse
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D001530:Belgium; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D008297:Male; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data*; D055553:Prescription Drugs / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000453:epidemiology / Q000503:physiopathology*
chemical_list: D055553:Prescription Drugs
keywords: Drug use; eGFR; elderly; inappropriate prescriptions; renal function