Prescription of addictive and non-addictive drugs to home-dwelling elderly.
BACKGROUND
Complex medical conditions are frequent among seniors, and their medical treatment represents a challenge. Older patients have a high rate of consumption of prescription drugs, greater risks of medication interactions, and a higher likelihood of side effects. Many common drugs used by the elderly also have addictive potential. Prescription patterns involving general practitioners (GPs) are not sufficiently known.


OBJECTIVE
Our objective was to examine the regular GP role in the prescription of addictive and non-addictive drugs to home-dwelling older people in Norway.


METHODS
The study was designed as a panel data study.


METHODS
Data on all prescription drugs dispensed at pharmacies to patients 70 years and older from the Norwegian Prescription Database were merged with data on GPs and GPs' patient lists from the Regular General Practitioner Database. The dataset included 624,308 patients and 4,520 GPs in the period from 2004 to 2007.


METHODS
Outcome measures included quantities of addictive and non-addictive drugs prescribed and dispensed per patient by the regular GP, other GPs, non-GP specialists, and hospital doctors; the number of prescribers per patient; and time trend over the observation period.


RESULTS
On average, 319 defined daily doses of medication were prescribed per quarter to an older patient, 6 % of which were classified as possibly addictive medications. Of all drugs, 72 % were prescribed by the patients' regular GP, 77 % of addictives and 71 % of non-addictives. Drug quantities prescribed increased with multiple prescribers and did so to a greater extent for addictives than for non-addictives. Time trends show an increasing number of prescribers and increasing drug quantities over the observation period.


CONCLUSIONS
The regular GP prescribes the major portion of non-addictive and, especially, addictive medications to older patients and thus holds a key role in the coordination of prescriptions to this group. Focusing on the role of the GP is important in view of the increasing time trends.
Health Services Research Centre (HØKH), Akershus University Hospital, PO Box 95, 1478, Lørenskog, Norway, inger.cathrine.kann@ahus.no.
Inger Cathrine
IC
Kann
Christofer
C
Lundqvist
Hilde
H
Lurås
D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000145:classification / Q000627:therapeutic use*; D000777:Anesthetics / Q000145:classification / Q000627:therapeutic use*; D014151:Anti-Anxiety Agents / Q000145:classification / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000145:classification / Q000627:therapeutic use*; D016208:Databases, Factual; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data / Q000639:trends; D058005:General Practitioners / Q000592:standards / Q000706:statistics & numerical data; D006299:Health Services for the Aged / Q000706:statistics & numerical data; D006801:Humans; D009664:Norway; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000706:statistics & numerical data
D000701:Analgesics, Opioid; D000777:Anesthetics; D014151:Anti-Anxiety Agents; D000927:Anticonvulsants