title: Prescription drug use among older adults in Italy: a country-wide perspective.
abstract: In Italy, prescription drug costs represent approximately 17% of total public health expenditures. Older adults commonly use multiple drugs and, for this reason, this population is responsible for a large portion of drug-related costs. In 2012, public expenditure for pharmaceuticals in primary care exceeded 11 billion Euros (approximately 15.2 billion US $), and older adults aged 65 or older accounted for more than 60% of these costs. Recently, increased attention has been focused on studies aimed at monitoring drug use and evaluating the appropriateness of drug prescribing in older adults. In this article, we examined studies that assessed these issues in different settings at a national level. Specifically, results of surveys of prescription drug use in primary care (OsMED), hospital (GIFA, CRIME, and REPOSI) and long-term care (ULISSE and SHELTER) settings are reviewed. Overall, these studies showed that the quality of drug prescribing in older patients is far from optimal. This leads to an increased risk of negative health outcomes and increased health care costs. Data from these studies are valuable, not only to monitor drug use, but also to target interventions aimed at improving the quality of prescribing. Translating the findings of clinical research and monitoring programs will be challenging, but it will lead to quantifiable improvements in the quality of drug prescribing at a national level.
authors.affiliation: Department of Geriatrics, Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: graziano.onder@rm.unicatt.it.
authors.forename: Graziano
authors.initials: G
authors.lastname: Onder
authors.affiliation: Department of Geriatrics, Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Davide Liborio
authors.initials: DL
authors.lastname: Vetrano
authors.affiliation: Geriatrics and Geriatric Emergency Care, Italian National Research Center on Aging (IRCCS-INRCA), Ancona, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cherubini
authors.affiliation: Scientific Direction, IRCCS San Raffaele Pisana, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Fini
authors.affiliation: Scientific Direction, IRCCS Ca' Granda Maggiore Policlinico Hospital Foundation, Milan, Italy.
authors.forename: Pier Mannuccio
authors.initials: PM
authors.lastname: Mannucci
authors.affiliation: Department of Clinical and Experimental Science, University of Brescia, Brescia, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Marengoni
authors.affiliation: Agenzia Italiana del Farmaco (AIFA), Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Monaco
authors.affiliation: Laboratory for Quality Assessment of Geriatric Therapies and Services, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Nobili
authors.affiliation: Agenzia Italiana del Farmaco (AIFA), Rome, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Pecorelli
authors.affiliation: Agenzia Italiana del Farmaco (AIFA), Rome, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Russo
authors.affiliation: Scientific Direction, IRCCS San Raffaele Pisana, Rome, Italy.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Vitale
authors.affiliation: Department of Geriatrics, Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bernabei
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004363:Drug Utilization / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006707:Homes for the Aged; D006761:Hospitals; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D019338:Polypharmacy; D055553:Prescription Drugs / Q000191:economics / Q000627:therapeutic use*; D011787:Quality of Health Care; D012042:Registries
chemical_list: D055553:Prescription Drugs
keywords: Italy; Medication use; appropriateness; elderly; polypharmacy; prescription