title: Drug prescription appropriateness in the elderly: an Italian study.
abstract: OBJECTIVE
  Correct drug prescription in the elderly is a difficult task that requires careful survey of the current pharmacological therapies. In this article, we reviewed the drug prescriptions provided to 860 persons aged 65 years or over, residing in a small city of Lombardy, Italy.
  
  
  METHODS
  Subjects were recruited from a local nursing home, the Pavia and Vigevano Neuropsychological Center for Alzheimer's Disease, general practitioners' offices, and the local University of the Third Age. For each patient, the amount of potentially inappropriate prescriptions (PIPs), sedative and anticholinergic load (SL and AL, respectively), and drug-drug interactions were evaluated.
  
  
  RESULTS
  Widespread polypharmacy, giving rise to 10.06% of PIPs in the whole collection of prescriptions, was observed. In particular, PIPs mainly concern drugs acting at the central nervous system level, mostly benzodiazepines and antipsychotics. Moreover, approximately one-fourth of the subjects had an elevated SL and approximately one-tenth a high AL. Drug-drug interactions were frequent (266 requiring medical attention), up to five for each single patient. Of concern was the underuse of antidementia drugs: only 20 patients received a cholinesterase inhibitor or memantine, although 183 patients were potentially suitable for this treatment.
  
  
  CONCLUSIONS
  These results demonstrate the need to develop novel strategies aimed at improving the quality of drug prescription.
authors.affiliation: Department of Brain and Behavioral Sciences, University of Pavia.
authors.forename: Nicola
authors.initials: N
authors.lastname: Allegri
authors.affiliation: Pavia and Vigevano Neuropsychological Center for Alzheimer's Disease.
authors.forename: Federica
authors.initials: F
authors.lastname: Rossi
authors.affiliation: Pavia and Vigevano Neuropsychological Center for Alzheimer's Disease.
authors.forename: Federica
authors.initials: F
authors.lastname: Del Signore
authors.affiliation: "Bertazzoni" Pharmacy General Partnership, Vigevano.
authors.forename: Paolo
authors.initials: P
authors.lastname: Bertazzoni
authors.affiliation: Nephrology and Dialysis Ward, Civil Hospital of Vigevano.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bellazzi
authors.affiliation: C. Mondino National Institute of Neurology Foundation, IRCCS.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Sandrini
authors.affiliation: Department of Brain and Behavioral Sciences, University of Pavia.
authors.forename: Tomaso
authors.initials: T
authors.lastname: Vecchi
authors.affiliation: Department of Brain and Behavioral Sciences, University of Pavia.
authors.forename: Davide
authors.initials: D
authors.lastname: Liccione
authors.affiliation: Department of Drug Sciences, Section of pharmacology, University of Pavia, Pavia, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Pascale
authors.affiliation: Department of Drug Sciences, Section of pharmacology, University of Pavia, Pavia, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Govoni
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002491:Central Nervous System Agents / Q000008:administration & dosage; D004347:Drug Interactions; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D007558:Italy; D008297:Male; D009735:Nursing Homes; D019338:Polypharmacy
chemical_list: D002491:Central Nervous System Agents
keywords: Beers criteria; drug prescription; drug–drug interactions; elderly; sedative load