Elderly Patients Prescribed Inappropriate Medications in 8 Percent of

WASHINGTON -- Elderly patients were prescribed inappropriate medications in almost 8 percent of doctor visits in 2000, about the same percent as 1995,

according to a new study of drug prescribing patterns published in the

Feb. 9, 2004 issue of Archives of Internal Medicine.

The study, based on data from the Centers for Disease Control (CDC)

surveys of ambulatory medical care providers, showed that inappropriate

medicines were prescribed in almost 8 percent of doctor visits made by

patients age 65 and older. Inappropriate medications were defined as

those that had a risk of adverse outcomes outweighing the potential

benefits for most elderly patients.

The article identified a small number of drugs including certain pain

relievers, anti-anxiety agents, antidepressants and sedatives as posing a

large share of the problem. In 2000, the inappropriate drugs most

frequently prescribed at doctor visits made by the elderly were the pain

reliever propoxyphene, the antihistamine hydroxyzine, the antianxiety

agent diazepam, the antidepressant amitriptyline, and the urinary tract

relaxant oxybutynin.

The likelihood that an inappropriate drug was prescribed was higher when

multiple medications were prescribed and double at doctor visits when

the patients were women. The likelihood of inappropriate medications

being prescribed was higher for patients ages 65 to 79 than for patients

age 80 and older, but the study found no difference by patient's race.

Nor was there any difference by geographic region of the country.

A panel of geriatric medicine and pharmacology experts used published

evidence on specific drugs and clinical experience to identify 38 drugs

or drug groups as generally inappropriate for patients older than age

65. The study applied that list to the drug information reported in the

National Ambulatory Medical Care Survey and the National Hospital

Ambulatory Medical Care Survey conducted by CDC's National Center for

Health Statistics. The surveys capture information on drugs ordered or

prescribed at visits to doctors in office-based practices and in

hospital outpatient departments. Since the outcomes of use of these

inappropriate medications are not measured in the survey, they may be

said to define potential, rather than actual, inappropriate prescribing.

In 2000, seniors made more than 200 million visits to the doctor either in

private offices or hospital outpatient clinics. No drugs were

prescribed in about a third of the visits; in another third, one or two

drugs were prescribed; and for the remaining third, three or more drugs

were prescribed.

Source: Centers for Disease Control and Prevention