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22-08-2012 | General practice | Article

Elderly patients get inappropriate scripts


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medwireNews: One in five prescriptions in primary care for the elderly is inappropriate, say the authors of a systematic review.

The review, which included data from 11 countries, including the UK, showed that both high- and low-risk medications were subject to inappropriate prescriptions.

"In spite of increasing attention to the quality of medication prescription among elderly persons presenting to the primary care setting, there are still high overall rates of inappropriate medication prescription [IMP]," say Dedan Opondo (University of Amsterdam, the Netherlands) and colleagues.

The systematic review included 19 English-language studies, which analysed rates of IMPs in patients aged over 65 years. They used the Beers criteria, which lists medications appropriate for elderly patients, and other tools to assess rates of IMP.

The authors found that the median rate of IMPs was 20.0%. However, it varied highly between studies, ranging from 2.9% to 38.5%.

The four most common IMPs were the pain reliever propoxyphene (4.5%), the antihypertensive doxazosin (4.0%), the antihistamine diphenhydramine (3.3%), and the antidepressant amitriptyline (3.2%).

Additionally, the authors found that some high-risk medications, such as diazepam and nifedipine, had high rates of IMPs compared with other medications in their therapeutic classes.

Writing in PloS One, they say that their results show a need for interventions in primary care to improve the quality of prescriptions for the elderly: "Prescription of high-risk medication exposes the elderly to frequent and severe adverse drug events. Alternative low-risk medications should be prescribed when available."

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Kirsty Oswald