A Database Analysis of Potentially Inappropriate Drug Use in an Elderly Medicaid Population

Abstract

We conducted a cross-sectional retrospective review of 1996 Kentucky Medicaid Pharmacy claims data to examine the prevalence of potentially inappropriate drug use in 64,832 Medicaid recipients aged 65 years and older who received a prescription. Twenty-seven percent of patients received at least one potentially inappropriate agent. Prevalence was higher for nursing home residents (33%) than for community dwellers (24%). Amitriptyline (7.6%), propoxyphene (6.5%), doxepin (4.0%), and indomethacin (2.3%) were the most prescribed potentially inappropriate agents. Education programs and interventions aimed at optimizing the prescribing and dispensing of the most appropriate drugs are needed.

Potentially inappropriate medications among elderly Brazilian outpatients

“…Furthermore, the study design and duration of data gathering may also contribute towards the differences. 21 The chance of prescribing a PIM was smaller among patients ≥ 70 years, and this tendency has also been observed by other authors. 21 In our study, the women presented greater likelihood of having PIMs prescribed than did the men.…”

“…21 The chance of prescribing a PIM was smaller among patients ≥ 70 years, and this tendency has also been observed by other authors. 21 In our study, the women presented greater likelihood of having PIMs prescribed than did the men. This association has also been reported in other studies, 21,22,26,28 including in the only Brazilian study that set out to investigate this relationship.…”

“…21 In our study, the women presented greater likelihood of having PIMs prescribed than did the men. This association has also been reported in other studies, 21,22,26,28 including in the only Brazilian study that set out to investigate this relationship. 18 However, do not know why women are more exposed to PIM prescription, but we observed in our study that they presented a higher mean number of medications prescribed than did the men (7.8 versus 6.5), which may have influenced this association.…”

“…These criteria only indicate that there would be a greater likelihood of occurrences of adverse reactions in elderly individuals. 21 Only limited generalization of the results to the general population can be made, because this study was restricted to the prescription profile of patients attended at a tertiary-level healthcare institution. In many cases, these patients had been referred to these services because of the complexity of their comorbidities.…”

Drug-related problems in elderly general practice patients receiving pharmaceutical care†

“…24 The high rates of DRP identification among seniors with chronic medical conditions is well documented. 18,[24][25][26] It is widely assumed that use of multiple medications is associated with increased risks to patients, 2,3 thus the pharmacist's role has been directed at reducing the number of medications in order to reduce the potential for adverse effects and to minimise costs. Pharmaceutical care requires a comprehensive patient assessment which focuses not only on the drug product but the net benefit patients are deriving from their medications.…”