High Prevalence of Poor Quality Drug Prescribing in Older Individuals: A Nationwide Report From the Italian Medicines Agency (AIFA)

Onder, Graziano; Bonassi, Stefano; Abbatecola, Angela Marie; Folino-Gallo, Pietro; Lapi, Francesco; Marchionni, Niccolò; Pani, Luca; Pecorelli, Sërgio; Sancarlo, Daniele; Scuteri, Angelo; Trifirò, Gianluca; Vitale, Cristiana; Zuccaro, Stefano Maria; Bernabei, Roberto; Fini, Massimo

doi:10.1093/gerona/glt118

Cited by 91 publications

(59 citation statements)

References 35 publications

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“…In an extensive Italian study conducted by AIFA (Italian Medicines Agency), the number of medications ≥5 per day was 69.1% in the cohort from 75 to 84 years old and 66.7% in the group over 85, whereas constant use of ACEi/ARBs plus aldosterone-antagonists plus non-steroidal anti-inflammatory drugs (NSAIDs) was, respectively, 0.9 and 0.4% [19].…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury and Chronic Kidney Disease in the Elderly and Polypharmacy

et al. 2018

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Background: Acute kidney injury (AKI) incidence is reported to be 10 times higher in aged people. Related to their higher prevalence of chronic kidney disease (CKD), older patients are at high risk of toxic effects driven by drugs. Methods: The demographics, hospitalizations, visits to the Emergency Department, pharmacological therapy, and lab tests were analyzed in 71,588 individuals. Results: Data showed a higher prevalence of AKI as well as CKD in the elderly as compared to the younger group, with an associated very high mortality. A broad number of drugs was prescribed, ranging from 1 to 35, the majority being between 5 and 9 drugs. Conclusion: Elderly patients who developed AKI had a higher number of hospitalizations (underlying frailty), were more likely to progress to more severe stages of CKD and to be affected by other non-renal pathologies (associated comorbidities) and to be given heavier pharmacological prescriptions (polypharmacy).

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Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury and Chronic Kidney Disease in the Elderly and Polypharmacy

et al. 2018

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“…It is estimated that one-fifth of adult patients are treated with polypharmacy (five or more drugs) and the prevalence of this phenomenon in the elderly is higher, ranging from 30% to 70%, even reaching 90% in residents of residential aged care facilities [1][2][3][4]. Polypharmacy in the elderly increases the risk of adverse reactions, inappropriate prescriptions, drug interactions, number of hospitalizations, costs, and even death [5].…”

Section: Deprescriptions; Polypharmacy; Pharmacovigilance; Pharmacoepmentioning

confidence: 99%

Deprescribing: a new goal focused on the patient

Machado‐Alba

Gaviria‐Mendoza

Machado‐Duque

et al. 2016

Expert Opinion on Drug Safety

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“…Data from the Italian Agency of Medicine showed that over 6,000,000 (50%) of Italians aged 65 or more chronically receive 5-9 drugs, whereas almost 1,400,000 of them are prescribed 10 or more [1] . Polypharmacy mainly derives from the application of disease-specific guidelines, targeting disease-specific goals, in persons affected by multiple chronic diseases [2] .…”

Section: Introductionmentioning

confidence: 99%

Potentially Serious Drug-Drug Interactions in Older Patients Hospitalized for Acute Ischemic and Hemorrhagic Stroke

et al. 2016

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Background: Polypharmacy is very common in older persons and it is associated with inappropriate prescribing and potential drug-drug interactions (DDIs). Aims of this study were to identify prevalence of DDIs in older persons with acute stroke and to evaluate the association between stroke and DDIs. Methods: One hundred forty-six patients admitted with diagnosis of acute stroke were enrolled. The therapeutic regimen of patients was analyzed at admission to identify the number of DDIs, prevalence and sorts of serious DDIs according to subtype of acute stroke (ischemic or hemorrhagic) and to its recurrence. Results: Five hundred eighty-two DDIs were identified: 18 mild, 415 moderate and 149 serious. Sixty-one percent of patients were exposed to at least one serious DDI. A higher percentage of patients were exposed to at least one serious DDI among those with a recurring ischemic event compared to those with a first event (74 vs. 50%; p < 0.01, respectively). Serious DDIs potentially associated with an increased risk of a cerebral event were identified in 19 (17%) patients with ischemic stroke, and in 7 (19%) patients with hemorrhagic stroke. Conclusions: The prevalence of serious DDIs was high in aging patients with acute stroke but different according to subtype and recurrence of the cerebrovascular event.

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High Prevalence of Poor Quality Drug Prescribing in Older Individuals: A Nationwide Report From the Italian Medicines Agency (AIFA)

Abstract: These results confirm the high frequency of suboptimal drug prescribing in older adults, using a database that covers the whole Italian population. In general, this descriptive study may help in prioritizing strategies aimed at improving the quality of prescribing in elderly population.

Cited by 91 publications

References 35 publications

Acute Kidney Injury and Chronic Kidney Disease in the Elderly and Polypharmacy

Acute Kidney Injury and Chronic Kidney Disease in the Elderly and Polypharmacy

Deprescribing: a new goal focused on the patient

Potentially Serious Drug-Drug Interactions in Older Patients Hospitalized for Acute Ischemic and Hemorrhagic Stroke

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