Study of medicine prescribing for elderly patients.

Adverse Reactions as a Cause of Hospital Admission in the Aged

“…Whereas the elderly over 65 years comprise about 15% of the population in the UK, it has been estimated that they consume between 2 and 3 times their share of drugs compared with the whole population (Moir & Dingwall-Fordyce 1980;O'Malley et al 1976; Report of the Royal College of Physicians 1984). Various estimates have been made of the number of prescribed drugs taken by the elderly in the community (Freer 1985;Law & Chalmers 1976;Martys 1982;Murdoch 1980). Many of these reports were from single family practices and they often considered the elderly as a homogeneous group, so it is difficult to draw general firm conclusions about prescribing in family practice.…”

Prescribing for the Elderly: Part II Prescribing Patterns: Differences Due to Age

“…There are two major shortcomings in the studies which have been done. Firstly, most of the data are concerned with prescribing in single practices 13–19 . Such data are helpful, but individual practices are not necessarily representative, and these data cannot be extrapolated to the general population.…”

“…In addition, data for the very old (those over 80 years of age) should be analyzed separately from data for patients aged 65 to 70 years since prescribing patterns can differ markedly between these groups 15, 20 . Only Skegg et al, 20 Murdoch, 15 and Castleden 21 compare prescribing patterns for young and elderly patients, whereas a number of reports describe prescribing for the elderly in isolation 13, 14, 18, 19 . Because of these inadequacies it is difficult to draw firm conclusions about the extent of drug prescribing for the elderly in family practice.…”

“…Some measure of the frequency of long‐term prescriptions is also important. Freer 19 reported that while 58% of his elderly patients had been prescribed at least one drug in the 6 months studied, only 42% were taking drugs on a long‐term basis. Similar estimates have been made by Martys 18 (32%) and Freer 17 (33%) in single practice studies.…”

Assessment of older people in the community: from ‘75-and-over checks’ to National Service Frameworks

“…Older people are not a homogenous group, and some studies indicate that not all older people would welcome the opportunity to formally review their medications with GPs 79 or others 80,81 Population and general practice studies report that between 20% and 42% of older people were not prescribed any medication, while between 17-27% of patients over 75 were prescribed three or more medications. 82,83,84 In contrast to hospital medicine, prescribing in general practice for older people is characterized by greater uncertainty about diagnoses, where people often present with multiple symptoms that are not easy to attribute and co-exist with several known medical problems. 85 Prescribing in these situations may be 'realistic' in the sense that it is aimed at symptom relief in the absence of diagnosis, or even at hypothesis testing to reach a diagnosis, without being rational in the clinical-pharmacological sense.…”