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INAPPROPRIATE PRESCRIBING IS COMMON IN OLDER AMERICANS.

The elderly use about a third of all prescription drugs in the U.S. This report, using data from the 1987 National Medical Expenditure Survey, shows that many of these prescriptions are inappropriate.

The survey collected data from 6171 people aged 65 or older who were living within the community. Researchers examined the rate of prescriptions for 20 drugs considered potentially inappropriate under criteria developed by an expert panel of geriatricians.

During 1987, 82 percent of community-dwelling elderly were using prescription drugs, and 23.5 percent were using at least one potentially inappropriate drug. Usage of such drugs was highest (27 percent) among people aged 80 to 84. Those most commonly prescribed were dipyridamole (doubted efficacy in most situations and potentially toxic); propoxyphene (relatively ineffective and potentially toxic); amitriptyline (side effects), chlorpropamide (long half- life), indomethacin (central-nervous-system toxicity), and the benzodiazepines chlordiazepoxide and diazepam (long half-life and sedation.)

Comment: Inappropriate prescribing can cause unnecessary medical problems in older people and can increase their risk for falls. It is clear that the care of elderly patients can be improved by educating physicians better about the effects of commonly-used drugs in this population.

— TH Lee

Published in Journal Watch General Medicine August 2, 1994

Citation(s):

Wilcox SM et al. Inappropriate drug prescribing for the community- dwelling elderly. JAMA 1994 Jul 27 272 292-296.

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