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PubMed2005

Evaluation of a drug-drug interaction alert structure through the retrospective analysis of statins-macrolides co-prescriptions.

The aim of this work was the evaluation of the existent drug interaction alert structure in Spain, which is based on yellow cards notifications and circulation of drug alert letters, through the retrospective analysis of CYP3A-metabolized statins and macrolides co-prescriptions in the Spanish province of Badajoz between May and September 2001. The period of study was planned to include the release of 2 drug alert letters released by the Spanish Drug Agency in June and July, addressed to all healthcare professionals, which warned against the concomitant prescription of statins and inhibitors of their metabolism, e.g. macrolides antibacterials. 4,600,764 prescriptions were examined, 664 of which corresponded to combinations of statins and macrolides. Although a decrease was detected in the number of these co-prescriptions throughout the study, 80 of these corresponding to 67 patients were still being prescribed in September, after the warnings by the Spanish Drug Agency had been released. 431 physicians prescribed these drugs simultaneously, with 22.9% of them having more than one patient at potential risk. Doctors working at rural healthcare centres or not directly attached to any healthcare facility were more prone to prescribe unsafe coprescriptions than those working at urban health centre. This study shows that the present drug alert system is not fully efficient when facing a situation like the one retrospectively reviewed in this study, in which a prompt action, in this case termination of potentially hazardous coprescriptions, was required. New systems developed to improve prescribing, including a new method based on personal contact between Drug Surveillance Centres and general practitioners, are discussed.

Aged↗
PubMed2000

Nurse practitioner student prescriptive patterns.

As employment of nurse practitioners (NPs) increases in health care systems, there is a need to have current data on their prescribing practices and patterns, and to implement a system for updating such data. This study reports prescriptive data based upon 10,421 primary care visits conducted by 55 family NP students over a 15-month period in 1997 and 1998. Numbers of over-the-counter drugs taken regularly, prescription drugs currently prescribed and prescription drugs prescribed or refilled at the visit were recorded in addition to types of drugs, compliance issues, diagnoses rendered and sociodemographic information. Individual student data were aggregated and analyzed using Epi Info (Epidemiology Program Office of the Centers for Disease Control) and SPSS-PC. Results identified that: 1) the majority of patient visits involved the prescription of 1-2 drugs (88%); 2) major compliance issues included financial concerns, knowledge deficits, and complexity/demands of treatment; 3) commonly rendered diagnoses at drug visits for chronic conditions were hypertension and diabetes; for acute conditions, otitis sinusitis and upper respiratory infections; 4) anti-microbial agents, drugs used for relief of pain, and cardiovascular drugs account for 60% of drug mentions; and 5) the numbers of drugs prescribed or refilled at visits were similar by type of preceptor, except fewer single drugs were prescribed or refilled at visits supervised by nurse preceptors. Findings are discussed relative to deepening the understanding of advanced practice nursing education and the prescribing practices of NP students and their preceptors.

Adolescent↗
PubMed2005

Prescription dose in permanent (131)Cs seed prostate implants.

Recently, 131Cs seeds have been introduced for prostate permanent seed implants. This type of seed has a relatively short half-life of 9.7 days and has its most prominent emitted photon energy peaks in the 29-34 keV region. Traditionally, 145 and 125 Gy have been prescribed for 125I and 103Pd seed prostate implants, respectively. Since both the half-life and dosimetry characteristics of 131Cs seed are quite different from those of 125I and 103Pd, the appropriate prescription dose for 131Cs seed prostate implant may well be different. This study was designed to use a linear quadratic radiobiological model to determine an appropriate dose prescription scheme for permanent 131Cs seed prostate implants. In this model, prostate edema was taken into consideration. Calculations were also performed for tumors of different doubling times and for other related radiobiological parameters of different values. As expected, the derived prescription dose values were dependent on type of tumors and types of edema. However, for prostate cancers in which tumor cells are relatively slow growing and are reported to have a mean potential doubling time of around 40 days, the appropriate prescription dose for permanent 131Cs seed prostate implants was determined to be: 127(+5)(-12)Gy if the experiences of 125I seed implants were followed and 121(+0)(-3)Gy if the experiences of 103Pd followed.

Body Burden↗
PubMed1976

Undispensed prescriptions in a mining general practice.

Seven per cent of prescription forms issued in a mining practice were not presented at chemists for dispensing. The people least likely to present their prescription forms were men aged 25-34 years, particularly miners. To get sickness benefit these men have to consult a doctor, but the medical content of the consultation in these circumstances is often perceived by them as irrelevant and the medication rejected. Children and old people nearly always presented their prescriptions. The percentage of undispensed prescription forms for the trainee doctor was higher than for the trainer, but age may have been a factor: older patients tended to consult the established doctor, whom they knew. Drugs affecting the cardiovascular system, moderate or strong analgesics, hypnotics, sedatives, tranquillisers, and antidepressants were rarely rejected, but mild analgesics and drugs prescribed for symptomatic relief, such as those affecting the alimentary system, cough mixtures, and skin preparations, were more often rejected.

Adolescent↗
PubMed2001

Randomised controlled trial of clinical medication review by a pharmacist of elderly patients receiving repeat prescriptions in general practice.

OBJECTIVE: To determine whether a pharmacist can effectively review repeat prescriptions through consultations with elderly patients in general practice. DESIGN: Randomised controlled trial of clinical medication review by a pharmacist against normal general practice review. SETTING: Four general practices. PARTICIPANTS: 1188 patients aged 65 or over who were receiving at least one repeat prescription and living in the community. INTERVENTION: Patients were invited to a consultation at which the pharmacist reviewed their medical conditions and current treatment. MAIN OUTCOME MEASURES: Number of changes to repeat prescriptions over one year, drug costs, and use of healthcare services. RESULTS: 590 (97%) patients in the intervention group were reviewed compared with 233 (44%) in the control group. Patients seen by the pharmacist were more likely to have changes made to their repeat prescriptions (mean number of changes per patient 2.2 v 1.9; difference=0.31, 95% confidence interval 0.06 to 0.57; P=0.02). Monthly drug costs rose in both groups over the year, but the rise was less in the intervention group (mean difference 4.72 pound sterling per 28 days, - 7.04 pound sterling to - 2.41 pound sterling); equivalent to 61 pound sterling per patient a year. Intervention patients had a smaller rise in the number of drugs prescribed (0.2 v 0.4; mean difference -0.2, -0.4 to -0.1). There was no evidence that review of treatment by the pharmacist affected practice consultation rates, outpatient consultations, hospital admissions, or death rate. CONCLUSIONS: A clinical pharmacist can conduct effective consultations with elderly patients in general practice to review their drugs. Such review results in significant changes in patients' drugs and saves more than the cost of the intervention without affecting the workload of general practitioners.

Aged↗
PubMed2006

Rate and predictors of treatment prescription for hepatitis C.

BACKGROUND: The true treatment rate for hepatitis C virus (HCV) in veterans is unknown. AIM: To determine the treatment prescription rates and predictors of treatment prescription for HCV in a large national population. METHODS: The Department of Veterans Affairs National Patient Care Database (NPCD) was used to identify all HCV-infected people between the fiscal years 1999 and 2003 using the International classification of diseases, 9th revision codes. Demographic information, medical and psychiatric comorbidities, and drug and alcohol use diagnoses were retrieved. Pharmacy data were retrieved from the Department of Veterans Affairs Pharmacy Benefits Management (PBM) database. Logistic regression analysis was used to determine the predictors of treatment for HCV in HCV. RESULTS: 113 927 veterans in the Department of Veterans Affairs care with a diagnosis of HCV were identified. The treatment prescription rate for HCV was 11.8%. Patients not prescribed treatment were older, more likely to be from minority races, have more alcohol and drug misuse, and have medical and psychiatric comorbid conditions. In a multivariate logistic regression model, the following factors were predictive of non-treatment for HCV: increasing age (odds ratio (OR) 0.77 for each 5-year increase in age; 95% confidence interval (CI) 0.76 to 0.78); black race (OR 0.64; 95% CI 0.6 to 0.68); Hispanic race (OR 0.88; 95% CI 0.8 to 0.96); alcohol abuse and dependence (OR 0.62; 95% CI 0.59 to 0.65); drug abuse and dependence (OR 0.78; 95% CI 0.74 to 0.82); anaemia (OR 0.18; 95% CI 0.16 to 0.21); hepatitis B infection (OR 0.72; 95% CI 0.62 to 0.83); coronary artery disease (OR 0.9; 95% CI 0.85 to 0.97); stroke (OR 0.75; 95% CI 0.67 to 0.85); bipolar disorder (OR 0.64; 95% CI 0.58 to 0.70); major depression (OR 0.72; 95% CI 0.67 to 0.77); mild depression (OR 0.56; 95% CI 0.53 to 0.59); and schizophrenia (OR 0.71; 95% CI 0.65 to 0.77). The following factors were associated with a higher likelihood of treatment prescription for HCV: liver cirrhosis (OR 1.6; 95% CI 1.5 to 1.7); and diabetes (OR 1.07; 95% CI 1.02 to 1.12). CONCLUSIONS: A small number of HCV-infected veterans were prescribed treatment for HCV. Non-treatment is associated with increasing age, non-white race, drug and alcohol abuse, and dependence and comorbid illnesses. Reasons for non-treatment need further study.

Age Factors↗
PubMed2003

Does influenza vaccination increase consultations, corticosteroid prescriptions, or exacerbations in subjects with asthma or chronic obstructive pulmonary disease?

BACKGROUND: Concern over the safety of influenza vaccination in individuals with obstructive airways disease has contributed to suboptimal rates of vaccine uptake in this group. We investigated the safety of influenza vaccine in older people with asthma or chronic obstructive pulmonary disease (COPD) in a cohort from the UK General Practice Research Database (GPRD). METHODS: A population based cohort study of 12,000 individuals with asthma or COPD from 432 general practices was conducted. Incidence rate ratios (IRR) were calculated for asthma or COPD diagnoses, prescriptions for oral corticosteroids, and acute exacerbations on the day of vaccination and on days 1-2 and 3-14 after vaccination compared with other time periods in the influenza season. RESULTS: The IRRs for asthma or COPD diagnoses and oral corticosteroid prescriptions were increased on the day of vaccination (for example, the IRR for oral corticosteroid prescriptions for subjects with asthma during the 1992-3 influenza season was 8.24 (95% confidence interval 5.54 to 12.26)). However, there was no consistent increase in the IRR of any of the outcomes on days 1-2 or 3-14 after vaccination, and most of these IRRs were close to 1. Rates of exacerbation were low and showed no consistent statistically significant increase during any risk periods. CONCLUSIONS: Older people with asthma or COPD commonly have diagnoses recorded or prescriptions for oral corticosteroids given on the day of influenza vaccination, but there is no increased risk of adverse acute outcomes in the first 2 weeks after vaccination. Our findings strongly suggest that influenza vaccination is safe in this population.

Adrenal Cortex Hormones↗
PubMed1981

Oriental medicine: a computerized study of complex recipes and their components: analysis of prescriptions used in the traditional medicine of Japan and Korea.

The materials presented here were obtained through a computerized study of 158 Chinese, 204 Korean and 196 Japanese traditional prescriptions with complex and multicomponent characteristics. Oriental medicine strives to complicate sets of prescriptions by using complex recipes and duplicating agents possessing identical effects. The absence of intolerability and side effects of these prescriptions may be given to account for their complexity far closer to the information contents of living bodies than modern scientific medicines which frequently apply substances synthesized or extracted from plants in pure form. Oriental remedial therapy is founded on the use of natural medicines of plant-, animal-, and mineral origin in the form of relatively large amounts of non-treated multi-component mixtures with a preferentially general effect on the organism. It involves the use of the underground parts of plants, aqueous extracts or ground medicinal raw materials. The absence of intensely active and poisonous plants and the scarcity of alkaloid-bearing plants explain the use of remedial mixtures in relatively large doses. Agents possessing antitoxic, anti-inflammatory and especially toning effects are most frequently used. Toning herbs should be given increased attention. A synthesis of traditional medicine and contemporary science on chemical composition and action of remedial plants and animals, and also on the effects that arise with applying complex prescriptions is essentially needed.

China↗
PubMed2005

[Gender and psychiatric drugs: a qualitative study to find the views of prescription-fillers].

OBJECTIVES: To find the views of those filling out prescriptions on the factors that affect differential prescription of psychiatric medication, and on reducing the prescription; and to analyse their discourse for possible implicit gender bias. DESIGN: Qualitative methodology. Semi-structured interviews conducted in 2002-2003. SETTING: Urban and rural health centres. PARTICIPANTS: Family and community medicine and psychiatry professionals working in the public health services of Andalusia, the Community of Madrid, and the Basque Country. Segmentation criteria: community of residence, age, sex, medical speciality, and location of centre. METHODS: Structural sample. Interviews conducted by the research team. Strategy of analysis in two distinct processes: contents analysis with agreed categories and gender analysis of the discourse. RESULTS. The prescribers found that taking psychiatric medication was associated with sex, age, social and economic category, and social expectations. In the discourses we found consumer profiles emerging that were not found in the epidemiological literature. Discourse analysis showed implicit gender bias in the beliefs of some prescribers. CONCLUSIONS. To minimise the growing offer and demand for psychiatric medication, prescribers thought training in diagnosis and psychotherapy should be improved, case-loads should be reduced, co-ordination between services improved and alternative treatments favoured. To minimise gender bias in the diagnosis and prescription of psychiatric medication, we think training is needed on the influence of cultural and gender factors on the process of construction of identities.

Adult↗
PubMed2006

[Selection of quality indicators for primary care prescription through a consensus group].

OBJECTIVE: To work out a system of indicators for improvement of primary care prescription, by incorporating the values and views of the professionals issuing prescriptions. DESIGN: Qualitative technique to search for consensus among experts, based on nominal groups. SETTING: All primary care areas in the Health Service of Aragon, Spain. PARTICIPANTS: Primary care doctors, doctors in primary care management teams, specialists, primary care pharmacists. METHOD: Two parallel groups involving a total of 24 experts were formed. In the session these questions were posed: "what indicators focusing on the drug and what indicators relating diagnosis and treatment do you think most useful for evaluating prescription quality?" Each panellist put forward indicators that were then discussed and placed on a scale of 1 to 9. RESULTS: One hundred and thirty six indicators were generated, 81 drug-focused and 55 relating diagnosis and treatment; 56% were given a weighting above 5. The 2 groups coincided in 11 cases. The most valued indicators were generally those that brought a greater degree of consensus. CONCLUSION: It is feasible, through this technique, to produce a set of agreed indicators for evaluating primary care doctors' prescription.

Adult↗
PubMedDate not supplied

Non-compliance with drug treatment and reading difficulties with regard to prescription labelling among seniors.

UNLABELLED: BACKGROUND; The link between experiencing difficulties in reading or understanding and non-compliance with drug treatment among seniors is not clearly established. OBJECTIVES: We measured the effect of both difficulties in reading, as well as difficulties in understanding prescription labelling, on non-compliance with drug treatments among seniors. Since the use of a pill organizer prepared by a pharmacist may compensate for the problems in reading, we also checked the potential modifying effect of the use of a pill organizer on these two associations. METHOD: Data on non-compliance with drug treatment, comprehension of prescription labelling and on the factors potentially linked to non-compliance, were collected during face-to-face interviews with 325 seniors. RESULTS: In all, 126 respondents (38.8%) were not able to read all the prescription labels and 218 (67.1%) did not fully understand all the information. 153 respondents were non-compliant with their drug treatment. After adjusting for sex, age, living alone or not, having had help with taking the medication, use of a pill organizer, having had sufficient funds to procure his medicine during the previous month, belief in the efficacy of his medication, perception of his state of health, satisfaction with physician-given and pharmacist-given information, as well as the complexity of the treatment, the two associations remained statistically non-significant. The use of a pill organizer was not a modifying factor. CONCLUSION: Our results did not demonstrate the existence, among seniors, of an association between non-compliance and difficulty in reading and understanding prescription labelling.

Aged↗
PubMed2006

Prescription practice for LH-RH analogs and androgen receptor antagonists in the treatment of advanced prostate cancer in Germany (1993-2003).

INTRODUCTION: Nearly 80% of the patients suffering from advanced stages of prostate cancer in Germany are treated currently with luteinizing hormone-releasing hormone (LH-RH) analogs alone or in combination with androgen receptor antagonists. The aim of this study was to assess whether the prescription practice for LH-RH analogs and direct antiandrogens between 1993 and 2003 parallels the rise in the incidence rates for prostate cancer associated with the proportional rise in daily doses. METHODS: Between 1993 and 2000 a yearly randomly selected number of receipts has been evaluated from official pharmacies in Germany which have been billed to public health insurance companies. Data concerning drug use, number of daily doses, and total cost of the respective drugs have been calculated by the Research Institute of the AOK (Wissenschaftliches Institut der AOK, WIdO). These prescription data have been related to incidence and mortality rates of patients with prostate cancer. RESULTS: Between 1993 and 2003 the age-standardized incidence rate of carcinomas of the prostate has risen by 180%, while the disease-specific mortality practically has remained nearly at the same level. The daily prescribed doses of LH-RH analogs have risen by a factor of 8.5 from 3.9 to 33.5 million daily doses during this time. In contrast, the daily doses of androgen receptor antagonists have remained unchanged between 1997 and 2001, followed by a rise of 50% between 2001 and 2003. CONCLUSIONS: The first analysis of the prescription practice of antiandrogens in the treatment of prostate cancer with respect to the incidence rates in Germany could only be facilitated by the fact that these medications are in exclusive use for this indication in Germany. The rise in prescriptions may be explained by the therapy shift from surgery to LH-RH application until the year 2000; the reasons for a further rise since 2000 remain speculative. In conclusion, only prevalence data would allow the exact calculation of medication needs among prostate cancer patients.

Aged↗
PubMed2006

The relationship between antidepressant prescription rates and rate of early adolescent suicide.

OBJECTIVE: In 2002, 264 children and adolescents ages 5-14 died by suicide in the United States, the fifth leading cause of death. Of these suicides, 260 were in the 10-14 year age group, making suicide the third largest cause of death behind accidents and malignancy. Although 60% of suicides in the general population occur in the midst of a mood disorder, usually untreated, little is known about the relationship between treatment of mood disorders and youth suicide. The FDA recently linked adverse event reports of suicidal ideation among children and adolescents in randomized controlled trials to selective serotonin reuptake inhibitors (SSRIs) and consequently required a change in labeling that included a black box warning regarding SSRI use for all age groups. Given that the age-adjusted suicide rate is about six times higher in 15-19 year olds compared with 10-14 year olds, the risk-benefit ratio may be different in younger children. Therefore, this study examined the association between antidepressant medication prescription rate and suicide rate in children ages 5-14 prior to the FDA findings by analyzing associations at the county level across the United States. METHOD: National county-level suicide rate data among children ages 5-14 were broken down by sex, income, and race during the period 1996-1998. National county-level antidepressant prescription rate data were expressed as number of pills prescribed per person. The primary outcome measure was the suicide rate in each county expressed as number of suicides for a given population size. RESULTS: After adjustment for sex, race, income, access to mental health care, and county-to-county variability in suicide rates, higher SSRI prescription rates were associated with lower suicide rates in children and adolescents. CONCLUSIONS: The aggregate nature of these observational data precludes a direct causal interpretation of the results. More SSRI prescriptions are associated with lower suicide rates in children and may reflect antidepressant efficacy, treatment compliance, better quality mental health care, and low toxicity in the event of a suicide attempt by overdose.

Adolescent↗
PubMed2001

Prescription of psychotropic medications to youths in office-based practice.

OBJECTIVE: This study sought to determine sociodemographic characteristics of treatment of children and adolescents for whom psychotropic medications are prescribed and to describe the clinical management approaches associated with the prescription of each major class of psychotropic medication in office-based medical practices in the United States. METHODS: Data for a four-year period (1992-1996) were drawn from the National Ambulatory Medical Care Survey, a nationally representative survey of office-based medical practices, to determine prescribing patterns, patients' sociodemographic characteristics, and clinical management approaches associated with visits during which psychotropic medications were prescribed to patients aged 19 years or under. RESULTS: Psychotropic medications were prescribed during 2.2 percent of all visits. A majority of the prescriptions for psychotropic medications (84.8 percent) were provided by general practitioners or pediatricians. For the visits during which a psychotropic medication was prescribed, stimulants were the most commonly prescribed (53.9 percent of such visits), but prescription of other classes of medications was not uncommon: antidepressants (30 percent), anxiolytics (7.2 percent), antipsychotics (7.2 percent), and mood stabilizers (12.7 percent). Significant differences were observed in the prescription of each class of medication by sex, race, and payment source. CONCLUSIONS: General practitioners and pediatricians have a role in the office-based treatment of youths with psychotropic medications.

Adolescent↗
PubMed2002

Prescription medication use among an aboriginal population accessing addiction treatment.

OBJECTIVES: Inappropriate prescription medication use can have significant consequences. Although it is suspected that Aboriginal populations within Canada have high rates of inappropriate use, published information is lacking. To better understand this issue, we studied an Aboriginal population seeking addiction treatment. METHODS: We surveyed Aboriginal clients who accessed addiction treatment in Calgary, Alberta, for prescription medication use in the previous year, frequency of medication use, and medication source(s), if inappropriately used. RESULTS: Sixty-nine percent of the clients completed the survey (n = 144). Most respondents were aged 31 to 50 years (56%), and 52% were male. Of the respondents, 48% reported that they used prescription medication inappropriately, 8% indicated appropriate use, and the rest indicated no medication use. Sedatives or relaxants were most frequently used inappropriately. Among those who inappropriately used medication, 47% used medication more than 10 times in the previous year. Common sources for those who used medication inappropriately included medication given by a friend or a stranger (52%), medication bought on the street (45%), and medication prescribed by a physician (41%). Age greater than or equal to 30 years was associated with inappropriate use. Sex, residence, and Aboriginal status were not found to be associated with inappropriate use. CONCLUSION: Inappropriate prescription medication use was a significant problem among an Aboriginal population that sought addiction treatment, and many of these individuals accessed medication from a prescribing physician.

Adolescent↗
PubMed1983

The effectiveness of auxiliary prescription labels: a pilot study.

Affixed auxiliary prescription labels are widely used in the practice of pharmacy because they supposedly provide the patient with pertinent information that is not contained within the prescription signature. Yet, whether the labels are effective is not known, nor is it known whether the label's elements, such as color, form, and logo, affect perception of the written text. Sound scientific analyses of these questions are limited. Therefore, a pilot study involving a series of experiments was designed to determine whether individual perception of pertinent information is affected by the use of affixed auxiliary prescription labels. The second objective of this study was to evaluate how color and logo differences affected perception of the label's written text. Participants were selected for the experiments after being screened for color blindness, corrected vision, and, in some cases, previous pharmacy employment. Subjects viewed labels affixed to prescription vials via a two-channel tachistoscope. The tachistoscopic methodology measured perception, and its accuracy was verified through a forced-choice instrument. Results from the pilot study were threefold: (1) a sound scientific analysis found affixed auxiliary labels to be effective, (2) significant variance could be attributed to both individual and subject differences, and (3) the unique effects of color and logo could not be determined.

Adult↗
PubMedDate not supplied

Relationships among prescription payment methods and interactions between community pharmacists and prescribers.

OBJECTIVE: This research was performed to examine community pharmacists' interactions with prescribers and to determine if these interactions are related to payment method. DESIGN: Randomly selected pharmacists (47 in chain pharmacies and 26 in independent pharmacies) collected data concerning prescriber interactions for a 40-hour period. These interactions were analyzed in terms of payment methods, prescriber acceptance, and types of information discussed. RESULTS: Information concerning 730 interactions by 72 pharmacists was obtained. Payment methods were related to the frequency of interactions per pharmacist (p less than 0.01). There were higher percentages of interactions for self-pay (median 2.2 percent) and Medicaid (median 1.8 percent) prescriptions than for third-party fee-for-service (mode 0 percent) or capitation prescriptions (mode 0 percent). Type of information discussed was related to payment method. The vast majority of information provided by pharmacists (91 percent) was accepted by prescribers. The rate of acceptance was 97 percent for prescriber-initiated interactions versus 88 percent for pharmacist- or patient-initiated interactions (p less than 0.01). CONCLUSIONS: Relationships between payment method and interactions were identified. These findings may be attributable to prescribing policies and reimbursement policies. Prescribing policies that restrict prescribers to a formulary may help make them become more adept at using those products; thus, they will make fewer prescribing errors. Reimbursement policies that require patients to consistently use a specific pharmacy (i.e., capitation) may help pharmacists become more familiar with the patient's prescription history. Therefore, interactions with prescribers are needed less frequently for these patients' prescriptions.

Capitation Fee↗
PubMed1993

Prescription drug use among ambulatory elderly in a Swedish municipality.

OBJECTIVE: To analyze prescription drug use among the elderly in a Swedish municipality. METHODS: The municipality of Tierp, located in mideastern Sweden, is a well-defined geographic area that includes both rural areas and a few small, industrial towns. All people aged 65 years and older (n = 4769) as of 1986 in a total population of 21,000 inhabitants were included in the study. Their drug use was studied by registering all prescriptions filled by the pharmacies in the area. RESULTS: Most of the elderly (> 70 percent) obtained at least one prescription during the year studied. Drug use was more common among women than men. However, the difference between men and women was much smaller among those aged 85 years or more. The drugs most commonly prescribed were cardiovascular, psychotropic, and analgesic agents. Furthermore, the study showed that simultaneous use of several drugs was quite common. One-fourth of all people aged 65 years and older used drugs from at least four different pharmacologic groups. CONCLUSIONS: Our results revealed widespread use of prescription drugs among the elderly. An important finding was extensive drug use among men aged 85 years or more. This age group is increasing and there is need for further studies of its medication use.

Aged↗