Drug prescription appropriateness in the elderly: An Italian study

Nicola Allegri, Federica Rossi, Federica Del Signore, Paolo Bertazzoni, Roberto Bellazzi, Giorgio Sandrini, Tomaso Vecchi, Davide Liccione, Alessia Pascale, Stefano Govoni

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Correct drug prescription in the elderly is a difficult task that requires careful survey of the current pharmacological therapies. In this article, we reviewed the drug prescriptions provided to 860 persons aged 65 years or over, residing in a small city of Lombardy, Italy. Methods: Subjects were recruited from a local nursing home, the Pavia and Vigevano Neu­ropsychological Center for Alzheimer’s Disease, general practitioners’ offices, and the local University of the Third Age. For each patient, the amount of potentially inappropriate pre­scriptions (PIPs), sedative and anticholinergic load (SL and AL, respectively), and drug–drug interactions were evaluated. Results: Widespread polypharmacy, giving rise to 10.06% of PIPs in the whole collection of prescriptions, was observed. In particular, PIPs mainly concern drugs acting at the central nervous system level, mostly benzodiazepines and antipsychotics. Moreover, approximately one-fourth of the subjects had an elevated SL and approximately one-tenth a high AL. Drug–drug interactions were frequent (266 requiring medical attention), up to five for each single patient. Of concern was the underuse of antidementia drugs: only 20 patients received a cholinesterase inhibitor or memantine, although 183 patients were potentially suitable for this treatment. Conclusion: These results demonstrate the need to develop novel strategies aimed at improv­ing the quality of drug prescription.

Original languageEnglish
Pages (from-to)325-333
Number of pages9
JournalClinical Interventions in Aging
Volume12
DOIs
Publication statusPublished - Feb 10 2017

Keywords

  • Beers criteria
  • Drug prescription
  • Drug–drug interactions
  • Elderly
  • Sedative load

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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