La prescrizione di farmaci per i bambini e gli anziani in Regione Lombardia

▶ Objectives. To evaluate the drug prescribing profiles in the paediatric and elderly populations. ▶ Methods. Prescriptions reimbursed by the National Health System, and dispensed during 2005 by the retail pharmacies of 15 local health units (LHUs) in the Lombardy Region (9,595,488 residents), were analysed. A logistic regression analysis was performed to evaluate the association between drug prescription and age, gender, prescriber, and setting. ▶ Results. In all, 60% of the residents in the Lombardy region received at least 1 drug prescription in 2005. The prescription prevalence varied according to age and ranged from 49% in children to 85% in the elderly. Antibiotics (56% of the population) and ACE-inhibitors (23%) were the most commonly prescribed therapeutic classes. In the paediatric population the prescription prevalence rate was highest in children 1-5 years old (65%) and decreased with increasing age to 38% in adolescents. Among the elderly, the greatest prevalence was observed in the 75-85 year olds. In all, 46% of the elderly received 5 or more different drugs, which in half of the cases were prescribed for chronic treatment. Differences were found in the drug prescription prevalence rate between the different LHUs. The rate ranged from 55% in the city of Milan to 63% in Brescia and Mantova. These differences were more evident in the paediatric population (range 38-55%). The LHU of residence resulted one of the main determinants of drug prescription in both the paediatric and elderly populations. ▶ Conclusions. The results resemble the profiles observed in other Italian contexts. However, differences were found between LHUs, highlighting the need for educational interventions at the local level aimed at improving rational drug use.