ABSTRACT
Objectives: The aims of this study were to evaluate: [1] the prevalence and types of potentially inappropriate prescribing in older adults with hypertension or diabetes mellitus and hypertension, and [2] whether or not differences in the training of primary care physicians were associated with potentially inappropriate prescribing
Materials and Methods: Primary care prescriptions issued by family physicians and general practitioners were audited using Screening Tool of Older Persons' Prescriptions criteria [version 1], with 18 out of 65 applicable criteria. Descriptive statistics were used to test the difference between proportions, and two-tailed t test was used for continuous variables
Results: A total of 2,090 outpatient prescriptions were written during the study period; of these, 712 [34.1%] were potentially inappropriate. The mean number of drugs per patient was 6.03 [+/-2.5]. Of the 712 prescriptions, 543 [76.3%] were used for the treatment of acute medical illnesses. The most common examples of potentially inappropriate prescribing were: orphenadrine [n = 174; 8.33%], long-term nonsteroidal anti-inflammatory drugs for > 3 months [n = 150; 7.18%], proton pump inhibitors for > 8 weeks [n = 135; 6.46%], antihypertensive therapy duplication [n = 59; 2.82%], long-acting glyburide [n = 48; 2.29%], and chlordiazepoxide for > 1 month [n = 44; 2.11%]. Family physicians showed a greater tendency toward potentially inappropriate prescribing compared to general practitioners, but the difference was nonsignificant [n = 514 [34.75%] vs. n = 162 [31.3%]; p = 0.16]
Conclusions: The prevalence of potentially inappropriate prescribing [i.e., 34.1%] was within the spectrum reported worldwide and unrelated to the training backgrounds of physicians. Most of the identified potentially inappropriate prescribing [76.3%] in older adults was associated with medications for acute medical illnesses and hence inappropriate polypharmacy should be discouraged