Indication for pharmacological treatment is often lacking: a cross-sectional study on the quality of drug therapy among the elderly

BMC Geriatrics

Research Article

Jessica Skoog¹  Anders Beckman¹  Patrik Midlöv¹  Anders Halling²  Jan Sundquist³ 

[1] Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, SE-205 02, Malmö, Sweden;Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, SE-205 02, Malmö, Sweden;Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, DK-5000, Odense C, Denmark;Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, SE-205 02, Malmö, Sweden;Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA;

关键词: Pharmacological treatment;    Drug therapy;    Elderly patients;    Aged patients;    Indication;    Prescription drugs;    Potential inappropriate medicine;    Discontinue treatment;   

DOI  :  10.1186/s12877-015-0117-x

 received in 2015-05-13, accepted in 2015-10-05,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundAlthough the elderly have a substantially higher drug use than younger patients, even after adjustment for multimorbidity, there is limited knowledge about the elderly’s indication for treatment. It is essential for elderly patients to have a well-planned drug therapy. The first step towards a correct and safe drug therapy is to ensure that the patient’s drugs have an indication, i.e. correct diagnoses are linked to all of the prescription drugs. The aim of this study was to examine to what extent elderly patients have indication for a number of their prescribed drugs and, furthermore, if there are any differences in indication for treatment depending on gender, age, level of multimorbidity and income.MethodData were collected on individuals aged 65 years or older in Östergötland County in Sweden. To estimate the individual level of multimorbidity the Johns Hopkins ACG Case-Mix System was used. A report from the Swedish National Board of Health and Welfare was used to identify prescription drugs, for which it is important to have a correct diagnosis. The proportions of patients having indication for these prescription drugs were calculated. Odds ratios of having indication for treatment depending on gender, age, multimorbidity level and income were calculated.ResultsOn average 45.1 % (range 12.9 % – 75.8 %) of the patients’ prescribed drugs had indication. Proton pump inhibitors were associated with the lowest level of indication (12.9 %) and digoxin was associated with the highest level of indication for treatment (75.8 %). Patients aged 80 years or older had the lowest odds ratios of having indication for treatment.ConclusionOn average, there was indication for treatment in less than half of the prescription drugs studied. The quality was highest in relation to multimorbidity and lowest in relation to age. The result may to some extent be explained by substandard registration of diagnoses. Since lack of quality of prescription drug use is highly associated with inconvenience among the elderly, as well as high costs to society, it is important that future research and allocation of resources focus on the quality of elderly patients’ drug therapy.

【 授权许可】

CC BY   
© Skoog et al. 2015