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Drug utilization and polypharmacy in an Italian elderly population: the EPIFARM-elderly project

Authors


  • Contribution: All authors conceived the idea for the study, designed the study, interpreted the data, and critically revised the manuscript. AN, MT, CF, and AB acquired and analyzed the data. MT did the statistical analysis. AN and MT drafted the manuscript. AN is guarantor.

  • Ethical Approval: Ethical approval was not necessarily due to the nature of the data (secondary data analysis of anonymized data). The study was based on administrative database and the participants were not identifiable to the authors.

ABSTRACT

Objective

To investigate the prescribing patterns and the prevalence of polypharmacy in community-dwelling elderly people, and to analyze the association of chronic medications and number of drug prescriptions with age and sex.

Methods

All prescriptions for people aged 65 years or older reimbursed by the Italian National Health Service (NHS) and dispensed by retail pharmacies of the 15 local health units (LHU) in the Lombardy Region during 2005 were analyzed. Logistic regression analysis was used to assess the association between drug prescription (overall, chronic drugs, and polypharmacy) and age, sex, and LHU of residence.

Results

Eighty-eight percent of the 1 767 239 analyzed elderly received at least one drug prescription. The overall prescription rate was slightly higher for women than men (odds ratio [OR] 1.20; 95%CI 1.19–1.21). Seventy-six percent of the elderly received at least one chronic drug, 46% were exposed to polypharmacy, and 20% to chronic polypharmacy. At multivariate analysis, age and LHU residence of the elderly were the main determinants of drug exposure. A significant correlation was found between the overall prescription prevalence rate and exposure to chronic drugs and to chronic polypharmacy (rs = 0.79, p < 0.0005 and rs = 0.84, p < 0.0001, respectively).

Conclusions

Our findings indicate that age and LHU residence of the elderly are the main determinants of drug prescribing, and there is evidence of a significant correlation between the overall prescription prevalence rate and exposure to chronic drugs and to chronic polypharmacy. Copyright © 2011 John Wiley & Sons, Ltd.

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