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WASHINGTON -- Elderly patients were prescribed inappropriate medications in almost 8 percent of doctor visits in 2000, about the same percent as 1995,
according to a new study of drug prescribing patterns published in the
Feb. 9, 2004 issue of Archives of Internal Medicine.
The study, based on data from the Centers for Disease Control (CDC)
surveys of ambulatory medical care providers, showed that inappropriate
medicines were prescribed in almost 8 percent of doctor visits made by
patients age 65 and older. Inappropriate medications were defined as
those that had a risk of adverse outcomes outweighing the potential
benefits for most elderly patients.
The article identified a small number of drugs including certain pain
relievers, anti-anxiety agents, antidepressants and sedatives as posing a
large share of the problem. In 2000, the inappropriate drugs most
frequently prescribed at doctor visits made by the elderly were the pain
reliever propoxyphene, the antihistamine hydroxyzine, the antianxiety
agent diazepam, the antidepressant amitriptyline, and the urinary tract
The likelihood that an inappropriate drug was prescribed was higher when
multiple medications were prescribed and double at doctor visits when
the patients were women. The likelihood of inappropriate medications
being prescribed was higher for patients ages 65 to 79 than for patients
age 80 and older, but the study found no difference by patient's race.
Nor was there any difference by geographic region of the country.
A panel of geriatric medicine and pharmacology experts used published
evidence on specific drugs and clinical experience to identify 38 drugs
or drug groups as generally inappropriate for patients older than age
65. The study applied that list to the drug information reported in the
National Ambulatory Medical Care Survey and the National Hospital
Ambulatory Medical Care Survey conducted by CDC's National Center for
Health Statistics. The surveys capture information on drugs ordered or
prescribed at visits to doctors in office-based practices and in
hospital outpatient departments. Since the outcomes of use of these
inappropriate medications are not measured in the survey, they may be
said to define potential, rather than actual, inappropriate prescribing.
In 2000, seniors made more than 200 million visits to the doctor either in
private offices or hospital outpatient clinics. No drugs were
prescribed in about a third of the visits; in another third, one or two
drugs were prescribed; and for the remaining third, three or more drugs
Source: Centers for Disease Control and Prevention