Prevalence and longitudinal trends in prescription of potentially inappropriate medications for the elderly in the Czech Republic
Abstract
The article deals with an evaluation of the prevalence and trends in prescribing potentially inappropriate medications for Czech senior citizens in out-patient care. It uses the newly revised and, in the Czech Republic, to date less known Beers's criteria 2003 (10), listing medications potentially inappropriate for the elderly based on pharmacological and pharmacoepidemiological studies.
Prescription of these medications in the elderly should be low, but previous studies have documented their frequent use in several European countries, including the Czech Republic (7). The most extensive sample has ever been analyzed in the Czech conditions - the dataset of 1 776 119 drugs dispensed on medical prescription to the over 65s insured through the .koda Employee Insurance Company, Mladá Boleslav, Czech Republic, during the period January 1997 - December 2001.
The analysis documented frequent use of potentially inappropriate medications, in 40 % of out-patient seniors in 1997 and in 30 % in 2001. When only "highly risky" medications were considered, the prevalence reached was also high - 34 % in 1997, with only mild longitudinal decline over time - 26% in 2001.
Among inappropriate medication users, females and "older" seniors (75 - 84 years old) were particularly identified. In the period studied, long-acting benzodiazepines and nitrofurantoin (11 % and 6 % in 1997, respectively) were the most frequently dispensed medications, with a nearly unchanged prevalence over time.
The use of ergot mesyloid, indomethacin and short-acting nifedipin decreased; use of doxazosin, ticlopidin, and short-acting oxybutinin increased.