Potentially inappropriate drug use in older people: a nationwide comparison of different explicit criteria for population‐based estimates

• Published in: British journal of clinical pharmacology 2015-08, Vol.80 (2), p.315-324
• Main Authors: Morin, Lucas, Fastbom, Johan, Laroche, Marie‐Laure, Johnell, Kristina
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Cross-Sectional Studies; Drug Prescriptions - standards; Drug Prescriptions - statistics & numerical data; Female; Human health and pathology; Humans; inappropriate drug use; Inappropriate Prescribing - statistics & numerical data; Life Sciences; Male; medications; Medicin och hälsovetenskap; older adults; Pharmacoepidemiology; Polypharmacy; Population Surveillance; Prescription Drugs - administration & dosage; Prevalence; Residence Characteristics - statistics & numerical data; Sweden
• ISSN: 0306-5251; 1365-2125; 1365-2125
• DOI: 10.1111/bcp.12615

Aims The aim was to investigate the prevalence of potentially inappropriate medication use among older people in Sweden according to five different published sets of explicit criteria from Europe and the US. Methods This was a nationwide cross‐sectional, register‐based study across the whole of Sweden in 2008. All individuals aged 65 years and older were included (n = 1 346 709, both community‐dwelling and institutionalized persons). We applied all drug‐specific criteria included in the 2012 Beers Criteria, the Laroche's list, the PRISCUS list, the NORGEP criteria and the Swedish National Board of Health and Welfare criteria. The main outcome was the potentially inappropriate drug use according to each set of criteria, separately and combined. Multivariate logistic regression models were used to identify individual factors associated with the use of potentially inappropriate drugs. Results The prevalence of potentially inappropriate medication use varied between the explicit criteria from 16% (NORGEP criteria) to 24% (2012 Beers criteria). Overall, 38% of the older people were exposed to potentially inappropriate drug use by at least one of the five sets of criteria. While controlling for other possible covariates, female gender, institutionalization and polypharmacy were systematically associated with inappropriate drug use, regardless of the set of explicit criteria we considered. Conclusion Although explicit criteria for inappropriate drug use among older people have been reported to be quite different in their content, they provide similar measures of the prevalence of potentially inappropriate drug use at the population level.