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Inappropriate medication prescribing in community-dwelling elderly people living in Iran

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Objectives

To determine the prevalence of inappropriate medication prescribing in Middle Eastern community-dwelling elderly persons, and to determine factors associated with inappropriate prescribing.

Methods

Prescriptions from 3,000 elderly-patient visits (≥65 years) to physicians in Isfahan, Iran were collected between September and December 2002; only the first patient visit was considered in the study. Inappropriate prescriptions were defined according to Beers’ explicit criteria (1997). The presence of at least one drug–drug interaction (DDI) and at least one drug-class duplication within each patient visit was also determined. Multivariate analyses were performed to determine factors associated with receiving at least one inappropriate medication. These factors included age, gender, number of prescribed medications per visit, DDIs, duplications, and physician’s number of years of experience. Similar analyses were performed to determine whether these factors were associated with a composite index (defined as having at least one of the following: receiving at least one inappropriate prescription, DDI, or duplication).

Results

The mean age of our cohort was 72.6 (±5.7) years, and 1,735 (57.8%) were females. A total of 829 (27.6%) patients received at least one inappropriate prescription, 285 (9.5%) had at least one DDI during the visit, and 746 (24.9%) had at least one duplication during the visit. The three most inappropriately prescribed medication classes were antihistamines (29%), non-steroidal anti-inflammatory agents (23%) and benzodiazepines (16%). In multivariate analyses, the number of prescribed medications per visit was the only factor significantly associated with receiving at least one inappropriate prescription (OR 1.24; 95%CI: 1.16–1.32); analyses using the composite index as outcome gave similar results (OR: 1.70; 95%CI: 1.60–1.80).

Conclusion

Our findings indicate a high prevalence of inappropriate prescribing in elderly patients. Given the potential severity of this problem, further steps need to be implemented to prevent this occurrence.

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Acknowledgements

This study was supported by the Research Council of Isfahan University of Medical Sciences. Laurent Azoulay is the recipient of a doctoral bursary from the Fonds de la recherche en santé du Québec. Dr. Anick Bérard is the recipient of a career award from the CIHR/Canadian Foundation for Health, and is on the endowment research Chair of the Famille Louis-Boivin on ‘Medications, Pregnancy and Lactation’ at the Faculty of Pharmacy of the University of Montreal.

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Authors and Affiliations

  1. Faculty of Pharmacy , University of Montreal, Montreal, Quebec, Canada

    Laurent Azoulay & Anick Bérard

  2. Research Centre, Sainte-Justine Hospital, 3175, Chemin de la Côte-Ste-Catherine, Montreal, Quebec, H3T 1C5, Canada

    Laurent Azoulay, Driss Oraichi & Anick Bérard

  3. School of Pharmacy, Isfahan University of Medical Sciences, Isfahan, I.R., Iran

    Amir Zargarzadeh & Zeinab Salahshouri

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  1. Laurent Azoulay
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  2. Amir Zargarzadeh
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  3. Zeinab Salahshouri
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  4. Driss Oraichi
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  5. Anick Bérard
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Correspondence to Anick Bérard.

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Azoulay, L., Zargarzadeh, A., Salahshouri, Z. et al. Inappropriate medication prescribing in community-dwelling elderly people living in Iran. Eur J Clin Pharmacol 61, 913–919 (2005). https://doi.org/10.1007/s00228-005-0036-4

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  • DOI: https://doi.org/10.1007/s00228-005-0036-4

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