gms | German Medical Science

Context: Drug treatment is an important and frequently used therapeutic option in the elderly but several specific conditions e.g. chronic diseases, multimorbidity, reduced renal and hepatic function and extensive self-medication make it difficult to manage drug treatment which becomes a complex process – in practice often with deficits and potential for optimization.

Aim of the Study: Aim of the analysis is to characterize drug prescription for the elderly and to identify resources to optimize treatment quality.

Material and Method: A statutory health insurance company’s (GEK, about 1,550,000 enrollees, about 140,000 aged 65years and older) person-specific but non-identifying prescription data from 2005 was analysed.

Results: About 91% of the enrollees aged 65 and older received at least one drug prescription in 2005 (drug treated patients, DTP). Age- and sex-standardized expenditures and prescribed amounts differed for males and females (726.56€ vs. 695.56€, 16.1 vs. 17.9 packages). High proportions of DTPs receive several different drugs: depending on 5-year agegroup 12-22% of males and 15-24% of females receive 9-12 different substances and 7-18% of males and 8-19% of females even 13 or more different drugs. Most relevant drugs regarding prescribed defined daily doses (DDD) were for treatment of cardiovascular diseases (C09, C10, C07, C03, C08), followed by antidiabetics (A10) and substances for COPD/Asthma (R03) among males resp. thyroid gland treatment among females. More detailed analyses of selected drug groups (antidiabetics, analgesics, psycholeptics and psychanaleptics) showed relevant sex- and age-specific characteristics.

Conclusion: Indicators for deficits in treatment quality are obvious. Therefore it is an important drug utilization research task to identify, evaluate and critically discuss drug prescription and utilization patterns in the elderly on a regular basis to improve treatment quality and effectiveness and to avoid hospital admissions.