gms | German Medical Science

Introduction: The use of potentially inappropriate medication (PIM) in elderly and/or multimorbid patients poses a threat to their health. Specific drugs can provoke harmful adverse events in these patients and drug-drug- and drug-disease-interactions can occur. These medications might impair the quality of life, increase the utilisation of the health care system and may even result in more hospital care. Studies using the so-called „Beers-list of potentially inappropriate medication“ estimate the prevalence of PIM-use in different countries to be between 6% and 42%. In Germany, only data from one statutory health insurance (GEK) are available: 22.3% of the patients above 65 years of this insurance got at least one medication out of the Beers-list in 2003.

Method: 3327 patients recruited at random from general practice and aged between 75 and 89 were visited at home. During the visit the patients were asked to show all medications they regularly use. Interviewers documented the drugs taken, not the dose. Recruitment of patients took place in a project of the German Competence Network Dementia, funded by the Federal Ministry of Education and Research. Beers-criteria for PIM use in older adults, independent of diagnoses or conditions, were applied to this data set.

Results: 23.3% of the patients who reported to take any medication reported the use of at least one PIM. Multimorbid patients and patients with polypharmacology are at higher risk to receive PIM. In spite of differences in data collection methodology, the frequency of use of PIM in this sample of elderly patients is comparable to other (western) European populations as well as the population of the one German statutory health insurance (GEK).

Conclusion: Based on drug visits at home, we present for the first time data of a general practice population in Germany and their use of PIM. We confirm predictors (multimorbidity, polypharmacology) for the use of these drugs also found in other studies.