gms | German Medical Science

MAINZ//2011: 56. GMDS-Jahrestagung und 6. DGEpi-Jahrestagung

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V.
Deutsche Gesellschaft für Epidemiologie e. V.

26. - 29.09.2011 in Mainz

Prescribing of potentially inappropriate medication in the elderly according to the recently published German PRISCUS list

Meeting Abstract

  • U Amann - Bremer Institut für Präventionsforschung und Sozialmedizin (BIPS), Bremen
  • N Schmedt - Bremer Institut für Präventionsforschung und Sozialmedizin (BIPS), Bremen
  • U Dittmann - Bremer Institut für Präventionsforschung und Sozialmedizin (BIPS), Bremen
  • E Garbe - Bremer Institut für Präventionsforschung und Sozialmedizin (BIPS), Bremen

Mainz//2011. 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi). Mainz, 26.-29.09.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11gmds242

DOI: 10.3205/11gmds242, URN: urn:nbn:de:0183-11gmds2424

Published: September 20, 2011

© 2011 Amann et al.
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Outline

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Background: For assessment of the impact of the recently published German PRISCUS list on prescribing of potentially inappropriate medication (PIM) in the elderly, baseline data of PIM prescribing in Germany are necessary. Aim of the study was to provide baseline prevalence of PIM prescribing in 2007 according to the PRISCUS list.

Methods: Data were derived from three statutory health insurances covering more than 8 million members throughout Germany. PIMs were identified from the PRISCUS list without consideration of dose or formulation. The 1-year-period prevalence of elderly persons (>=65 y) with PIM prescriptions was calculated in insurants who were continuously insured or deceased in 2007. Estimation of prevalence was based on persons with at least one PIM prescription in 2007 and assessed by age and sex (standardized to the population of Germany in 2007).

Results: Of 806,651 elderly with a mean age of 71.6y (SD: 6.1) we identified 207,871 (25.8%) who received at least one PIM prescription in 2007. The PIM prevalence increased with age from 20.8% in the 65-69 year old up to a maximum of 42.9% in the 90-94 year old. In this latter age strata, it was most pronounced for psycholeptics (ATC code N05: 20.2%), psychoanaleptics (N06: 9.4%) and cardiac therapy (C01: 9.0%). After standardization by age and sex the overall PIM prevalence was 29.1%. The prevalence was higher in women (32.7%) than in men (24.2%), and also for most of the 18 drug classes, except urologicals, antihypertensives, beta blocking agents and antithrombotic agents. The highest PIM prevalence was observed for amitriptyline with 2.6%, followed by acetyldigoxin (2.4%), nifedipine (2.2%), tetrazepam (2.0%) and oxazepam (2.0%).

Conclusion: These baseline data provide evidence of considerable PIM prescribing in elderly patients in Germany. Further research should analyse the impact of publication of the PRISCUS list on prescribing behaviour and assess the clinical relevance of drugs listed in the PRISCUS list by analysing their risks in the elderly in comparison to non PIM drugs.