Pharmacologically inappropriate prescriptions for elderly patients in general practice: How common?

Abstract

OBJECTIVE: To assess Norwegian general practitioners' (GPs') level of potentially harmful drug prescribing for elderly patients. DESIGN: Prescription data for 12 months were retrospectively retrieved from the Norwegian Prescription Database (NorPD). Data were assessed in relation to 13 prescription quality indicators. SETTING: General practice. SUBJECTS: A total of 454 GPs attending continuous medical education (CME) groups in Southern Norway, 85,836 patients >or=70 years who received any prescription from the GPs during the study period. MAIN OUTCOME MEASURES: Number of prescriptions assessed in relation to pharmacological inappropriateness based on a list of 13 explicit prescription quality indicators. RESULTS: Some 18.4% of the patients (66% females with mean age 79.8 years, 34% males with mean age 78.7 years) received one or more inappropriate prescriptions from their GP. An NSAID in a potentially harmful combination with another drug (7%) and a long-acting benzodiazepine (4.6%) were the most frequent inappropriate prescriptions made. Doctor characteristics associated with more inappropriate prescribing practice were old age and working single-handed with many elderly patients. CONCLUSION: The study reveals areas where GPs' prescribing practice for elderly patients can be improved and which can be targeted in educational interventions.