The Prevalence of Potentially Inappropriate Drug Prescription among Elderly Patients Registered in Balder Clinic in Åmål, Sweden

Background: Medication is necessary for the treatments of illness, to maintain current health problems and to prevent further decline of health. However, it can be challenging to select the best treatment for a patient as several treatment options and several drug alternatives are available, particularly when prescribing to elderly patients. The Swedish National Board of Health and Welfare has developed some indicators to screen the quality of drug therapy among the elderly. These quality indicators show medications that have a high tendency for adverse drug effects when used by the elderly; it also recommends alternatives with low or no risk. Aim: The aim of this study was to investigate the prevalence in prescribing potentially inappropriate drug to patients that are 75 years old or older registered at the Balder clinic in Åmål, Sweden. Methods: Data was analyzed based on age, sex and number of prescribed drugs for patients 75 years or older who were registered in Balder clinic in Amål, Sweden. The prescription pattern was followed from August 2015 – August 2016. All inappropriate drugs where identified and noted using the quality control guidelines from the Swedish National Board of Health and Welfare. These include: benzodiazepines, anticholinergic drugs, three or more psychotropic drugs, NSAIDs and drug combinations that have the potential to be involved in drug-drug interactions, in particularly severe (D) interactions. Results: The prevalence of inappropriate drug prescription (a drug is said to be inappropriate for treating older population when the risk for harmful effect outweighs the benefit for the person and there is a safer alternative with a better outcome) was in total 39.2% of which; the prescription of 3 or more psychotropic drugs was 18.5%, the prescription of drugs with anticholinergic properties 13.1%, NSAIDs 8.6%, long acting benzodiazepines 6.6% and potential drug-drug interaction 2.8%. Conclusion: This study indicates that potentially inappropriate prescription is common among elderly patients at the Balder clinic in Åmål, Sweden. The adherence to the different prescribing quality indicators was not generally high. The use of more than 3 psychotropic drugs was high while drug with potential drug-drug interaction was low compared to the other quality indicators. Younger elderly patients (75-79 years) had a better quality of drug prescription compared with older elderly patients (80 years or more). Health care providers should be aware of the risk involved when a patient is exposed to such combinations. For elderly patients, medications should be evaluated at each patient visit to prevent unnecessary exposure to potentially harmful treatments.