Analysis of inappropriate medication prescribing in Slovenian elderly patients based on the Beers and Laroche criteria

Abstract

Purpose: Given a great number of elderly people using medications, the main objective of the analysis was to determine the prevalence of prescribing inappropriate medications to the elderly in 2006. Potentially inappropriate medications were identified on the basis of the Beers 2002 and the Laroche 2007 criteria and according to the combined criteria of inappropriate prescribing. Methods: We analysed the anonymous database of dispensed outpatient medications prescribed in 2006 provided by The Health Insurance Institute of Slovenia. Beers's 2002 criteria were used for the elderly people aged 65 or more and the Laroche 2007 and the combined criteria for the age group of 75 years and over. Results: According to the Beers 2002 criteria, 22.41 per cent of the elderly patients were prescribed at least one inappropriate medical ingredient; by the Laroche 2007 criteria, the percentage of older people receiving inappropriate drugs was 25.72 and by the combined criteria 35.95. Judging by the published data, these shares are rather high. The prevalence of inappropriately prescribed medications (with respect to all prescriptions) was 3.43 per cent by the Beers 2002 criteria, 4.01 per cent, according to the Laroche 2007 criteria and 6.03 per cent according to the combined criteria. These shares are higher than in Croatia mainly because of the greater quantity of inappropriate medications used in Slovenia. Further it was discovered, that the probability of being prescribed an inappropriate medication increases along with the number of prescribed medications. Discussion: Despite the established high prevalence of potentially inappropriate prescriptions, there is no unanimity in the literature concerning the influence of inappropriate prescribing on the health of older people. We would emphasise here that the criteria discussed are intended to help rather than convince physicians to choose the appropriate therapy. They are also meant to be used in pharmacoepidemiological studies. Ways to reduce the rate of inappropriate medication prescribing are put forward.