Inappropriate prescribing in an elderly population: findings from a South African public sector survey

Abstract

Objective: To quantify the extent of potentially inappropriate prescribing among elderly patients seen at public sector primary health care facilities and old age homes in a South African urban setting. Method: Cross-sectional survey of the prescription charts of patients aged 65 years or older, using a list of potentially inappropriate medicines in elderly patients, modified from that established by Beers and further developed by consensus. Setting: A provincial government chronic prescription pharmacy servicing public sector primary health care clinics and old age homes in the Durban metropole. Key findings: Of the 6,410 prescriptions that were reviewed, 1,926 (30.0%) included at least one medication listed as potentially inappropriate in the elderly. The median number of chronic medications prescribed per patient was 4 (range 1 to 11). Although the prevalence of potentially inappropriate prescribing in patients receiving medication at primary health care clinics (29.7%) was similar to the prevalence in those resident in old age homes (31.8%), this difference was shown to be significant upon multivariate analysis. Age was not found to be a predictor of inappropriate prescribing. An association was found between sex and inappropriate prescribing, with female sex being associated with a greater degree of potentially inappropriate prescribing. Conclusion: This study has shown that 30% of elderly patients were prescribed at least one potentially inappropriate medicine. Women were more likely than men to be prescribed potentially inappropriate medicines.