Frequency of inappropriate drugs in primary care: analysis of a sample of immobile patients who received periodic home visits

Abstract

Background: drug intake is associated with the risk of drug-related problems (DRPs), e.g. the intake of PIM.

Objective: the proportion of potentially inappropriate medication (PIM) taken by elderly people was analysed.

Design: community-based, prospective cohort study.

Setting: ambulatory health-care sector in a German rural area.

Subjects: seven hundred and forty-four patients with age >65 years and regular intake of drugs.

Methods: comprehensive home medication review (HMR) provided by specially qualified assistants of GP practices using electronic case reporting forms (eCRFs), and GP's diagnoses were extracted from patients' health records. Updated Beers' list of Fick et al. was used to detect PIM for patients >65 years and drug-condition interaction.

Results: a total of 18% (n= 134) of the patients received 163 inappropriate drugs. Out of these drugs, most prevalent PIM were benzodiazepine derivates (n= 45). Out of all drugs, 25 drug-condition interactions were identified. The intake of PIM was slightly associated with self-reported falls (: 0.1074; P= 0.0244). Multivariate logistic regression showed significant results for the number of taken substances (OR = 1.176; 95% CI 1.121-1.234, P< 0.001).

Conclusions: a high proportion of patients taking PIM in a community-based setting were investigated. Statistical associations with self-reported falls were found. Confounding may influence data. Further research to investigate findings is needed.