Use of potentially inappropriate medications in elderly patients is a major health care concern, according to background information in the article. It is likely to increase the risk of adverse drug events, which are estimated to be the fifth most common cause of death among hospitalized patients and which account for a large number of hospital admissions and a substantial increase in health care costs.

In the United States and Canada, epidemiological studies have documented widespread use of potentially inappropriate medications among nursing home residents (up to 40 percent) and community-dwelling elderly persons (14 percent-37 percent). In contrast, in Europe little information has been available about potentially inappropriate medication use and is based on small studies with uncertain generalizability.

Daniela Fialov, Pharm.D., of Charles University, Prague, Czech Republic, and colleagues conducted a study to determine from a large sample of European home care elderly patients the prevalence of potentially inappropriate medication use. The study included 2,707 elderly patients receiving home care (average age, 82.2 years) in metropolitan areas of the Czech Republic, Denmark, Finland, Iceland, Italy, the Netherlands, Norway, and the United Kingdom. Patients were assessed between September 2001 and January 2002.

Combining 3 sets of expert panels criteria, the researchers found that 19.8 percent of patients in the total sample used at least 1 inappropriate medication; using older 1997 criteria it was 9.8 percent to 10.9 percent. Substantial differences were documented between Eastern Europe (41.1 percent in the Czech Republic) and Western Europe (average 15.8 percent, ranging from 5.8 percent in Denmark to 26.5 percent in Italy). Po
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Contact: Daniela Fialov
fickova@faf.cuni.cz
JAMA and Archives Journals
15-Mar-2005