Advanced Age and Medication Prescription: More Years, Less Medications? A Nationwide Report From the Italian Medicines Agency

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• 作者：Graziano Onder ; MD ; PhD^a ; ^{graziano.onder@rm.unicatt.it" class="auth_mail" title="E-mail the corresponding author} ; Alessandra Marengoni ; MD ; PhD^b ; Pierluigi Russo ; MD ; PhD^c ; Luca Degli Esposti ; Econ D ; PhD^d ; Massimo Fini ; MD^e ; Alessandro Monaco ; PhD^c ; Stefano Bonassi ; PhD^e ; Katie Palmer ; PhD^c ; Walter Marrocco ; MD^c ; Giuseppe Pozzi ; MD^f ; Diego Sangiorgi ; MStat^d ; Stefano Buda ; MD^d ; Niccolò ; Marchionni ; MD^g ; Federica Mammarella ; MD ; PhD^a ; ^c ; Roberto Bernabei ; MD^a ; Luca Pani ; MD^c ; Sergio Pecorelli ; MD^c ; on behalf of the Geriatrics Working Group of the Italian Medicines Agency (Agenzia Italiana del Farmaco ; AIFA)
• 关键词：Prescribing ; polypharmacy ; end of life
• 刊名：Journal of the American Medical Directors Association
• 出版年：2016
• 出版时间：1 February 2016
• 年：2016
• 卷：17
• 期：2
• 页码：168-172
• 全文大小：321 K

文摘

In older adults co-occurrence of multiple diseases often leads to use of multiple medications (polypharmacy). The aim of the present study is to describe how prescription of medications varies across age groups, with specific focus on the oldest old.

Methods

We performed a cross-sectional study using 2013 data from the OsMed Health-DB database (mean number of medicines and defined daily doses prescribed in 15,931,642 individuals). There were 3,378,725 individuals age 65 years or older (21.2% of the study sample).

Results

The mean number of prescribed medications progressively rose from 1.9 in the age group <65 years to 7.4 in the age group 80–84 years and then declined, with a more marked reduction in the age group 95 years or older with a mean number of 2.8 medications. A similar pattern was observed for the mean number of defined daily doses. Among participants age ≥65 years, proton pump inhibitors were the most commonly prescribed medication (40.9% of individuals ≥65 years), followed by platelet aggregation inhibitors (32.8%) and hydroxy-methylglutaryl-coenzyme A reductase inhibitors (26.1%). A decline in prescription was observed among individuals age 90 years or older, but this reduction was less consistent for medications used to treat acute conditions (ie, antibiotics and glucocorticoids) rather than preventive medicines commonly used to treat chronic diseases (ie, antihypertensive medications and hydroxy-methylglutaryl-coenzyme A reductase inhibitors).

Conclusions

The burden of medication treatment progressively increases till age 85 and substantially declines after age of 90 years. Patterns of medication prescription widely vary across age groups.