POLYPHARMACY AND INAPPROPRIATE DRUG PRESCRIBING IN ELDERLY NURSING HOME RESIDENTS

Background Polypharmacy and inappropriate drug use are common in nursing home residents, who are therefore at increased risk for potential adverse drug effects and drug interactions. In Slovenia, this is the first study of drug prescribing in elderly nursing home residents. Methods This study was cross-sectional, including 2040 elderly nursing home residents in 12 nursing homes in Slovenia. 2003 Beers criteria and ten most common drug interactions were used to determine potentially inappropriate prescriptions. Results The mean age was 82.0 years (SD 7.7 years), 1597 (78%) were female patients. The mean number of regularly prescribed drugs was 5.8, 1032 (50.6%) of patients were taking more than 6 drugs at once. Higher number of drugs were more often prescribed to female patients. Patients with dementia and fully dependant patients were prescribed less, and patients with depression and those who were partially dependent in their daily activities were prescribed more drugs. 455 (22.3%) residents had at least one inappropriately prescribed drug or combination of drugs. Male patients (p = 0.008), residents partially dependent on daily activities (p = 0.001) and patients with more prescribed drugs (p < 0.001) were more likely to have an inappropriate prescription. The most common inappropriate prescriptions were cyclooxigenase 2 non-selective nonsteroid anti-inflammatory drugs (NSAID), a prescription of NSAID, dipyridamole, ticlopidine or clopidogrel in patients with blood-clotting disorders or patients taking anticoagulants, a prescription of the combination of digoxine and amiodarone, and the combination of an ACE inhibiting drugs and spironolactone. Conclusions Obtained results about number of drugs and inappropriate drugs or drug combinations show that the situation in Slovenia is similar to the the situation in western European countries and better than in eastern Europe, but still half of the elderly nursing home residents in Slovenia are exposed to polypharmacy and one fifth to inappropriate drug prescribing.