Potentially Inappropriate Prescribing in Middle-Aged Adults

Dawn O'Shea

March 02, 2021

Almost a fifth of middle-aged adults taking prescribed medicines are exposed to potentially inappropriate prescribing (PIP), suggest the findings of a study published in the British Journal of General Practice.

The repeated cross-sectional study was conducted using primary care data in London. PIP was defined using the PRescribing Optimally in Middle-aged People's Treatment (PROMPT) criteria. Prescribing and demographic data were extracted from Lambeth DataNet (LDN), a pseudonymised database of all patients registered at general practices in Lambeth. Date related to patients aged 45-64 years prescribed one or more medicines in each year, 2014-2019 (n=46,633-52,582). Prevalence and trends over six years were investigated.

The results show that the prevalence of PIP decreased from 20 per cent in 2014 to 18 per cent in 2019.

The most prevalent PROMPT criteria in 2019 were the use of two or more drugs from the same pharmacological class (7.6%), use of nonsteroidal anti-inflammatory drugs for more than three months (7%) and use of PPIs above recommended maintenance dosages for more than eight weeks (3%).

Over the study period, the prevalence of multimorbidity increased (47%-52%), and polypharmacy remained stable (27%).

Polypharmacy, multimorbidity, deprivation and age were independently associated with PIP.

Polypharmacy (incidence rate ratios [IRR], 3.91) and multimorbidity (IRR, 2.47), as well as living in a more deprived area, and being older, significantly increased the odds and incidence rates of PIP.

While PIP is common in older adults, this is the first study to report trends in PIP in middle-aged adults over time.

Br J Gen Pract. 2021;BJGP.2020.1048. Abstract

This article originally appeared on Univadis, part of the Medscape Professional Network.

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