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Potentially inappropriate drug use among older persons in Finland: application of a new national categorization

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

The Finnish Medicines Agency published a new consensus categorization for potentially inappropriate drug (PID) use among persons aged 75 years and older (A = suitable, B = limited evidence, C = suitable for use under certain conditions only, D = inappropriate) in 2010. We investigated factors associated with use of one or more Category D drugs.

Method

Cross-sectional analyses were conducted using baseline data from the Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) Study collected in Kuopio, Finland, in 2004. From a random sample of 1000 persons aged 75 years and older, 781 persons provided consent to participate. Logistic regression was used to compute unadjusted and adjusted odds ratios (ORs) and 95 % confidence intervals (95 % CIs) for factors associated with PID use.

Results

PIDs were used by 30 % (n = 234) of all participants on a regular or as-needed basis. Among the 764 persons (98 %) who used prescription or non-prescription drugs, PID use was associated with the number of drugs in use (adjusted OR 1.20; 95 % CI 1.13–1.28) and moderate self-rated health compared to good self-rated health (adjusted OR 1.74; 95 % CI 1.19–2.55). PID use was associated with poor maximum walking speed (adjusted OR 1.64; 95 % CI 1.10–2.45), poor Timed Up and Go (TUG) test scores (adjusted OR 1.66; 95 % CI 1.11–2.47), impaired instrumental activities of daily living (adjusted OR 1.50; 95 % CI 1.06–2.12) and Mini Mental State Examination scores <18 (adjusted OR 2.27; 95 % CI 1.41–3.65).

Conclusion

PID use was highly prevalent and associated with impaired functional outcomes. This highlights the importance of clinicians conducting regular reviews of drug therapy.

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Acknowledgments

The authors also thank the Social Insurance Institution of Finland and City of Kuopio for supporting the Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) Study. No other sources of funding were used to assist in the preparation of the manuscript.

Conflict of interest

The authors report no conflicts of interest relevant to the content of the manuscript. J Simon Bell, PhD, and Jouni Ahonen, PhD, contributed equally to this manuscript and are joint first authors.

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Authors and Affiliations

  1. Kuopio Research Centre of Geriatric Care, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland

    J. Simon Bell, Jouni Ahonen, Piia Lavikainen & Sirpa Hartikainen

  2. Clinical Pharmacology and Geriatric Pharmacotherapy Unit, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland

    J. Simon Bell, Jouni Ahonen, Piia Lavikainen & Sirpa Hartikainen

  3. Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia

    J. Simon Bell

  4. Pharmacy Department, Kuopio University Hospital, Kuopio, Finland

    Jouni Ahonen

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  1. J. Simon Bell
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Correspondence to J. Simon Bell.

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Bell, J.S., Ahonen, J., Lavikainen, P. et al. Potentially inappropriate drug use among older persons in Finland: application of a new national categorization. Eur J Clin Pharmacol 69, 657–664 (2013). https://doi.org/10.1007/s00228-012-1372-9

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  • DOI: https://doi.org/10.1007/s00228-012-1372-9

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