Background
Methods
Sample
Data collection
Measurements
Excluded from the criteria independent of disease or condition:
| |
Because the drugs were unavailable in Japan
| |
Propoxyphene | Hyoscyamine |
Trimethobenzamide | Tripelennamine |
Carisoprodol | Dexchlorpheniramine |
Medaxalone | Cyclandelate |
Cyclobenzaprine | Meperidine |
Chlordiazepoxide-amitriptyline | Ketorolac |
Perphenazine-amitriptyline | Daily fluoxetine |
Doxepine | Orphenadrine |
Meprobamate | Guanethidine |
Oxazepam | Guanadrel |
Temazepam | Nitrofurantoin |
Clidinium-chlordiazepoxide | Mesoridazine |
Halazepam | Mineral oil |
Chlorazepate | Amphetamines (excluding methylphenidate hydrochloride and anorexics) |
Because long-term use could not be tracked
| |
Long-term use of full-dosage, longer-half life, non-COX-selective NSAIDs | |
Long-term use of stimulant laxatives | |
Excluded from the criteria dependent on disease or condition:
| |
Because the drug was unavailable in Japan
| |
Seizure disorder (Bupropion was unavailable.) | |
Because the patients with these disease or conditions could not be identified
| |
Gastric or duodenal ulcers | SIADH/hyponatremia |
Bladder outflow obstruction |
Statistical analysis
Results
Characteristics | Number of patients as a percentage of the total (N = 1669) |
---|---|
Gender | |
Male | 25.3 |
Female | 74.7 |
Age | |
65 – 69 | 3.7 |
70 – 74 | 7.1 |
75 – 79 | 13.9 |
80 – 84 | 22.2 |
85 – 89 | 24.8 |
90 - | 28.4 |
Mean age (years) | 84.5 |
4 or more diseases | 31.4 |
ADL score of 2 or more* | 69.1 |
CPS score of 2 or more** | 76.3 |
DRS score of 3 or more*** | 7.1 |
Number of medications | |
1 or more | 94.1 |
6 or more | 36.2 |
9 or more | 11.9 |
Psychotropic drug use | 18.6 |
Drugs | Severity* | Number of patients as a percentage of total (N = 1669) |
---|---|---|
Pentazocine | High | 0.2 |
Muscle relaxants and antispasmodics | High | 0.9 |
Amitriptyline | High | 0.0 |
Long-acting benzodiazepines | High | 1.9 |
Disopyramide | High | 0.2 |
Digoxin >0.125 mg/d | Low | 0.0 |
Short-acting dipyridamole | Low | 0.0 |
Gastrointestinal antispasmodic drugs | High | 0.1 |
Anticholinergics and antihistamines | High | 1.4 |
Ferrous sulfate>325 mg/d | Low | 0.2 |
Ticlopidine | High | 6.3 |
Doxazosin | Low | 1.5 |
Thioridazine | High | 0.1 |
Short-acting nifedipine | High | 2.0 |
Cimetidine | Low | 1.5 |
Indomethacin | High | 0.1 |
Desiccated thyroid | High | 0.1 |
Methyldopa | High | 0.1 |
Use of any inappropriate drugs | 21.1 |
Disease or condition | Drug | Severity | n/N * | % |
---|---|---|---|---|
Heart failure | Disopyramide, high sodium content drugs | High | 4/114 | 3.5 |
Seizures or epilepsy | Chlorpromazine, thioridazine | High | 2/57 | 3.5 |
Blood clotting disorders or receiving anticoagulant therapy | Aspirin, NSAIDs, dipyridamole, ticlopidine | High | 4/27 | 14.8 |
Stress incontinence** | α-Blockers, anticholinergics, tricyclic antidepressants, long-acting benzodiazepines | High | 89/1028 | 8.7 |
Arrhythmias | Tricyclic antidepressants | High | 1/106 | 0.9 |
Insomnia | Decongestants, theophylline, methylphenidate, MAOI, amphetamines | High | 4/92 | 4.3 |
Parkinson's disease | Metoclopramide, conventional antipsychotics | High | 19/88 | 11.4 |
Cognitive impairment | Barbiturates, anticholinergics, antispasmodics, muscle relaxants, CNS stimulants | High | 52/1273 | 4.1 |
Depression | Sympatholytic agents | High | 8/119 | 6.7 |
Syncope or falls | Short to intermediate-acting benzodiazepine, tricyclic antidepressants | High | 23/103 | 22.3 |
COPD | Long-acting benzodiazepines, β-blockers | High | 1/44 | 2.3 |
Chronic constipation | Calcium channel blockers, anticholinergics, tricyclic antidepressants | Low | 165/548 | 30.1 |
Use of any of above for each disease or condition | 300/1669 | 18.0 |
Variable | Odds ratio | 95%CI | P value | Correlation coefficient* |
---|---|---|---|---|
Psychotropic drug use | 1.528 | 1.133 – 2.059 | 0.005 | 0.156 |
Medication cost per day** | 1.172 | 1.011 – 1.360 | 0.036 | 0.213 |
Number of medications per day | 1.141 | 1.075 – 1.211 | 0.000 | 0.268 |
Age | 0.981 | 0.965 – 0.998 | 0.029 | -0.124 |