215307 Inappropriate Prescribing for Elderly in Ambulatory Care: A cross sectional study

Monday, November 8, 2010

Sameer Arora, MPH , Department of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, VA
Background: By 2050, 20% of the population will be 65 years of age or older, and the population of elderly over 85 years of age is expected to grow from 5.3 million in 2006 to nearly 21 million by 2050. Elderly patients are 2-3 times more likely to experience an adverse drug event than patients aged 20 to 30 years old.

Objective: Purpose of this study is to describe the prevalence of inappropriate medications prescribing for elderly in non-traditional ambulatory care settings.

Methods: Cross sectional study of 2007 National Ambulatory Medical Survey (NAMCS) analysis involving 233,148 subjects aged 65 years and above. Analysis done using SAS version 9.2

Main Outcome Measure: Physician-reported prescribing of inappropriate medication for elderly as identified by listing of certain medications in the 2007 NAMCS survey.

Results: Health care providers in non-traditional ambulatory care settings are less likely to prescribe inappropriate medications for elderly than in traditional ambulatory care settings (Adjusted odds ratio =0.86{95% confidence interval: 0.83-0.88}). Study results also suggest that psychiatrists are prescribing the potentially inappropriate medications most as compared to other physician specialties.

Conclusion: Health care providers in non-traditional ambulatory settings are less likely to prescribe inappropriate medications for elderly than in traditional ambulatory settings. Physician specialty, Type of health care coverage, Gender , Access to Primary care Physician (PCP) and if seen earlier in practice may directly influence the prescribing of inappropriate medications to elderly. Interventions to improve physician behaviors regarding medication prescription are needed considering the potential for adverse drug events.

Learning Areas:
Clinical medicine applied in public health
Epidemiology
Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
To describe the prevalence of inappropriate drug prescribing for elderly in non-traditional ambulatory care settings. To assess the impact of physician characteristics and patient demographics on prescription of inappropriate medications for elderly in various ambulatory care settings.

Keywords: Elderly, Drug Use

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a prior clinical background working in primary care and I was specifically interested in working on the topics related to use of medications for elderly in ambulatory settings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.