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

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.