LONGITUDINAL TRENDS IN PRESCRIBING FOR ELDERLY PATIENTS - 2 SURVEYS 4YEARS APART

Background. Elderly people are prescribed more drugs than younger peop le. The consequences of excessive or unwise prescribing, such as drug interactions, are well known. Aim. A longitudinal study was undertaken to examine levels and patterns of prescribed drug use among a group o f elderly people. Method. Use of prescribed drugs by a sample of elder ly people in Nottingham aged 65 years and over was assessed on two occ asions four years apart, in 1985 and 1989. Results. Complete drug data were available for 1003 respondents in 1985 and 662 respondents in 19 89 (with attrition due mainly to mortality). Drug use increased signif icantly with age. Women took significantly more drugs than men. Approx imately half of respondents were taking at least two drugs. The overal l number of drugs per person being taken in 1989 was significantly gre ater than in 1985. This difference remained significant when age and m ortality were controlled suggesting that changes in drug use over time within this sample may reflect genuine changes in prescribing practic e (rather than simply the effects of ageing). The most commonly prescr ibed drug classes on each occasion were drugs for the cardiovascular s ystem, central nervous system, musculoskeletal system, gastro intestin al tract and respiratory system. The subgroups of drugs most commonly reported at each interview were diuretics, hypnotics and anxiolytics, analgesics and nonsteroidal anti-inflammatory drugs. Drugs within the category 'hypnotics and anxiolytics' showed clear and differential tre nds over time, with the use of anxiolytics falling, while the use of h ypnotics increased. Among those respondents admitted to residential ca re during the course of the study higher levels of psychotropic drug u se, and an increase in antipsychotic medication, were observed. Conclu sion. It is important that the drug regimens of elderly people are fre quently reviewed to ensure that only the minimum number of effective d rugs, in the simplest regimen, are prescribed.