DRUG-USE BY THE ELDERLY IN ITALY

OBJECTIVES: To evaluate drug consumption in the elderly aged 75 years or more living at home. DESIGN: Cross-sectional study. SETTING: Old-ol d (i.e., greater than or equal to 75 y) people living in central Turin , a city in northern Italy. PARTICIPANTS: Thirty-four general practiti oners (GPs), with 50 or more old-old people in their patient list, ran domly chosen among the GPs working in the Unita Socio-Sanitaria Locale I (Local Health Unit I) of Turin; 261 old-old people (135 men and 126 women) randomly selected from the practice records. METHODS: Data wer e collected by the GP through a structured questionnaire during an off ice visit and by a social worker in a home interview within 14 days of the GP visit. GPs were asked to record every diagnosis and drug curre ntly taken by the patient; social workers were trained in the administ ration of a structured questionnaire exploring sociodemographic variab les, drug use (following the medication inventory strategy), disabilit y, cognitive functions, and depressive symptoms. RESULTS: Nearly all s ubjects (95% of the women and 91% of the men) were taking at least 1 d rug. The overall number of drugs recorded was 917 (47.1% for men and 5 2.9% for women), of which 172 (18.8%) were not reported by the GP but were recorded during the social worker's visit. The mean number of dru gs was 3.2 for men and 3.8 for women, with a statistically significant difference (p = 0.02), while the mean number of diagnoses was 2.3 and 2.6, respectively, The study of correlates of drug consumption showed a strong association with number of diagnoses at univariate analysis (p < 0.0001, with a linear correlation coefficient of 0.64), No multiv ariate model showed a clear superiority over the simple one containing only the number of diagnoses in predicting the total number of drugs taken. Cardiovascular, nervous system, and alimentary tract drugs were the most frequently used. A total of 107 subjects (41%) were taking a t least 1 unreported drug, CONCLUSIONS: Our study shows high drug cons umption among old-old people, with nearly 20% of drugs taken not repor ted by the GP, These results emphasize the need for an essential thera peutic approach in old-old people, prescribing only drugs of scientifi cally proven efficacy. Furthermore, the GP must make more effort when collecting a drug history from old-old patients.