The influence of new scientific information on the treatment of elderly patients in general practice

It has been proven that with an increasing number of diseases elderly patie nts are treated by an increasing number of drugs despite the fact that trea tment of elderly persons should be as simple as possible. Simpler dosage of (fewer?) drugs may contribute to a good cooperation on the part of patient s, as well as to a lower incidence of undesirable effects and drug interact ions. Sticking to established medication schemes is another feature observe d in practice, which interferes with the introduction of novelties. The aim of this study was to investigate the actual situation of medication of eld erly patients treated by general practitioners in this country. Between 1996 and 1998, a random group of 1481 patients aged older than 75 w as studied in cooperation with general practitioners. A detailed history wa s obtained and physical examination was performed, signs of depression were assessed, Barthel's test of everyday activities, and IADL (activities of d aily living) and MMSE (Mini Mental State Examination) tests were applied. A unified "Protocol on Examination" was used in which three questions were c oncerned with medication - the kinds of drugs taken by the patient, their n ames and dosage, and whether any hypnotics were taken. The five most frequently prescribed groups include vasodilators (62 % patie nts), cardiotonics (39 %), analgetics (41 %) and Ca-antagonists (25 %). The dynamics of the prescription were remarkable - a significant decrease of t he use of analgetics and cardiotonics was observed in comparison with a sig nificant increase in the use of ACE inhibitors, The number of drugs adminis tered is as follows: while only 1.3 % patients took no drugs, 1.6 % patient s took more than 13 drugs. 61 % patients rank among the categories taking 4 -5 or 6-8 kinds of drugs. On the whole, general practitioners tend to presc ribe medicaments in doses one tablet per day, Conclusions: The results suggest that, even nowadays, elderly patients are treated with a rather high number of medicaments. In contrast, the dosage o f one tablet a day decreases the total number of the tablets taken. A signi ficant influence of new scientific information was visible in the prescript ion habits of general practitioners. Be that as it may, in elderly patients , the simplest possible medication should continue to be aimed at.