Dr Kathleen Kerse
Registrar, Christchurch Hospital
Registrar, Christchurch Hospital
Prescribing Patterns in Very Elderly Inpatients in Christchurch, New Zealand
Introduction. Advancing age is an important risk factor for both polypharmacy and adverse events related to prescribing. We hypothesise that inpatients aged 90 or over would be prescribed fewer regular medicines than those aged 65-80.
Aims. Compare medicines prescribed to inpatients aged 65-80 and aged 90 or over; both overall number of medicines and frequency of prescribing of particular medicines of interest.
Methods. Retrospective cross-sectional study. Prescribing data pertaining to all hospital inpatients aged 65-80 and 90 or over discharged in Christchurch, New Zealand in the year 2021 were extracted from a database generated by online prescribing software and a dataset with all regular medicines active at discharge generated. Comparative analyses were performed, using t-tests to generate relative risk. Only one admission per individual patient was included, all medical and surgical specialties were included, and medicines prescribed ‘as needed’ were excluded.
Results. 83,400 medicines were active at time of discharge for 11,422 individual patients (9887 aged 65-80 and 1535 aged 90 or over) during 2021. Patients aged 90 or over were prescribed fewer medicines overall (7.31 vs 6.64, P value <.001), a smaller difference than expected. Frequency of polypharmacy (five to nine medicines) was similar (50.4 vs 52.4%), but hyperpolypharmacy (ten or more medicines) was less common in the older group (RR 0.77, P value <0.001). The older group were more likely to be prescribed anticoagulants (RR 1.21), sleeping aids (RR 2.1), haloperidol (RR 3.57) and furosemide (RR 2.35), and less likely to be prescribed antihypertensives (RR 0.56), statins (RR 0.56), tramadol (RR 0.25) and non-steroidal anti-inflammatory drugs (RR 0.09).
Conclusion. Though limited by absence of community data and medicine indication, our large population demonstrates that those aged 90 or over are still prescribed many medicines, some of which they may not benefit from.
Introduction. Advancing age is an important risk factor for both polypharmacy and adverse events related to prescribing. We hypothesise that inpatients aged 90 or over would be prescribed fewer regular medicines than those aged 65-80.
Aims. Compare medicines prescribed to inpatients aged 65-80 and aged 90 or over; both overall number of medicines and frequency of prescribing of particular medicines of interest.
Methods. Retrospective cross-sectional study. Prescribing data pertaining to all hospital inpatients aged 65-80 and 90 or over discharged in Christchurch, New Zealand in the year 2021 were extracted from a database generated by online prescribing software and a dataset with all regular medicines active at discharge generated. Comparative analyses were performed, using t-tests to generate relative risk. Only one admission per individual patient was included, all medical and surgical specialties were included, and medicines prescribed ‘as needed’ were excluded.
Results. 83,400 medicines were active at time of discharge for 11,422 individual patients (9887 aged 65-80 and 1535 aged 90 or over) during 2021. Patients aged 90 or over were prescribed fewer medicines overall (7.31 vs 6.64, P value <.001), a smaller difference than expected. Frequency of polypharmacy (five to nine medicines) was similar (50.4 vs 52.4%), but hyperpolypharmacy (ten or more medicines) was less common in the older group (RR 0.77, P value <0.001). The older group were more likely to be prescribed anticoagulants (RR 1.21), sleeping aids (RR 2.1), haloperidol (RR 3.57) and furosemide (RR 2.35), and less likely to be prescribed antihypertensives (RR 0.56), statins (RR 0.56), tramadol (RR 0.25) and non-steroidal anti-inflammatory drugs (RR 0.09).
Conclusion. Though limited by absence of community data and medicine indication, our large population demonstrates that those aged 90 or over are still prescribed many medicines, some of which they may not benefit from.
