Key result
Furosemide and atorvastatin were the most prescribed drugs among 2.2 million older adults in Portugal, with significant geographic variation and high potentially inappropriate prescribing in females.
Why the study?
Multiple medication use in older adults is associated with a higher risk of adverse drug reactions and potentially inappropriate medication, prompting an evaluation of top prescribed substances and geographical variation.
Observational (n=2,228,090)
Cardiovascular medications like furosemide and atorvastatin are the most prescribed drugs among older adults in Portugal, with significant geographic variation and notable rates of potentially inappropriate prescribing of benzodiazepines and opioids in women.
Answers are grounded in this paper and cite their sources.
Supports targeted PIM review in older Portuguese women; leaves open drivers of regional prescribing variation.
Background: The use of multiple medications by older adults is considered a Public Health concern since it is associated to a higher risk of adverse drug reactions and potentially inappropriate medication (PIM). This study aimed to describe the top-10 prescribed active substances in older adults considering geographical distribution and PIM prescription. Methods: A retrospective ecological study was conducted using data on the prescribed active substances during 2020 to people with 65 years or older. Information on active substances and defined daily doses (DDD) by age group, sex and region were retrieved from a Portuguese health administrative database. The average number of prescribed packages and DDD per 1000 inhabitants per day of top-10 active substances were calculated. Results: A total of 2228090 older adults (58% females) were included. The active substances with higher prescription rates (mean DDD/1000 inhabitants/day) in all ARS were furosemide and atorvastatin in both males and females, compared to the other active substances of the top-10. Geographic differences in prescription were observed (higher prescription in ARS North and Centre and lower in ARS Algarve). In females, 2/10 most prescribed active substances were PIM (benzodiazepines and opioids) with geographic disparities across regions. Conclusions: Most prescribed active substances to older adults belong to the cardiovascular system. The prescription of benzodiazepines and opioids in females, classified as PIM, alert for the need of public health policies to reduce inappropriate prescribing. Geographic differences in the top-10 most prescribed active substances and in PIM highlighted the importance of medication optimisation across regions.
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Roque et al. (2022) conducted an observational in Medication use and potentially inappropriate prescription (n=2,228,090). Prescription medications was evaluated on Average number of prescribed packages and defined daily doses (DDD) per 1000 inhabitants per day of top-10 active substances. Furosemide and atorvastatin were the most prescribed drugs among 2.2 million older adults in Portugal, with significant geographic variation and high potentially inappropriate prescribing in females.
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