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Changes in drug prescribing to Italian community-dwelling elderly people: the EPIFARM–Elderly Project 2000–2010

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the changes in the last decade (2000–2010) in drug prescribing among community-dwelling elderly people aged 65–94 years, in relation to age and sex.

Methods

We analyzed the data of nearly two million subjects ranging in age from 65 to 94 years recorded in the Drug Administrative Database of the Lombardy Region (Italy) from 2000 to 2010. Associations between drug use (at least one drug, one chronic drug, polypharmacy or chronic polypharmacy) and age, sex, and year of prescription were analyzed by logistic regression analysis. We also analyzed differences in changes linked to sex and age.

Results

Between 2000 and 2010, the prescriptions of at least one drug or one chronic drug increased by 2 % (from 88.0 to 90.3 %; p < 0.0001) and 8 % (from 73.8 to 82.0 %; p < 0.0001), respectively, while the mean number of packages/person/year rose from 34.6 [standard deviation (SD) 32.4] to 48.5 (SD 42.2). During this same period, there was a 10 % increase in the prevalence of elderly people exposed to polypharmacy (≥5 different active substances) (from 42.8 to 52.7 %; p < 0.0001), and the prevalence of those exposed to chronic polypharmacy (≥5 different chronic drugs) doubled (from 14.9 to 28.5 %; p < 0.0001). Males were less frequently treated than females, except for chronic polypharmacy. People aged ≥80 years showed the largest increase in all prescribing patterns. Drug consumption in ATC groups A, H, and N (women) and in B and C (men) increased most, with the greatest absolute differences occurring in the consumption of proton pump inhibitors (31.1 %), platelet aggregation inhibitors (30.1 %), and statins (23.8 %).

Conclusion

Prescriptions to community-dwelling elderly people have increased substantially during the last 10 years. Although this might indicate an improvement in care, the large increase in the number of elderly people exposed to polypharmacy and chronic polypharmacy should be carefully analyzed in terms of quality of care, patient safety, and costs.

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Competing interests

None.

Funding

This study was supported by grants from the Region Health Ministry of the Lombardy Region (Progetto ‘EPIdemiologia dei FARMaci’ – EPIFARM).

Ethics approval

All data were managed according to the current Italian law on privacy.

Author information

Authors and Affiliations

  1. Laboratory for Quality Assessment of Geriatric Therapies and Services, IRCCS-Istituto di Ricerche Farmacologiche “Mario Negri”, Via Giuseppe La Masa, 19, 20156, Milan, Italy

    Carlotta Franchi, Luca Pasina, Codjo Djade Djignefa & Alessandro Nobili

  2. Laboratory of Geriatric Neuropsychiatry, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy

    Mauro Tettamanti

  3. Regional Health Ministry, Lombardy Region, Milan, Italy

    Ida Fortino, Angela Bortolotti & Luca Merlino

Authors
  1. Carlotta Franchi
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  2. Mauro Tettamanti
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  3. Luca Pasina
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  4. Codjo Djade Djignefa
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  5. Ida Fortino
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  6. Angela Bortolotti
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  7. Luca Merlino
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  8. Alessandro Nobili
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Corresponding author

Correspondence to Carlotta Franchi.

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Franchi, C., Tettamanti, M., Pasina, L. et al. Changes in drug prescribing to Italian community-dwelling elderly people: the EPIFARM–Elderly Project 2000–2010. Eur J Clin Pharmacol 70, 437–443 (2014). https://doi.org/10.1007/s00228-013-1621-6

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  • DOI: https://doi.org/10.1007/s00228-013-1621-6

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