Quality indicators of drug therapy at hospital admission among elderly patients

Objective: Increased morbidity and higher prevalence of medication use commonly coexists among the elderly. When managed appropriately, older patients can benefit from drug therapy. However, drug related problems are more frequent and more serious in the elderly. The aim of the study was to assess the quality of medication use in older people at hospital admission. Material and methods: A retrospective medical record review was performed for patients 70 years and older who had an unplanned admission to the internal medicine and geriartic units at Landspitali University Hospital in 2007. Among the sampled medical records, 913 met inclusion criteria. Assessment was carried out using 15 drug-specific quality indicators. Results: Mean age was 80.9 years and 54.5% were women. Mean number of drugs at admission was 7.0 for women and 6.5 for men (p=0.047). The prevalence of having one or more quality indicators on admission was 48.4%. Women were more likely to have a quality indicator than men (women 56.2%, men 39.9%). The probability also increased with increasing age and number of drugs. Conclusions: The quality of drug therapy among older patients at hospital admission appears to be suboptimal. A more accurate estimate of the problem could be obtained through a prospective study where drug regimens are correlated with symptoms and reason for admission. Additional studies are also needed in the outpatient setting. Such studies could provide more accurate evidence and assist policy making towards improved quality of drug prescribing for a growing number of older patients.