Consumption of prescribed and over-the-counter medicines with prolonged oral clearance used by the elderly in the Northern Region of England, with special regard to generic prescribing, dose form and sugars content

As the longevity and population of elderly people has increased, the use of regular long-term medication for chronic medical problems has become more common. Medicines with prolonged oral clearance, for example syrups and chewable tablets, are commonly used in the elderly, many of whom retain their natural teeth into old age. These medicines may threaten dental health if they contain acidogenic sugars and are used long-term. As a part of an overall study of medication use in the elderly, three surveys were undertaken to assess the numbers of prescriptions and quantities of prescribed and 'over-the-counter' medicines with prolonged oral clearance dispensed during a I y period (1994), nationally and regionally. Of the 0.51 million litres of liquid oral medicines dispensed potentially for regular and long-term use by the elderly in the Northern Region in 1994, 94% was prescribed in primary care and 4% was sold over-the-counter from community pharmacies. When the effect of generic prescribing upon the sugars content of these medicines was considered, 96% of the volume of proprietary liquid oral medicines dispensed in primary care was sugars-free compared with 9% of generic liquid oral medicines. Of the 0.1 million litres of 'over-the-counter' liquid oral medicines sold in the Northern Region during 1994, 49% were sugars-free. In conclusion, although many prolonged oral clearance medicine preparations are sugars-free, due to generic prescribing a large proportion of the quantities dispensed for possible long-term use in the elderly are sugar-containing liquid oral medicines. In view of the increasing numbers of dentate elderly who require long-term medication, this is of some concern. The role of health professionals in raising awareness of the impact of generic prescribing on the sugars content of medicines is crucial if consumers are to benefit from the sugars-free option.