Potentially inappropriate medication in older persons in Austria: A nationwide prevalence study

Background: Potentially inappropriate medication (PIM) is associated with adverse outcomes like hospitalisation and death. The aim of this study was to assess the nationwide prevalence of PIM among aged Austrians in 2012. Methods: We analysed pseudonymised claims data of all 19 Austrian Statutory health insurances including all prescriptions of beneficiaries aged >= 70 years which were reimbursed by the insurances in 2012. Drugs priced <= (sic) 5.15 (which equals the co-payment demanded per prescription) could only be included in the analysis if persons were exempted from co-payment. Potential inappropriateness of prescriptions was assessed by means of a recently published Austrian PIM list containing 73 drugs to be avoided in older patients. Results: In the full survey of persons aged >= 70 years, 52.4% of all 1,123,832 insurants were prescribed at least one reimbursed PIM prescription, with higher rates in women (56.9%) than in men (45.8%). The three most often identified PIM groups were non-steroidal anti-inflammatory drugs (28.9%), vasodilators (16.0%) and psychotropic drugs (12.5%). The three most often prescribed inappropriate single drugs included diclofenac (183%), ginkgo biloba (12.5%), and tramadol (8.9%). In insurants who were exempted from co-payment, PIM prevalence was 71.6% and 73.3%. In this person group, high prevalences were found for psychotropic PIM; 33.3% in permanently and 28.3% in temporarily exempted insurants. Conclusions: PIM prescription has a high prevalence in the older Austrian population. Thus, Austria urgently needs a nationwide strategy to reduce the high overall prevalence of PIMs and especially of psychotropic PIMs. (C) 2014 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.