Pharmacoepidemiology and Prescription

European Journal of Clinical Pharmacology

, Volume 60, Issue 11, pp 813-819

First online:

Frequency and risk factors of potentially inappropriate medication use in a community-dwelling elderly population: results from the 3C Study

  • Nathalie Lechevallier-MichelAffiliated withDépartement de Pharmacologie, EA 3676 Médicaments, Produits et Systèmes de Santé, Université Victor Segalen Bordeaux 2
  • , Marion Gautier-BertrandAffiliated withINSERM Unité 360, Hôpital de la Salpêtrière
  • , Annick AlpérovitchAffiliated withINSERM Unité 360, Hôpital de la Salpêtrière
  • , Claudine BerrAffiliated withINSERM EMI-9930, Hôpital de la Colombière
  • , Joël BelminAffiliated withService de Gériatrie, Hôpital Charles Foix
  • , Sylvie LegrainAffiliated withService de Gériatrie, Hôpital Bichat
  • , Olivier Saint-JeanAffiliated withService de Gériatrie, Hôpital Européen Georges Pompidou
  • , Béatrice TavernierAffiliated withCentre Gériatrique de Champmaillot, CHU de Dijon
  • , Jean-François DartiguesAffiliated withINSERM Unité 593, Université Victor Segalen Bordeaux 2
    • , Annie Fourrier-RéglatAffiliated withDépartement de Pharmacologie, EA 3676 Médicaments, Produits et Systèmes de Santé, Université Victor Segalen Bordeaux 2 Email author 
    • , On behalf of the 3C Study group

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Abstract

Objective

To estimate the frequency of potentially inappropriate medication use among community-dwelling elderly subjects and to identify socio-demographic factors associated with this use.

Methods

Data were collected in the Three-City Study, a French longitudinal study on vascular factors and cognitive decline. The study population was composed of 9,294 subjects aged 65 years and older, living in the community. Inappropriate medication use was assessed using a list derived from the Beers criteria by a panel of French experts.

Results

Nearly 40% of the participants used at least one potentially inappropriate medication: 23.4% used cerebral vasodilators, 9.2% long-acting benzodiazepines and 6.4% drugs with anticholinergic properties. Excluding cerebral vasodilators from the list, the frequency of potentially inappropriate medication use was 21.7%. This use was significantly more frequent among women, older subjects and poorly educated subjects. Adjusted analyses showed that these associations could not be explained by a confounding effect of medical factors. Compared with 13.0% of men with a high educational level, 27.9% of women with a low educational level used at least one potentially inappropriate medication (odds ratio=2.0; 95% confidence interval: 1.7–2.3).

Conclusion

This study is the first attempt to evaluate the frequency of potentially inappropriate medication use in the elderly French population. Female gender and low socio-economic characteristics reduced the chances of receiving optimal pharmacotherapy. The proportion of elderly subjects receiving potentially inappropriate medication was higher than shown in previous studies. This is mainly explained by differences in the use of cerebral vasodilators.

Keywords

Drug use Aged Beers criteria Epidemiology