Drugs & Aging

, Volume 23, Issue 4, pp 333–343 | Cite as

Use of Inappropriate Medications and Their Prognostic Significance Among In-Hospital and Nursing Home Patients with and without Dementia in Finland

  • Minna M. Raivio
  • Jouko V. Laurila
  • Timo E. Strandberg
  • Reijo S. Tilvis
  • Kaisu H. Pitkälä
Original Research Article



Although the Beers criteria have been frequently utilised to describe the use of inappropriate medications in various elderly populations, less is known about the use of such medications among patients with dementia, and nor have many studies dealt with their impact on mortality or use of healthcare services. This study examines the use of inappropriate drugs and their impact on mortality and use of health services among Finnish elderly nursing home and hospital patients. Patients with dementia were studied as a special subgroup.


A total of 425 patients consecutively admitted to seven Finnish nursing homes and two hospitals in 1999–2000 were examined. Details of all medications prescribed and administered were retrieved from medical records and coded according to the Beers 1997 criteria. Mortality data as well as days in acute hospital were obtained from central registers and all area hospitals during 2 years of follow-up.


The entire population was old and frail (mean age 86 years, 82% females), 60% had dementia and 36.2% received at least one potentially inappropriate drug (PID). No differences existed in the proportion of users of PIDs among those 60% of patients with dementia compared with those without. The most common PID was temazepam, with 14% of all patients on high doses. Other commonly used PIDs were oxybutynin and dipyridamole. Amitriptyline was more commonly used among patients without dementia (4.7%) compared with those with dementia (0.8%). Nevertheless, in this very old and frail study population, use of inappropriate drugs did not predict mortality or use of health services.


Use of PIDs is common in nursing homes and hospitals in Finland but has no impact on mortality or hospital admissions. Use of high-dose temazepam as a hypnotic accounted for most of the high use of PIDs.


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Copyright information

© Adis Data Information BV 2006

Authors and Affiliations

  • Minna M. Raivio
    • 1
    • 2
  • Jouko V. Laurila
    • 3
  • Timo E. Strandberg
    • 4
  • Reijo S. Tilvis
    • 1
  • Kaisu H. Pitkälä
    • 5
    • 6
  1. 1.Department of General Internal Medicine and GeriatricsUniversity of HelsinkiHelsinkiFinland
  2. 2.Memory Research And Treatment Centers FinlandMedical Center HemoLahtiFinland
  3. 3.Department of General Internal Medicine and GeriatricsHelsinki University HospitalHelsinkiFinland
  4. 4.Department of Public Health Science and General PracticeUniversity of Oulu and University HospitalOuluFinland
  5. 5.Department of General Practice and Primary Health CareUniversity of HelsinkiHelsinkiFinland
  6. 6.The Central Union for the Welfare of the AgedHelsinkiFinland

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