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Patterns of drug prescription in a geriatric evaluation and management unit as compared with the general medical wards: a randomised study

  • Pharmacoepidemiology and prescription
  • Published:
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Abstract

Objective

This study's objective was to determine whether patients treated in a geriatric evaluation and management unit (GEMU) had a more appropriate drug profile than patients treated in the general medical wards (MW).

Methods

Frail elderly patients admitted as emergencies to the medical department were randomised to treatment in the GEMU (n=127) or MW (n=127). Drugs used at inclusion and discharge were registered retrospectively and analysed with regard to polypharmacy, number of drugs withdrawn or started, potential drug-drug interactions (DDIs), number of anticholinergic drugs prescribed, and the number of inappropriate drug prescriptions according to Beers' criteria. Utilisation of psychotropic and cardiovascular drugs was compared in detail according to prespecified hypotheses.

Results

The number of patients with polypharmacy did not differ significantly between the GEMU and MW. The median number of scheduled drugs withdrawn per patient was higher in the GEMU than in the MW (p=0.005). Drugs with anticholinergic effects (p=0.003); cardiovascular drugs (p<0.001), particularly digitalis glycosides (p<0.001); and antipsychotic drugs (p=0.009) were withdrawn more often in the GEMU. The median number of scheduled drugs started was higher in the GEMU than in the MW (p=0.03). In particular, antidepressants (p<0.001) and estriol (p=0.001) were started more often in the GEMU than in the MW. Fewer GEMU than MW patients had potential DDIs at discharge (p=0.009).

Conclusion

Drug treatment in the GEMU as compared with the MW was more appropriate in terms of prescription of fewer drugs with anticholinergic effects and fewer potential DDIs. There were distinct differences in treatment patterns of cardiovascular and psychotropic drugs.

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Acknowledgements

The authors acknowledge the members of the staff in the Geriatric Evaluation and Management Unit for their enthusiasm and willingness during the study. The study was supported by grants from the Norwegian Ministry of Health and Social Affairs, Saltvedt’s work was supported by the Research Council of Norway. The study complies with the current laws of Norway, including the law of ethics.

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Authors and Affiliations

  1. Section of Geriatrics, Division of Medicine, St. Olavs University Hospital, Trondheim, Norway

    Ingvild Saltvedt & Olav Sletvold

  2. Unit of Applied Clinical Research, Norwegian University of Science and Technology, Trondheim, Norway

    Ingvild Saltvedt, Peter Fayers & Stein Kaasa

  3. Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway

    Ingvild Saltvedt & Olav Sletvold

  4. Department of Clinical Pharmacology, St. Olavs University Hospital, Trondheim, Norway

    Olav Spigset

  5. Department of Laboratory Medicine, Children's and Women's Disease, Norwegian University of Science and Technology, Trondheim, Norway

    Olav Spigset

  6. Section for General Practice, Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway

    Sabine Ruths

  7. Department of Public Health, University of Aberdeen, Aberdeen, UK

    Peter Fayers

  8. Palliative Medicine Unit, Department of Oncology and Radiotherapy, St. Olavs University Hospital, Trondheim, Norway

    Stein Kaasa

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  1. Ingvild Saltvedt
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  2. Olav Spigset
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Correspondence to Ingvild Saltvedt.

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Saltvedt, I., Spigset, O., Ruths, S. et al. Patterns of drug prescription in a geriatric evaluation and management unit as compared with the general medical wards: a randomised study. Eur J Clin Pharmacol 61, 921–928 (2005). https://doi.org/10.1007/s00228-005-0046-2

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  • DOI: https://doi.org/10.1007/s00228-005-0046-2

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