Improper medication use varies widely in Europe

The degree to which elderly home-care patients in Europe are prescribed potentially inappropriate medication varies widely between countries, according to a report in the Journal of the American Medical Association. This seems to be a big problem in the Czech Republic.

Several large surveys have explored potentially inappropriate medication use in the United States. By contrast, relatively little information exists regarding this problem in Europe.

To investigate, Dr. Daniela Faviola, from Charles University in Prague, Czech Republic, and colleagues conducted a study of 2707 home-care patients living in the Czech Republic, Denmark, Finland, Iceland, Italy, the Netherlands, Norway or the UK. Criteria from two expert panels convened in 1997, and one convened in 2003, were used to determine potentially inappropriate medication use.

Using all criteria, nearly 20 percent of subjects used at least one inappropriate medication, the investigators found. When only the criteria from 1993 were used, the rate was around 10 percent.

By far, the country with the highest rate of inappropriate use was Czech Republic at 41 percent. The average rate for the remaining countries studied was 15.8 percent, ranging from 5.8 percent for Denmark to 26.5 percent for Italy.

On a patient basis, poor economic situation and taking multiple drugs each nearly doubled the risk of potentially inappropriate medication use. In addition, anti-anxiety drug use and depression increased the risk of inappropriate use. In contrast, living alone and being at least 85 years of age cut the risk by about 23 percent each.

"Because one of the current principal aims of the European Union is to improve practice, rules, and regulations throughout Europe, harmonizing drug policy and regulatory measures with respect to potentially inappropriate medication use should be a major focus," the investigators emphasize.

SOURCE: Journal of the American Medical Association, March 16, 2005.