[Polypharmacy among elderly patients in Luxemburg].

BACKGROUND: Since years it was suspected that a large number and possibly inappropriate medicines were prescribed to patients > 65y.

OBJECTIVE: The objective of this study was the inventory of polypharmacy and the inappropriate drugs prescribed to patients of 65 years and older during the year 2008 in Luxembourg.

DESIGN: For this study anonymized data were used from the data base of the medical control administration of the social security CMSS ("administration du contrôle médical de la sécurité sociale").

RESULTS: 580 general practitioners (GPs) had written 399 401 prescriptions for 58 592 patients.1080 medical specialists had written 272 197 prescriptions for 50 609 patients. Drug therapies prescribed by GPs cost 641,26 € per patient and prescribed by medical specialists 559,12 € per patient in 2008. Quantitative polypharmacy was prescribed to 17, 91% of patients (19, 99% to women and 14, 83% to men) by GPs. Medical specialists prescribed polypharmacy to 8,65% of patients (7,98% to women and 9,59% to men) by GPs. Among the 20 most prescribed drugs, inappropriate medicines for seniors were observed in the group of GPs as well as in the group of medical specialists. Family doctors prescribed inappropriate drugs to 13, 69% of patients and medical specialists to 5,46% of patients. In both groups lorazepam, zolpidem and lormetazepam have been identified as inappropriate active pharmaceutical ingredient (API).

CONCLUSION: The pivotal role of the GPs in drug therapy of the elderly could be established. Polypharmacy as well as inappropriate drug prescriptions were more frequently observed in the group of GPs than in the group of medical specialists. Benzodiazepines and analogues are the most prescribed inappropriate medications to the elderly.