Abstract
Background: The PharE Study (Pharmacovigilance in the Elderly) is an ongoing study in the ASP Catanzaro, Italy, on elderly home care patients affected with dementia. The aim of the present study is: to assess the use of inappropriate drugs; to study the possible drug-drug interactions; to perform the possible strategies for avoiding the potential harmful prescriptions, by using the STOPP and START criteria. Methods: Preliminary data were obtained from 461 home patients, 185 men, 276 women, mean age 81.1 ± 6.8 years old. Overall patients with Alzheimer’s dementia were 39%, vascular and mixed dementia 52%, other dementias 9%. A classification of potential inappropriate drugs was made according to the Beers criteria. Data were collected through an appropriate software able to gather the main information. In the case of suspected adverse event, Naranjo Scale was applied. The study of possible drug-drug interactions was made by Micromedex 2.0. All analyses were performed using the SPSS program version 18.0 for Windows. Results: Patients were functionally impaired (ADL 0.8 ± 1.9, IADL 0.1 ± 0.4) and moderately to severely cognitively impaired (MMSE 12.1 ± 2.5). 71.8% of patients used 5–9 drugs and 10.6% more than 10 drugs. The bivariate relationship between number of drugs and Modification of Diet in Renal Disease (MDRD) showed that the higher the number of drugs used is, the worst is kidney function (p= 0.0001). Among the inappropriate drugs anticholinergic drugs were 13.2%, tricyclics antidepressants 2.8% and ticlopidine 2.1%. Long half-life benzodiazepines were used in 4.3% of patients. Antipsychotics were used in 20% of the cases. Proton pump inhibitors were used in 86.6% of the cases. Some interesting case reports were recorded too. Conclusions: These preliminary data are very impressive and show the need for an accurate choice of drugs in elderly people. The implementation of data collected will bring further details and the application of STOPP and START criteria will improve drug use in older age.