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Frequency and risk factors of potentially inappropriate medication use in a community-dwelling elderly population: results from the 3C Study

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Objective

To estimate the frequency of potentially inappropriate medication use among community-dwelling elderly subjects and to identify socio-demographic factors associated with this use.

Methods

Data were collected in the Three-City Study, a French longitudinal study on vascular factors and cognitive decline. The study population was composed of 9,294 subjects aged 65 years and older, living in the community. Inappropriate medication use was assessed using a list derived from the Beers criteria by a panel of French experts.

Results

Nearly 40% of the participants used at least one potentially inappropriate medication: 23.4% used cerebral vasodilators, 9.2% long-acting benzodiazepines and 6.4% drugs with anticholinergic properties. Excluding cerebral vasodilators from the list, the frequency of potentially inappropriate medication use was 21.7%. This use was significantly more frequent among women, older subjects and poorly educated subjects. Adjusted analyses showed that these associations could not be explained by a confounding effect of medical factors. Compared with 13.0% of men with a high educational level, 27.9% of women with a low educational level used at least one potentially inappropriate medication (odds ratio=2.0; 95% confidence interval: 1.7–2.3).

Conclusion

This study is the first attempt to evaluate the frequency of potentially inappropriate medication use in the elderly French population. Female gender and low socio-economic characteristics reduced the chances of receiving optimal pharmacotherapy. The proportion of elderly subjects receiving potentially inappropriate medication was higher than shown in previous studies. This is mainly explained by differences in the use of cerebral vasodilators.

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Acknowledgements

We acknowledge the following persons for serving on our expert panel: Pr. Jean Doucet (Centre Hospitalier Universitaire Bois Guillaume, Service de Gériatrie, Rouen, France), Dr. Jean-Marie Vétel (Centre Hospitalier Universitaire du Mans, Service de Gérontologie Clinique, Le Mans, France), Dr. Gilles Berrut (Hôpital d’Angers, Service de Gérontologie, Angers, France), Pr. Régis Gonthier (Hôpital de la Charité, Service de Gériatrie, Saint-Etienne, France), Pr. Jacques Massol (Masson, La Presse Médicale, Paris, France), Pr. Michel Andréjack (Centre Hospitalier Universitaire d’Amiens, Service de Pharmacologie, Amiens, France), Pr. Louis Merle (Centre Hospitalier Universitaire de Limoges, Centre de Pharmacovigilance, Limoges, France), Dr. Claudine Soubrie (Hôpital de la Salpêtrière, Centre de Pharmacovigilance, Paris, France), Dr. Ghada Miremont-Salamé (Centre Hospitalier Universitaire Pellegrin, Centre de Pharmacovigilance, Bordeaux, France).

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Authors and Affiliations

  1. Département de Pharmacologie, EA 3676 Médicaments, Produits et Systèmes de Santé, Université Victor Segalen Bordeaux 2, 146 rue Léo Saignat, 33076, Bordeaux Cedex, France

    Nathalie Lechevallier-Michel & Annie Fourrier-Réglat

  2. INSERM Unité 360, Hôpital de la Salpêtrière, Paris, France

    Marion Gautier-Bertrand & Annick Alpérovitch

  3. INSERM EMI-9930, Hôpital de la Colombière, Montpellier, France

    Claudine Berr

  4. Service de Gériatrie, Hôpital Charles Foix, Ivry-sur-Seine, France

    Joël Belmin

  5. Service de Gériatrie, Hôpital Bichat, Paris, France

    Sylvie Legrain

  6. Service de Gériatrie, Hôpital Européen Georges Pompidou, Paris, France

    Olivier Saint-Jean

  7. Centre Gériatrique de Champmaillot, CHU de Dijon, Dijon, France

    Béatrice Tavernier

  8. INSERM Unité 593, Université Victor Segalen Bordeaux 2, Bordeaux, France

    Jean-François Dartigues

Authors
  1. Nathalie Lechevallier-Michel
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  2. Marion Gautier-Bertrand
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  3. Annick Alpérovitch
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  4. Claudine Berr
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  5. Joël Belmin
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  6. Sylvie Legrain
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  7. Olivier Saint-Jean
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  8. Béatrice Tavernier
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  9. Jean-François Dartigues
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  10. Annie Fourrier-Réglat
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Consortia

On behalf of the 3C Study group

Corresponding author

Correspondence to Annie Fourrier-Réglat.

Appendix

Appendix

The 3C study group

Scientific Committee: A. Alpérovitch (principal investigator), P. Amouyel, J.F. Dartigues (co-principal investigator), P. Ducimetière, B. Mazoyer, K. Ritchie, C. Tzourio. Coordination and Data Management: C. Dufouil, M. Gautier, S. Artero, C. Helmer, A. Fourrier, A. Alpérovitch. Blood Specimen and DNA bank: P. Amouyel, P. Gambert, N. Fiévet, A. Dupuy. Ultrasound Investigations: M. Zureik, D. Courbon, J. Gariépy, A. Simon, P. Ducimetière. MRI Database: F. Crivello, N. Delcroix, C. Dufouil, P. Guillon, B. Mazoyer, C. Tzourio.

3C-Bordeaux Investigators: J.F. Dartigues (principal investigator), P. Barberger-Gateau, C. Fabrigoule, C. Helmer, L. Letenneur, H. Amieva. Study Staff: V. Cressot, V. Chrysostome, T. Gaida, S. Larrieu, K. Pérès, C. Sourgen. 3C-Dijon Investigators: C. Tzourio (principal investigator), C. Dufouil, A. Elbaz, M. Gautier, M.Giroud. Study Staff: B. Tavernier and B. Février (local coordinators), E. Boiget, L. Charles, C. Desbrosses, S. Gomar, A. Lenoir, M. Maurage, M.P. Monin, J. Rénier. 3C-Montpellier Investigators: K. Ritchie (principal investigator), J. Touchon, F. Portet, M.L. Ancelin, C. Berr, A. Besset, B. Moulard. Study Staff: L. Touati, L. Brissaud, M. Deusy, I. Beluche, M. Renaudin, M.C. Lorenzini, F. Jourdan, J. Norton.

Partnership and supports

The 3C Study was conducted under a partnership agreement between the Institut National de la Santé et de la Recherche Médicale (INSERM), the University Victor Segalen Bordeaux 2. The Fondation pour la Recherche Médicale funded the preparation and initiation of the study.

The 3C Study was also supported by the Caisse Nationale Maladie des Travailleurs Salariés, Direction Générale de la Santé, MGEN, Institut de la Longévité, Agence Française de Sécurité Sanitaire des Produits de Santé, Conseils Régionaux of Aquitaine and Bourgogne, Fondation de France, Ministry of Research - INSERM Programme “Cohortes et collections de données biologiques”.

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Lechevallier-Michel, N., Gautier-Bertrand, M., Alpérovitch, A. et al. Frequency and risk factors of potentially inappropriate medication use in a community-dwelling elderly population: results from the 3C Study. Eur J Clin Pharmacol 60, 813–819 (2005). https://doi.org/10.1007/s00228-004-0851-z

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  • DOI: https://doi.org/10.1007/s00228-004-0851-z

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