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Table 1 Prevalence* of Inappropriate Medication Use (IMU), characteristics of studies (1990-2010)

From: Inappropriate medication use among the elderly: a systematic review of administrative databases

Reference/Year Country/Cohort** Population characteristics Sample(N); Sex (% Males); Age (years) Criteria# Prevalence
Lai et al., 2009 [21] Taiwan/NHIRD N = 2 133 864 elderly Age: ≥ 65 Beers 2002 (excluded drug-disease interaction, short-acting bzd, medications not marketed in Taiwan, not reimbursed by NHI and classified as second-degree controlled substances) 62.5%
Fick et al., 2008 [35] USA/Southeast Managed Care Organization N = 16 877 elderly Males:39% *** Age: ≥ 65/mean = 73.3(SD = 6.47) Beers 2002 (do not use, excluded oxybutinin, dose) 40.7%§
Pugh et al., 2008 [26] USA/VA N = 850 154 elderly Males: 98% Age: ≥ 65 Zhan 26.2%
Bierman et al., 2007 [27] USA/VA N = 965 756 elderly Males: 98%*** Age: ≥ 65 years Zhan 23% (men); 26.7% (women)
Roughead et al., 2007 [23] Australia/VA N = 192 363 elderly Males: 52.6% Age: ≥ 70/mean = 81.7(SD = 4.8) Beers 2002/McLeod (do not use) 21.2%§
Barnett et al., 2006 [28] USA/VA N = 123 633 elderly Males:97.3% Age: ≥ 65/mean = 74.7(SD = 5.8) Zhan 21.3%§§
Maio et al., 2006 [22] Italy/Emilia Romagna outpatient prescriptions claims database N = 849 425 elderly Males: 41.1%*** Age: ≥ 65/mean = 75.6(SD = 7.5) Beers 2002 (do not use; excluded medications not marketed in Italy or not reimbursed by the Italian National Formulary) 18%
Pugh et al., 2006 [30] USA/NPCD/VA/Large Health Survey of Veterans N = 1 096 361 elderly Males: 98%*** Age: ≥ 65 HEDIS 2006 19.6%
Zuckerman et al., 2006 [34] USA/MarketScan Medicare Supplemental and Coordination of Benefits N = 487 383 elderly Males: 55.5% Age: ≥ 65/mean = 73.8(SD = nr) Beers 2002 41.9%
Pugh et al., 2005 [24] USA/VA N = 1 265 434 elderly Males: 98% Age: ≥ 65/mean = 73.5(SD = 5.6) Beers 1997 (dose)/Zhan 23%
Rigler et al., 2005 [36] USA/Kansas Medicaid beneficiaries N = 1 163 elderly Males: 30.5% Age: ≥ 60 Beers 1997 (do not use) 21%
Simon et al., 2005 [29] USA/10 HMOs N = 157 517 elderly Males: 43.5% Age: ≥ 65 Zhan 28.8% (95% CI 28.6-29.1) §§
Curtis et al., 2004 [37] USA/Advanced PCS N = 765 423 elderly Males: 41.7%*** Age: ≥ 65/mean = 73.7(SD = 6.5) Beers 1997 (do not use) 21.2%
Howard et al., 2004 [25] Canada/OCB/RPDB N = 777 elderly Males: 37.5% Age: ≥ 65/mean = 74.1(SD = 6.0) Beers 1991/Beers 1997 (included bzd with > 30 days supply and > 1 bzd or NSAID simultaneously) 16.3%
Rigler et al., 2004 [39] USA/Kansas Medicaid beneficiaries N = 1 163 elderly Males: 30.5% Age: ≥ 65 Beers 1997 (do not use) 21%
Fick et al., 2001 [33] USA/Southeastern HMO N = 2 336 elderly Males: 40.2%*** Age: ≥ 65 Beers 1997(do not use) 24.2%
Mott & Meek, 2000 [38] USA/Database of ambulatory pharmacies of a Midwestern state N = 1 185 elderly Males:35.7%*** Age: range 65-97/mean = 74.9(SD = 7.06) Beers 1997 (do not use) 14.3%
Piecoro et al., 2000 [31] USA/Kentucky Medicaid Recipients N = 44 259 elderly Age: ≥ 65 Beers 1997 (do not use, excluded antihistamines) 24.4%
Futterman et al., 1997 [32] USA/HMO Medicare plan/PBM N = 10 076 elderly Age: ≥ 65 Beers 1991 11.53% (1994); 12.8% (1993)
  1. * in the preceding year
  2. ** Advanced PCS = outpatient prescription claims database of national pharmaceutical benefit manager; HMO = Health Maintenance Organizations; NHI = National Health Insurance program; NHIRD = National Health Insurance Research Database - year 2004; NPCD = National Patient Care Database; OCB = Ontario Drug Benefit Plan; PBM = Pharmaceuticals benefit manager; RPDB = Registered Persons Database; VA = Veterans Affairs administrative and pharmacy database.
  3. *** Recovered values; nr = not reported
  4. # data in brackets refer to the subtype or modification of criteria used in the study: "do not use" refers to drugs that should be avoided in any circumstances, "dose" refers to drug doses that should not be exceeded and "drug-disease interactions" refers to drugs to avoid in patients with specific conditions; bzd = benzodiazepines; HEDIS = Healthcare Effectiveness Data and Information measures.
  5. § prevalence in the preceding 6 months; §§ prevalence in the preceding 18 months