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Table 2 Prevalence of potentially inappropriate medication use in nursing home residents ≥70 years according to NORGEP-NH

From: Potentially inappropriate medication use in nursing homes: an observational study using the NORGEP-NH criteria

NORGEP-NHa List of Explicit Criteria

Freq., regular med. Only, in %

Freq., incl. PRNb medication, in %

A: Single Substance Criteria. The following should be avoided for regular use whenever possible:

1.  Combination analgesic with codeine/paracetamol

0.8

6.8

2.  Tricyclic antidepressants (TCAs) for depression

0.9

0.9

3.  NSAIDs

1.1

7.7

4.  First generation antihistamines

4.5

6.0

5.  Diazepam

1.4

10.7

6.  Oxazepam: Dosage >30 mg/day

0.8

N/A

7.  Zopiclone: Dosage >5 mg/day

14.1

N/A

8.  Nitrazepam

2.8

3.6

9.  Flunitrazepam

0.3

0.3

10.  Chlometiazole

1.2

8.7

11.  Regular use of hypnotics

30.9

N/A

B: Combination Criteria. The following drug combinations should be avoided whenever possible:

12.  Warfarin + NSAIDs

0.0

0.5

13.  Warfarin + SSRI/SNRI

1.6

1.6

14.  Warfarin + ciprofloxacin/ofloxacin/ erythromycin/ clarithromycin

0.3

0.5

15.  NSAIDs/coxibs + ACE-inhibitors/AT2-antagonists

0.2

1.1

16.  NSAIDs/coxibs + diuretics

0.6

3.9

17.  NSAIDs/coxibs + glucocorticoids

0.0

0.0

18.  NSAIDs/coxibs + SSRI/SNRIs

0.2

2.0

19.  ACE-inhibitors/AT2-antagonists + potassium or potassium-sparing diuretics

1.9

1.9

20.  Beta blocking agents + cardioselective calcium antagonists

0.0

0.1

21.  Erythromycin/clarithromycin + statins

0.1

0.1

22.  Bisphosphonate + proton pump inhibitors

1.6

1.7

23.  Concomitant use of three or more psychotropic drugs

14.5

41.5

24.  Tramadol + SSRIs

1.4

6.1

25.  Metoprolol + paroxetine/fluoxetine/bupropion

0.0

0.0

26.  Metformin + ACE-inhibitors/AT2-antagonists + diuretics

1.0

1.0

C: Deprescribing criteria. Need for continued use should be reassessed:

27.  Anti-psychotics

10.3

14.2

28.  Anti-depressants

35.3

35.5

29.  Urologic spasmolytics

0.7

0.7

30.  Anticholinesterase inhibitors

5.9

6.0

31.  Drugs that lower blood pressurec

62.5

65.2

32.  Bisphosphonates

5.4

5.6

33.  Statins

12.1

12.1

34.  General use of preventive medication

N/Ad

N/Ad

  1. aThe Norwegian General Practice criteria for assessing potentially inappropriate prescriptions to elderly patients in Nursing Homes. bPro re nata, drugs given as needed. cIncl. in the figures: All drugs that have the lowering of blood pressure as primary outcome (i.e. hypertensives). Excl. drugs with lower blood pressure as side effect, wanted or unwanted. dCriterion 34 on the NORGEP-NH list, “General use of preventive medication”, was not assessed in this paper, as information was lacking on whether medication was given for the purpose of treatment or prevention. Abbreviations: NSAIDs: Non-steroid anti-inflammatory drugs. SSRIs: Selective serotonin reuptake inhibitors. SRNIs: Selective norepinephrine reuptake inhibitors. Coxibs: Cyclooxygenase-2-selective inhibitors. ACE-inhibitors: Angiotensin-converting enzyme inhibitors. AT2-antagonists: Angiotensin II receptor antagonists
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BMC Geriatrics

ISSN: 1471-2318

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