Non communicable diseases and medicines use in elderly attending public sector hospitals in Sri Lanka
Keywords:
elderly, medicines, appropriateness, Sri LankaAbstract
World population is aging and it is aging fast. Globally there is a dual burden of increase in the elderly population and prevalence of non communicable diseases. Elderly are a special population concerning drug use and are particularly vulnerable for inappropriate prescribing. Elderly population and the chronic diseases are both increasing in Sri Lanka and this study was  conducted to identify the types of diseases for which elderly seek treatment from medical and diabetic clinics, drug categories prescribed and to determine whether prescribing is appropriate.
Materials and methods - We analysed 1114 prescriptions and clinic records of elderly patients (> 60 years) attending medical and diabetic clinics of three selected public hospitals. Data was collected over period of one month from each hospital.
Results - Majority of the elderly patients were females (56.9%). Most were from the 60-69 year age group (58.6%) while the very old (> 80 years) accounted for only 6.4%. The most common diseases for which treatment was given from these clinics were  hypertension, ischaemic heart disease, diabetes mellitus and bronchial asthma. Five or more drugs were prescribed daily to 68% with antiplatelets, statins and diuretics being the most commonly prescribed. Renal function was not documented in 66% of records within the previous year. Antiplatelets were not prescribed to those with ischaemic heart disease (11.1%), strokes (15%) and diabetes (20.9%) despite absence of contraindications documented.
Conclusions - Cardiovascular diseases and diabetes are the chronic diseases that are most commonly treated from these clinics. Prescribing needs to be improved in keeping with accepted guidelines and doses to ensure the desired benefits and minimize harm.
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