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Composition and Cost of Drugs Stored at Home by Elderly Patients

Associate Medical Director, University Hospital (CHUV), Lausanne, Switzerland

Robert Bourgeois, MD

Primary Care Practitioner, Chardonne, Switzerland

Christophe Büla, MD

Medical Director, Division of Geriatric Medicine, University Hospital (CHUV), Lausanne

Bertrand Yersin, MD

Associate Professor, Interdisciplinary Emergency Center, University Hospital (CHUV), Lausanne

Thierry Buclin, MD

Clinical Specialist, Division of Clinical Pharmacology, University Hospital (CHUV), Lausanne

Reprints: Jean-Blaise Wasserfallen MD MPP, University Hospital CHUV, CH-1011 Lausanne, Switzerland, FAX 41 21 314 18 18, E-mail jwasserf{at}chuv.hospvd.ch

BACKGROUND: Elderly people often have multiple chronic diseases, are frequently treated by several physicians, and also use over-the-counter medications. Excessive prescribing, imperfect therapeutic adherence, treatment modifications after hospitalization, and oversized drug packages result in home storage of leftover drugs, resulting in a waste of healthcare resources.

PATIENTS AND METHODS: All patients aged 75 years hospitalized for >24 hours during a 6-month period in an urban teaching hospital in Switzerland were eligible for inclusion in a study collecting sociodemographics, medical, functional, and psychosocial characteristics. Six months later, a research nurse visited the patients at home and recorded the names, number of tablets, and expiration dates of all open or intact drug packages, and the doses actually taken. Acquisition costs of these drugs were computed.

RESULTS: One hundred ninety-five patients were included (127 women; mean age 82.2 ± 4.8 y, range 75–96). They had a total of 2059 drugs (mean per patient 10.3 ± 6.7, range per patient 1–42), corresponding to a total cost of (US) $62 826 (mean per patient 322 ± 275, range per patient 10–1571). Self-reported drug intake was regular for 36% of the drugs (46.5% of total costs) and occasional for 11% (6.1%), whereas 35.7% (30.1%) had been stopped during the last month. Cardiovascular drugs amounted to 36.6% of the drugs and 55.5% of the costs. None of the patients' characteristics was significantly associated with a greater number of drugs and higher costs.

CONCLUSIONS: Drugs stored at home by elderly patients were worth about $320 per patient. Only about one-third of these drugs were regularly taken. In the context of resources shortage, innovative solutions should be found to reduce the waste linked with drugs stopped in previous months.

Key Words: elderly, home health care, pharmacoeconomics, polypharmacy

Published Online, April 1, 2003. www.theannals.com, DOI 10.1345/aph.1C310

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