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MEDICATION SAFETY

Potentially Inappropriate Medication Use by Elderly Mexican Americans

Assistant Professor and Director, Memory Loss Clinics; Associate Director, The University of Texas Medical Branch Geriatric Fellowship Training Program, Sealy Center on Aging, Department of Internal Medicine, The University of Texas Medical Branch, Galveston, TX

Glenn V Ostir, PhD

Assistant Professor, Sealy Center on Aging, Department of Internal Medicine, The University of Texas Medical Branch

Kyriakos S Markides, PhD

Professor and Director, Sociomedical Sciences Division, Department of Preventive Medicine and Community Health, The University of Texas Medical Branch

David V Espino, MD

Professor and Director, Division of Community Geriatrics, Department of Family & Community Medicine, University of Texas Health Science Center, San Antonio, TX

James S Goodwin, MD

Professor of Medicine, Chief of Geriatrics Division & Director of Sealy Center on Aging, Department of Internal Medicine, The University of Texas Medical Branch

Reprints: Mukaila A Raji MD MSc, Memory Loss Clinics, Sealy Center on Aging, Department of Internal Medicine, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0460, FAX 409/772-6931, muraji{at}utmb.edu

BACKGROUND: Use of inappropriate medications by the elderly is a public health concern with potentially serious health consequences. Research indicates relatively high rates of inappropriate prescription drug usage for older whites and African Americans. However, rates for older Mexican Americans are unknown.

OBJECTIVE: To examine the prevalence and predictors of inappropriate prescription medication use by older Mexican Americans.

METHODS: A cross-sectional study of 3050 Mexican Americans aged 65 years living in the southwestern US was conducted. Inhome interviews in 1993 and 1994 assessed prescription medication use. Descriptive statistics and logistic regression models were used to estimate prevalence and risk of inappropriate prescription drug use.

RESULTS: Approximately 12% (n = 365) of the sample had used at least 1 of 32 potentially inappropriate prescription medications within 2 weeks of the baseline assessment. Four drugs, chlorpropamide, propoxyphene, amitriptyline, and dipyridamole, accounted for 54% of all inappropriate prescribing. Unmarried subjects, those with 1 chronic diseases, high depressive symptoms, frequent physician visits, and combined Medicaid and Medicare insurance were more likely to have used at least 1 of the 32 potentially inappropriate drugs.

CONCLUSIONS: The prevalence of inappropriate medication use is lower in older Mexican Americans than in similar white and African American populations. More studies are needed on the pattern of inappropriate prescribing over time and on intervention programs to reduce potentially adverse health outcomes in older Mexican Americans most at risk.

Key Words: elderly, inappropriate prescribing, Mexican Americans

Published Online, July 25, 2003. www.theannals.com, DOI 10.1345/aph.1C480

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