Prescription Database (prescription + database)

Distribution by Scientific Domains

Kinds of Prescription Database

  • norwegian prescription database


  • Selected Abstracts


    Prescription pattern of codeine for non-malignant pain: a pharmacoepidemiological study from the Norwegian Prescription Database

    ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 5 2009
    O. M. S. FREDHEIM
    Background: Opioid prescription for pain relief is increasing. Codeine is the dominating opioid in several European countries, with Norway being among the highest codeine users. Aim: To determine whether codeine is primarily used for acute pain or whether there is a prescription pattern indicating problematic opioid use. Methods: All pharmacies in Norway are obliged to submit data electronically to the Norwegian Prescription Database at the Norwegian Institute of Public Health on all dispensed prescriptions. Because all prescriptions are identified with a unique person identifier, it is possible to identify all prescriptions to one subject. All subjects who had prescription(s) of codeine dispensed to them in 2004, 2005 or 2006 are included in the study. Results: 385 190 Norwegian persons had at least one prescription of codeine dispensed to them due to non-cancer pain in 2005, corresponding to a 1-year periodic prevalence of 8.3%. 223 778 (58%) received only one prescription in 2005, 121 025 (31%) received more than one prescription but <120 defined daily doses (DDDs), 30 939 (8%) received between 120 and 365 DDDs, 7661 (2%) between 365 and 730 DDDs, while only 1787 (0.5%) exceeded the maximum recommended dose of 730 DDDs. In the latter group, co-medication with benzodiazepines (65%) and carisoprodol (45%) was prevalent. Conclusion: About one in 10 adult persons in Norway were dispensed codeine in 2005. A majority (58%) received codeine only once, most likely for acute pain, whereas a small minority (0.5%) had a prescription pattern indicating problematic opioid use. [source]


    Self-reported antenatal adherence to medical treatment among pregnant women with Crohn's disease

    ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2010
    M. J. Nielsen
    Aliment Pharmacol Ther 2010; 32: 49,58 Summary Background, Adherence to medical treatment among women with Crohn's disease (CD) prior to and during pregnancy has never been reported. Aim, To examine both the predictors and prevalence rates of non-adherence to maintenance medical treatment among women with CD prior to and during pregnancy Methods, Among a population of 1.6 million inhabitants, we identified a total of 132 women with CD who had given birth during 2000,2005. Questionnaires were used to investigate predictors and extent of adherence. The validity of self-reported use of medication was assessed using data from the Danish Prescription Database. We used logistic regression to estimate prevalence odds ratios for non-adherence according to smoking status and other predictors. Results, Eighty percent of the patients returned the questionnaire. A total of 58 (54%) women reported to have been on medical treatment, 50 of whom had fulfilled a prescription on relevant medication. Adherence to medical treatment was 72%. Fear of a negative effect on fertility/foetus was a reason for non-adherence by 18.8% prior to, and by 45.5% during, pregnancy. Among smokers, 30.8% were non-adherent compared with 11.5% among nonsmokers (prevalence odds ratio 3.41, 95% CI 0.8,14.7). Conclusions, Despite fear of a negative effect on fertility/foetus, adherence to medical treatment is high in women with CD. There is no substantial variation in adherence prior to and during pregnancy. Smoking prior to pregnancy is a predictor of non-adherence. [source]


    Switching statins in Norway after new reimbursement policy , a nationwide prescription study

    BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue 4 2007
    Solveig Sakshaug
    What is already known about this subject ,,Use of statins is growing worldwide and costs represent a burden to public budgets. ,,The introduction of simvastatin generics, generic substitution and price regulations have contributed to price reductions and resulted in overall cost reductions of statin use in Norway. What this study adds ,,New reimbursement regulations for statins in Norway in June 2005, making simvastatin the drug of choice, had a great impact on physicians' prescribing of statins. ,,Nearly 40% of the atorvastatin users switched to simvastatin during the 13-month period after implementation of the new regulations. ,,Among the new users of statins the proportion receiving simvastatin increased from 48% in May 2005 to 92% in June 2006. ,,The new regulations have reduced costs of statins, even though the prevalence of statin use has increased. Aims To assess the changes in prescribing of statins in Norway after implementation of the new reimbursement regulations for statins in June 2005. Methods Data were retrieved from the Norwegian Prescription Database covering the total population in Norway (4.6 million). Outcome measures were the proportion of atorvastatin users switching to simvastatin and changes in the proportion of new statin users receiving simvastatin. Based on retail costs for all statin prescriptions dispensed in Norway, expenditure was measured in Norwegian currency. Results One-year prevalences of statin use increased from 6.3 to 6.8% for women and from 7.5 to 8.1% for men from the year before to the year after the new statin regulations. Of atorvastatin users (N = 131 222), 39% switched to simvastatin during the 13-month period after the implementation. The proportion of switching was higher in women (41%) than in men (36%). In May 2005, 48% of the new statin users received simvastatin. The proportion of new users receiving simvastatin increased rapidly after implementation of the new regulations to 68% in June 2005 and reached 92% in June 2006. Expenditure was reduced from ,120 million to ,95 million when comparing the year before with the year after the new statin regulations. Conclusions The new reimbursement policy for statins has had a great impact on physicians' prescribing of statins in Norway. Physicians in Norway acknowledge the importance of contributing to cost containment. [source]


    Prostate cancer and PSA among statin users in the Finnish prostate cancer screening trial

    INTERNATIONAL JOURNAL OF CANCER, Issue 7 2010
    Teemu J. Murtola
    Abstract Decreased risk of advanced prostate cancer has been reported among men using statins. However, the evidence on overall prostate cancer risk is conflicting. We compared the relative risk between current users and non-users of statins or other cholesterol-lowering medications in a population undergoing systematical prostate cancer screening. The study cohort comprised of 23,320 men participating in the screening arm of the Finnish prostate cancer screening trial during 1996,2004. Information on medication use was obtained from a comprehensive national prescription database. Cox proportional hazards regression was used to calculate multivariable adjusted hazard ratios (HRs) for prostate cancer. Serum prostate-specific antigen (PSA) level was compared between current users and non-users of cholesterol-lowering drugs. Compared with medication non-users, the overall prostate cancer incidence was decreased among statin users [HR 0.75, 95% confidence interval (CI) 0.63,0.89]. The inverse association was dose-dependent with cumulative amount of statin use, and strongest for low-grade and early stage tumors. The incidence was nonsignificantly lower also among users of other types of cholesterol-lowering drugs (HR 0.62, 95% CI 0.28,1.38), but without dose-dependence. Age-adjusted median serum PSA tended to be lower among users of cholesterol-lowering drugs, but the relative risk decrease among statin users was not related to decreased PSA. Overall incidence of prostate cancer was lowered among statin users when bias due to differential PSA testing between medication users and non-users was eliminated by systematical prostate cancer screening. Cholesterol-lowering with statins seems beneficial for prostate cancer prevention. [source]


    Potentially severe drug interactions in elderly outpatients: results of an observational study of an administrative prescription database

    JOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 4 2009
    A. Nobili MD
    Summary Purpose:, To estimate the prevalence of potentially severe drug,drug interactions (DDIs) and their relationship with age, sex and number of prescribed drugs. Methods:, We analysed all prescriptions dispensed from 1 January 2003 to 31 December 2003 to individuals aged 65 or more registered under the Local Health Authority of Lecco, a northern Italian province with a population of almost 330 000 persons. Elderly who received at least two co-administered prescriptions were selected to assess the presence of DDIs. Results:, The prevalence of potentially severe DDIs was 16%, and rose with increasing patient's age and number of drugs prescribed. At multivariate analysis, the adjusted odds ratios rose from 1·07 (95% CI 1·03,1·11) in patients aged 70,74 to 1·52 (95% CI 1·46,1·60) in those aged 85 or older. Elderly taking more than five drugs on a chronic basis had a statistically significant higher risk of sever DDIs than those receiving less than 3 or 3,5 such drugs. Conclusions:, The elderly constitutes a population at high risk of DDIs. As physicians still have some difficulty in managing this problem, it is essential to highlight for them, which factors raise the risk of DDIs. [source]


    Corticosteroid use and risk of hip fracture: a population-based case,control study in Denmark

    JOURNAL OF INTERNAL MEDICINE, Issue 5 2003
    P. Vestergaard
    Abstract. Vestergaard P, Olsen ML, Paaske Johnsen S, Rejnmark L, Toft Sørensen H, Mosekilde L (Aarhus University Hospital, Denmark; and Aarhus and Aalborg University Hospitals; Aarhus, Denmark). Corticosteroid use and risk of hip fracture: a population-based case,control study in Denmark. J Intern Med 2003; 254: 486,493. Background. Corticosteroids (CS) are used in a wide range of conditions but have several possible adverse effects including an increased risk of osteoporotic fractures. Objective. To examine the association between cumulative CS dose and risk of hip fracture. Design. Population-based case,control design. Subjects and methods. A total of 6660 subjects with hip fracture and 33 272 age-matched population controls were identified using the County Hospital Discharge Registry in North Jutland County, Denmark and the Danish Central Personal Registry, respectively. Data on redeemed prescriptions for CS within the last 5 years before the index date were retrieved from a population-based prescription database, and recalculated to prednisolone equivalents. Cases and controls were categorized according to cumulative CS dose: (i) no use; (ii) <130 mg (e.g. equivalent to 30 mg of prednisolone for 4 days given for an acute exacerbation of asthma); (iii) 130,499 mg (e.g. equivalent to a short course of prednisolone of 450 mg for acute asthma); (iv) 500,1499 mg (e.g. equivalent to 7.5 mg prednisolone daily for 6 months or 800 ,g day,1 of inhaled budesonide for 1 year); and (v) ,1500 mg (e.g. equivalent to >4.1 mg day,1 for 1 year, a long-term high dose). Data were analysed using conditional logistic regression adjusted for potential confounders including gender, redeemed prescriptions for hormone replacement therapy, antiosteoporotic, anxiolytic, antipsychotic and antidepressant drugs. Results. Compared with never users, an increased risk of hip fracture was found for CS users, with increasing cumulative doses of any type of CS use during the preceding 5 years [adjusted odds ratio (OR) = 0.96, 95% confidence interval (CI) = 0.89,1.04] for <130 mg prednisolone; OR = 1.17 (CI = 1.01,1.35) for 130,499 mg; OR = 1.36 (CI = 1.19,1.56) for 500,1499 mg; and OR = 1.65 (CI = 1.43,1.92) for ,1500 mg. An increased risk was also found when the study population was stratified according to gender, age and type of CS (systemic or topical). Conclusions. Even a limited daily dose of CS (more than an average dose of approximately 71 ,g prednisolone per day) was associated with an increased risk of hip fracture. [source]


    Impact of Helicobacter pylori on the management of dyspepsia in primary care

    ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2006
    K. BENNETT
    Summary Background, It is unclear what impact Helicobacter pylori infection has had on the management of dyspepsia in primary care and to what extent published guidelines on H. pylori are implemented in routine clinical practice. Aim, To assess the impact of H. pylori infection on the management of dyspepsia in primary care. Methods, Patients referred by primary care doctors to an open-access 13-carbon urea breath test service over a 2-year period for their first urea breath test were included in the study. Individual breath results were linked with data on prescribing obtained from the General Medical Services prescription database. Results, Of 805 patients, 374 (47%) had a positive urea breath test and 431 (54%) a negative urea breath test. Of positive urea breath test patients, only 245 (64%) were prescribed eradication therapy in the 3 months after the breath test and only 43% were referred back for re-testing. In the year after the urea breath test, there was a significant fall in prescribing of antisecretory therapy which was greatest in the patients who received H. pylori therapy (P < 0.001). Conclusions, There appears to be under and inappropriate treatment of H. pylori infection in primary care, and a low rate of re-testing after eradication, indicating that current guidelines are not well implemented in practice. [source]


    Lack of symptom benefit following presumptive Helicobacter pylori eradication therapy in primary care

    ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 11 2001
    D. Williams
    Background: Helicobacter pylori eradication regimens have failure rates under 10%, however little information is available on the effect of treatment success in reducing the subsequent prescription of anti-ulcer medications in primary care. Aims: To determine, using a large prescription database in eastern Ireland, the success of presumptive eradication therapy in improving symptoms of dyspepsia in primary care, as judged by a reduction in the subsequent prescription of anti-ulcer medications. Methods: In a cross-sectional study, we identified 3847 patients who received a prescription for eradication therapy for Helicobacter pylori, including 826 who were followed for 9,11 months. Those who subsequently received anti-ulcer medications were deemed failures to obtain symptom relief. Results: For 3847 patients with a median follow-up of 8 months, the failure rate was 49%. Of 826 patients, followed for a longer period (9,11 months), the overall failure rate was 56% (range 44,62% depending on the eradication regimen used). Age over 65 years (hazard ratio=1.57, 95% confidence interval= 1.29,1.91, P < 0.001), prior use of anti-ulcer medications (hazard ratio=1.97, 95% confidence interval=1.63,2.37, P < 0.001) and prior use of aspirin/NSAIDs (hazard ratio=1.43, 95% confidence interval=1.18,1.73, P < 0.001) all predicted failure to obtain relief of symptoms of dyspepsia from eradication therapy. Conclusions: Such high failure rates of eradication therapy in reducing the subsequent consumption of anti-ulcer medications have both clinical and economic implications for the use of eradication therapy for Helicobacter pylori in primary care. [source]


    COMT genotypes and use of antipsychotic medication: linking population-based prescription database to the HUNT study,

    PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 4 2008
    Dr Knut Hagen
    Abstract Purpose The aim of this prospective study was to evaluate the impact of codon 158 polymorphism at the catechol- O -methyltransferase (COMT) gene on prescription of antipsychotic medication in a general population. Methods The sample comprised 2623 non-diabetic individuals who participated in the Nord-Trøndelag Health Study (HUNT) in the period 1995,97 and who were alive 1 January 2004. The subjects were followed up with respect to prescription of antipsychotic medication based on data obtained from the Norwegian prescription database. Results Among the group of 76 individuals who had been prescribed antipsychotic medication the distribution did not differ between genotypes and alleles when compared to a control group. For 47 individuals with at least three prescriptions a correlation between median total defined daily doses (DDDs) and genotype groups was found (Spearman's rho, ,0.40, p,=,0.01), being highest for the Met/Met genotype (250), intermediate for the Met/Val genotype (126) and lowest for the Val/Val genotype (47) (p,=,0.03). Conclusion In this population-based cohort of 2623 adults, the Val158Met polymorphism at the COMT gene had no major impact on number of individuals who had been prescribed antipsychotic medication. However, linkage to the prescription database may in an indirect way indicate an association between the COMT Val158Met polymorphism and treatment response or dose requirements of antipsychotic medication. Copyright © 2008 John Wiley & Sons, Ltd. [source]


    Prevalence, incidence and persistence of antipsychotic drug prescribing in the Italian general population: retrospective database analysis, 1999,2002,

    PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 6 2006
    Mersia Mirandola StatD
    Abstract Purpose To investigate the prevalence, incidence and persistence with antipsychotic drug therapy in a large and geographically defined catchment area of Italian general population. Methods All antipsychotic drug prescriptions dispensed during 1999, 2000, 2001 and 2002 were extracted from an administrative prescription database covering a population of 2,640,379 individuals. Antipsychotic drug users were defined as patients who had at least one recorded prescription in the current year. New users were defined as patients receiving a first prescription without any recorded antipsychotic drug treatment in the previous 12 months. Prevalence data were calculated by dividing users by the total number of male and female residents in each age group. Incidence data were calculated as the number of new users divided by the person-time free from antipsychotic drugs in the current year. The cumulative persistence of each medication was calculated by dividing the total prescribed amount of antipsychotic drug by the recommended daily dose, according to each agent's defined daily dose (DDD). Results A progressive rise in prevalence and incidence rates was observed during the 4-year period. In each census year, the prevalence and incidence of prescribing was higher in females than males, and progressively rose with age, with the highest rates in old and very old subjects. The analysis of persistence with therapy revealed that 3176 individuals (78.5%) were occasional antipsychotic drug users, and that occasional use was more frequent among individuals receiving conventional antipsychotic drugs than among individuals receiving novel antipsychotic drugs. This difference was not explained by differences in the occurrence of neurologic adverse reactions, as shown by the concurrent prescribing of anticholinergic drugs, which was fairly similar between the two groups of new drug users. Additionally, we found that conventioal antipsychotic drugs were more often used in older individuals, where occasional use is very frequent, while novel antipsychotic drugs were more often prescribed in young and adult individuals, where regular use is more frequent. Conclusions An epidemiologically relevant proportion of everyday individuals is annually exposed to antipsychotic drugs. The distribution of prevalence and incidence rates by age highlighted an emerging public health issue related to the adverse and beneficial consequences of antipsychotic drug exposure in the elderly. The finding that persistence with therapy was longer in new users of novel antipsychotic drugs compared with new users of conventional agents might be explained by the different demographic and clinical characteristics of individuals receiving these two drug classes and not by the different tolerability profile of these two drug classes. Copyright © 2005 John Wiley & Sons, Ltd. [source]


    Income related inequality in prescription drugs in Denmark,,

    PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 5 2005
    Jens Gundgaard
    Abstract Purpose To examine income-related inequity in utilisation of prescription drugs in Funen County, Denmark after a new reimbursement system was implemented. Methods An individual level prescription database was merged with a health survey of 2927 respondents interviewed in 2000 and 2001 about their health status and socio-economic and socio-demographic characteristics. An index of horizontal inequity was used to estimate the degree of inequity in drug utilisation across income groups, using the indirect method of standardisation to control for age, gender and health status as a proxy for need. The results were compared to estimates from a traditional regression analysis. Results The least advantaged with respect to income consume a bigger share of the prescription drugs than the most advantaged. After standardisation for age, gender and health status the least advantaged have a lower share of the drug consumption than expected. However, traditional regression analysis showed no signs of an income effect on the level of consumption of prescription drugs. Conclusions The index of horizontal inequity suggests that some horizontal inequity favouring the better off is present. However, the results deviate from what can be found by traditional regression analysis. Copyright © 2004 John Wiley & Sons, Ltd. [source]


    General practitioners' ranking of evidence-based prescribing quality indicators: a comparative study with a prescription database

    BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue 2 2006
    Ifeanyi Okechukwu
    Background To ensure that indicators for assessing prescribing quality are appropriate and relevant, physicians should be involved in their development. How general practitioners (GPs) rank these indicators is not fully understood. Aims (i) To determine how GPs in Ireland rank a set of evidence-based prescribing quality indicators in order of importance and relevance to their practice, and (ii) to compare the GPs' ranking of the defined set of indicators with actual prescribing practice using a prescription database. Methods A postal questionnaire was sent to 105 GPs, who were asked to rank a set of 11 prescribing quality indicators, identified from the literature from most to least important. The results were aggregated and a weighted score for each indicator determined. These same prescribing indicators were then applied to a prescription database to compare the ranking provided with actual prescribing practice. Results Eighty-six GPs (82%) returned the completed questionnaire. The higher ranks were for quality issues,use of inhaled corticosteroids, statins and benzodiazepines. Actual prescribing data showed prolonged use of benzodiazepines in over half of the prescriptions dispensed (n = 18 171), 52.48% (95% confidence interval 51.95, 53.01) and low usage of generic drugs, 17.78% (17.70, 17.90) despite their high ranking by the GPs. Conclusion While GPs have diverse views about the value of different prescribing quality indicators, the results suggest that they do rank evidence-based guidelines on patient management highly, but those based on costs and less evidence the lowest. There was considerable divergence between theory and practice in the application of quality indices. [source]


    Antihypertensive Drugs and New-Onset Diabetes: A Retrospective Longitudinal Cohort Study

    CARDIOVASCULAR THERAPEUTICS, Issue 3 2009
    Gwo-Ping Jong
    Antihypertensive drugs have been linked to new-onset diabetes (NOD); however, data on the effect of these drugs on the development of NOD in hypertensive patients has not been well determined. We aimed to investigate the association between antihypertensive drugs and NOD. This was a retrospective cohort study performed using data from claim forms provided to the central region branch of the Bureau of National Health Insurance in Taiwan from January 2002 to December 2007. Prescriptions for antihypertensive drugs before the index date were retrieved from a prescription database. We estimated the odds ratios (ORs) of NOD associated with antihypertensive drug use; nondiabetic subjects served as the reference group. A total of 4233 NOD cases were identified in 24,688 hypertensive patients during the study period. The risk of NOD after adjusting for sex and age was higher among users of diuretics (OR = 1.10, 95% confidence interval [CI]= 1.01,1.20), beta-blockers (BBS; OR = 1.12, 95% CI = 1.04,1.21), and calcium channel blockers (CCBs; OR = 1.10, 95% CI = 1.02,1.18) than among nonusers. Patients who take angiotensin-converting enzyme (ACE) inhibitors (OR = 0.92, 95% CI = 0.84,1.00), angiotensin receptor blockers (ARB; OR = 0.90, 95% CI = 0.81,0.98), or alpha-blockers (OR = 0.88, 95% CI = 0.80,0.98) are at a lower risk of developing NOD than nonusers. Vasodilators were not associated with the risk of NOD. The results of this study suggest that hypertensive patients who take ACE inhibitors, ARBs, or alpha-blockers are at a lower risk of NOD. Diuretics, BBs, and CCBs were associated with a significant increase in the risk of NOD. [source]


    Antibiotic usage, dosage and course length in children between 0 and 4 years

    ACTA PAEDIATRICA, Issue 7 2009
    Josta De Jong
    Abstract Aim:, Antibiotic drugs are most frequently used by 0- to 4-year-old children. We performed a cross-sectional study in the Netherlands using a pharmacy prescription database to investigate the use, dose and course length of antibiotic drugs in 0- to 4-year-olds. Methods:, We used a database with pharmacy drug-dispensing data. We investigated all prescriptions of systemic antibiotics prescribed in the years 2002,2006 for children of 0,4 years of age. Prescriptions for children under the age of 3 months were excluded. Results:, Children of 9,12 months of age received more antibiotics than children in other age groups. In the 3- to 6-month-olds, amoxicillin was prescribed in 75.2% of the cases. This percentage was 50.4% in the 4-year-olds. The contribution of other broad-spectrum antibiotics increased with age (clarithromycin and amoxicillin/clavulanic acid). Small-spectrum penicillins were prescribed less often than the broad-spectrum antibiotics. From the prescriptions of the five most used drugs, 97.6% were within the recommended dose range. Most course lengths corresponded with the guidelines. Of the prescriptions, 3.9% were unlicensed or off-label. Conclusion:, Within the group of 0- to 4-year-old children, most antibiotics were used by 9- to 12-month-olds. The doses and course lengths were mostly correct, but the choice of antibiotics was not according to the guidelines. Young children received unlicensed and off-label prescribed antibiotics. [source]


    Using explicit criteria to evaluate the quality of prescribing in elderly Italian outpatients: a cohort study

    JOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 2 2010
    V. Maio PharmD MS MSPH
    Summary Background and objective:, Inappropriate prescribing in the elderly population is a well-recognized problem in public health. The Beers criteria have been widely used to evaluate the quality of prescribing for the elderly. However, because the Beers criteria were developed in the United States, they are not fully applicable in Italy. The purpose of this study was to establish explicit criteria for potentially inappropriate medication prescribing (PIP) for the elderly and assess the prevalence of and factors associated with PIP among elderly residents in the Local Health Unit of Parma, Italy according to the developed criteria. Methods:, A nine-member expert panel was convened to identify a list of inappropriate medications reflecting the Italian prescribing habits. The panel decided to refine and update the 2002 Beers criteria. Consensus through a Nominal Group Technique was reached to classify the identified 23 inappropriate medications into three categories: 17 medications to be always avoided, three medications rarely appropriate, and three medications with some indications but often misused. A retrospective cohort study using the 2006 Parma Local Health Unit automated outpatient prescriptions database was conducted. The cohort comprised 91 741 elderly individuals ,65 years with at least one prescription medication. PIP was defined as having a prescription claim for at least one inappropriate medication. Results and discussion:, A total of 23 662 elderly in the cohort (25·8%) had at least one PIP. Of these, 14·1% received prescriptions for two medications of concern, and 2·0% for three or more. Using the expert panel's categories, 59·2% of the elderly receiving PIP had prescriptions for drugs that should always be avoided, 33·9% for rarely appropriate drugs, and 19·1% for drugs that have some indications but are often misused. Non-steroidal anti-inflammatory drugs (35·7% of subjects) were the most frequently occurring PIP, followed by ticlopidine (17·6%), doxazosin (15·5%), and amiodarone (13·6%). Female, older age, overall number of drugs prescribed, greater number of chronic conditions were factors associated with greater odds of receiving PIP. Conclusion:, Via the developed criteria, the study corroborates that PIP among elderly outpatients is a substantial issue in Parma Local Health Unit, Italy. Knowledge of the prevalence of PIP and associated factors should gear efforts to develop strategies to reduce PIP in outpatient settings in Italy. [source]