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Women more likely than men to be prescribed inappropriate drugs

Particular issue for those over 65, study suggests

Caroline White

Friday, 06 May 2016

Women are more likely than men of the same age to be prescribed inappropriate drugs, finds a Canadian study* published in Age and Ageing.

Women over the age of 65 seem to be at particular risk, the findings show.

The researchers looked at the prescribing patterns of 660,679 British Columbian residents aged 65 and older in 2013.

The appropriateness of the prescriptions were measured against the American Geriatrics Society’s 2012 list of drugs that should be avoided in older adults.

Women made up just over half of the study participants (54%) and were more likely to be over the age of 85, live in a care/nursing home, be on five or more different types of drugs, and to have low income.

Men in the study had relatively poor health, which was associated with higher crude prevalence of potentially inappropriate prescriptions.

Despite increased awareness among doctors and pharmacists of the harms associated with prescribing certain drugs to older patients, the study found older people continue to routinely be prescribed inappropriate drugs.

Being sicker, receiving more than one drug for a diagnosed condition, and receiving care from five or more doctors all increased the adjusted odds of filling one or more potentially inappropriate prescriptions, the findings showed.

But women were much more likely to be prescribed drugs than men. Almost one in three women (31%) compared with around one in four (26%) men received one or more potentially inappropriate prescriptions.

Even after taking account of several potentially influential clinical and socioeconomic factors, women were 16% more likely than men to be given a potentially inappropriate prescription.

Most of this difference resided in the prescription of benzodiazepines and other sedatives, antidepressants (tricyclics) and anti-inflammatory drugs (NSAIDs).

“The effect of a patient’s sex on the risk of inappropriate prescribing is of tremendous clinical and social concern,” commented lead researcher Professor Steve Morgan, of the University of British Columbia’s School of Population and Public Health.

“For men, being married or in a high income bracket reduced the risk of receiving inappropriate prescriptions. These factors had no significant effect for women. On the other hand, being Chinese or South Asian significantly lowered women’s risk of receiving an inappropriate prescription, but did not affect men’s risks,” he added.

“Being a woman is double jeopardy when it comes to taking medications,” said Dr Cara Tannenbaum, scientific director of the Canadian Institutes of Health Research’s Institute of Gender and Health. “Women metabolize drugs differently than men. Gender roles and social circumstances also place them at risk.”

The researchers found that the sex differences in older adults’ risk of receiving a potentially inappropriate prescription were significantly influenced by social dynamics, including differences in patients’ care seeking and care giving behaviours, as well as differences in the relationships and communications between patients and healthcare providers.

The researchers say that more nuanced solutions will be needed to address how gender —on its own and interacting with age, wealth and ethnicity—affect prescribing.

* Morgan SG, et al. Sex differences in the risk of receiving potentially inappropriate prescriptions among older adults. Age Ageing, first published online: 5 May 2016. DOI: 10.1093/ageing/afw074

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