Prescription patterns of diuretics in Dutch community‐dwelling elderly patients

• Published in: British journal of clinical pharmacology Vol. 46; no. 4; pp. 403 - 407
• Main Authors: Van Kraaij, Dave J. W., Jansen, René W. M. M., De Gier, Johan J., Gribnau, Frank W. J., Hoefnagels, Willibrord H. L.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.10.1998; Blackwell Science
• Subjects: Age Factors; Aged; Aged, 80 and over; Antihypertensive agents; Biological and medical sciences; Cardiotonic agents; Cardiovascular Agents - therapeutic use; Cardiovascular system; Cross-Sectional Studies; diuretics; Diuretics - therapeutic use; Drug Prescriptions - statistics & numerical data; Drug Utilization; elderly; Female; Humans; Male; Medical sciences; Netherlands; Pharmacology. Drug treatments; prescription patterns; Sex Factors; Netherlands; Human; Cardiotonic agent; Calcium antagonist; Sex; Posology; Diuretic; Medical prescription; Organic nitrate; Antihypertensive agent; Glycoside; Elderly; Age; Comparative study; ACE inhibitor; Beta blocking agent
• ISSN: 0306-5251; 1365-2125
• DOI: 10.1046/j.1365-2125.1998.00793.x

Aims  To describe age‐ and gender‐related prescription patterns of diuretics in community‐dwelling elderly, and to compare diuretics to other cardiovascular (CV) medications. Methods  Cross‐sectional study of patient‐specific prescription data derived from a panel of 10 Dutch community pharmacies. Determination of proportional prescription rates and prescribed daily dose (PDD) of diuretics, cardiac glycosides, nitrates, angiotensin converting enzyme (ACE) inhibitors, β‐adrenoceptor blockers, and calcium channel blockers in all 5326 patients aged 65 years or older dispensed CV medications between August 1st, 1995 and February 1st, 1996. Results  Diuretics were prescribed to 2677 of 5326 patients (50.3%), 1325 patients (24.9%) using thiazides and 1198 patients (22.5%) using loop diuretics. Prescription rates of loop diuretics increased from 15.1% in patients aged 65–74 years to 37.2% in patients aged 85 years or older. Rates also increased for digoxin and nitrates. Rates for thiazide diuretics remained unchanged with age; rates for β‐adrenoceptor blockers, ACE inhibitors and calcium channel blockers declined with age. Thiazides were prescribed to 30.1% of women compared with 16% of men (P<0.001). Average PDD was 135±117% of defined daily dose (DDD) for loop diuretics, and highest for bumetanide (245±2.01% of DDD, equivalent to 2.5±2.0 mg). Average PDD was 74±40% of DDD for thiazides, and highest for chlorthalidone (100±49% of DDD, equivalent to 25±12 mg). Conclusions  Important characteristics of diuretic usage patterns in this elderly population were a steep increase in loop diuretic use in the oldest old, a large gender difference for thiazide use, and high prescribed doses for thiazides.