Potentially sub-optimal prescribing of medicines for older Aboriginal Australians

A newly published cross-sectional study has investigated the potentially inappropriate medicine use for 273 Aboriginal Australians aged 45 years or older, in remote Western Australia. The mean number of prescribed medicines was 5.1 (SD, 3.6) per person, and at least one form of sub-optimal prescribing was identified for 61% of those assessed. Frequently encountered issues included polypharmacy for (n = 145, 53%), potential under‐prescribing of at least one indicated medicine for (n = 33, 12%), and potentially inappropriate prescribing for (n = 54, 20%). Potential prescribing cascades or drug interactions were identified for 12 participants (4%). Sub-optimal prescribing was identified for 53% of the participants. Examples of potential under-prescribing included history without antiplatelet agent or anticoagulant therapy, history of stroke without angiotensin‐converting enzyme (ACE) or inhibitor/angiotensin II antagonist + statin prescribed; history of ischaemic heart disease without the prescription of an antiplatelet agent, ACE inhibitor/angiotensin II antagonist, β‐blocker, and statin therapy, or a history of hypertension without the prescription of an appropriate antihypertensive agent. Potentially inappropriate prescribing included the use of various medications that are relatively contraindicated for older people, prescribing of drugs with a higher risk of harm for older people, or prescribing of medicines suggesting either a prescribing cascade or a drug interaction. The researchers note that suggest that polypharmacy affects remote Aboriginal people at a younger age than other Australians, and advocate for culturally appropriate, targeted strategies for improving prescribing for older people in remote Aboriginal communities. Read the full paper, published in the Medical Journal of Australia, here.