Medication prescribing practices for older prisoners in the Texas prison system

Am J Public Health. 2010 Apr;100(4):756-61. doi: 10.2105/AJPH.2008.154591. Epub 2009 Sep 17.


Objectives: We sought to assess appropriateness of medication prescribing for older Texas prisoners.

Methods: In this 12-month cross-sectional study of 13 117 prisoners (aged > or = 55 years), we assessed medication use with Zhan criteria and compared our results to prior studies of community prescribing. We assessed use of indicated medications with 6 Assessing Care of Vulnerable Elders indicators.

Results: Inappropriate medications were prescribed to a third of older prisoners; half of inappropriate use was attributable to over-the-counter antihistamines. When these antihistamines were excluded, inappropriate use dropped to 14% (> or = 55 years) and 17% (> or = 65 years), equivalent to rates in a Department of Veterans Affairs study (17%) and lower than rates in a health maintenance organization study (26%). Median rate of indicated medication use for the 6 indicators was 80% (range = 12%-95%); gastrointestinal prophylaxis for patients on nonsteroidal anti-inflammatories at high risk for gastrointestinal bleed constituted the lowest rate.

Conclusions: Medication prescribing for older prisoners in Texas was similar to that for older community adults. However, overuse of antihistamines and underuse of gastrointestinal prophylaxis suggests a need for education of prison health care providers in appropriate prescribing practices for older adults.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Age Factors
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Antihypertensive Agents / therapeutic use
  • Cross-Sectional Studies
  • Female
  • Gastrointestinal Agents / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Prisoners / statistics & numerical data*
  • Prisons / standards
  • Prisons / statistics & numerical data
  • Texas


  • Anti-Inflammatory Agents, Non-Steroidal
  • Antihypertensive Agents
  • Gastrointestinal Agents