Inappropriate prescribing and health outcomes in elderly veteran outpatients

Ann Pharmacother. 1997 May;31(5):529-33. doi: 10.1177/106002809703100501.


Objective: To determine the relationship of inappropriate prescribing in the elderly to health outcomes.

Setting: General Medical Clinic of the Durham Veterans Affairs Medical Center.

Patients: A total of 208 veterans more than 65 years old who were each taking five or more drugs and participated in a pharmacist intervention trial.

Measurements: Prescribing appropriateness was assessed by a clinical pharmacist using the medication appropriateness index (MAI). A summed MAI score was calculated, with higher scores indicating less appropriate prescribing. The health outcomes were hospitalization, unscheduled ambulatory or emergency care visits, and blood pressure control.

Results: Bivariate analyses revealed that mean MAI scores at baseline were higher for those with hospital admissions (18.9 vs. 16.9, p = 0.07) and unscheduled ambulatory or emergency care visits (18.8 vs. 16.3, p = 0.05) over the subsequent 12 months than for those without admissions and emergency care visits. MAI scores for antihypertensive medications were higher for patients with inadequate blood pressure control (> 160/90 mm Hg) than for those whose blood pressure was controlled (4.7 vs. 3.1, p = 0.02).

Conclusions: Inappropriate prescribing appeared to be associated with adverse health outcomes. This findings needs to be confirmed in future studies that have larger samples and control for potential confounders.

Publication types

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

MeSH terms

  • Aged*
  • Analysis of Variance
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure / drug effects
  • Drug Prescriptions*
  • Female
  • Health Resources / statistics & numerical data
  • Hospitalization
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / physiopathology
  • Male
  • Medication Errors*
  • Prospective Studies
  • Treatment Outcome
  • Veterans


  • Antihypertensive Agents