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

Medication prescribing practices for older prisoners in the Texas prison system.

Author information

  • 1Department of Medicine, University of California, San Francisco, CA, USA. brie.williams@ucsf.edu

Abstract

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.

PMID:
19762661
[PubMed - indexed for MEDLINE]
PMCID:
PMC2836339
Free PMC Article
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