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Norwegian Prescription Database

76,000 elderly people were dispensed at least 15 medicines during 2017

Drug use among the elderly has increased year-on-year. In 2017, approximately 76,000 elderly people living at home were dispensed at least 15 prescription drugs, and 570,000 were dispensed five or more.

Illustrasjonsfoto: Colourbox.com
Illustrasjonsfoto: Colourbox.com

Drug use among the elderly has increased year-on-year. In 2017, approximately 76,000 elderly people living at home were dispensed at least 15 prescription drugs and 570,000 were dispensed five or more.

These are among the findings in the Norwegian Institute of Public Health's new report "Norwegian Prescription Database 2013-2017". Drug use among the elderly is the theme of this year’s report.

In recent years, there has been a focus on medication reviews and "deprescribing" among the elderly.

"Regular medication reviews for the elderly help to identify cases where the risk of taking many drugs exceeds the benefit," says Christian Berg, one of the authors of the report.

Two out of three drug users receive at least five medicines

The new figures from the Norwegian Prescription Database show that many older people are prescribed multiple drugs.

five drugs.png

The figure shows the number of drugs (defined as different ATC 5 levels) dispensed on prescription in 2017 to people aged 65 years or older who were living at home. In this population group as a whole, nine out of ten received at least one drug during the year. 570, 000 users living at home were given five or more medicines during the year.

Multiple drugs increase misuse risk

An important indicator of inappropriate prescribing to the elderly is the number of prescribed drugs. Several drugs may be required to treat or prevent a single disease. However, if someone has more than one disease, the risk of misuse, unwanted effects, interactions, admission to hospital and death may increase.

"Elderly people having to cope with multiple drugs increases the potential for misuse," warns Christian Berg.

More people receive at least 15 medicines

The new figures show that many older people have to deal with more drugs and that this number is increasing.

15 prescriptions.png

The figure shows the proportion of elderly drug users who were dispensed at least 15 medicines per year in the period 2004-2017.

  • The proportion of women aged 65 years or older who received 15 drugs or more increased from 6.9 per cent to 10.5 per cent during the period.
  • The proportion of men increased from 4.7 per cent to 7.5 per cent.


Berg explains that all drugs may not all be used at the same time. Some drugs will be for short-term or acute treatment, such as treatment of infection with antibiotics. The statistics show all different medicines dispensed to a person in the course of the year.

These drugs are increasing most among the elderly

The increase in the proportion of users over time is most apparent for mild analgesics, drugs for peptic ulcers and oesophageal inflammation (heartburn / gastroesophageal reflux) and drugs that lower cholesterol and other fats in the blood (lipid-modifiers).

However, the proportion of anxiolytics and hypnotics has decreased, and the proportion of antibiotic use declined slightly in 2017.

Table 1. Use of medicines in the elderly (≥70 years) in Norway in 2006, 2011, 2016 and 2017, shown as a percentage (%) of the population who were dispensed at least one prescription of a drug in a drug group in that year. Only groups with more than 10 per cent of the elderly population are included in the table.

Drug groups (ATC-codes)

2006

2011

2016

2017

Cardiovascular system (C03, C07, C08, C09)

58

61

61

61

Anti-thrombotics (B01A)

42

47

47

47

Lipid-modifying drugs – treatment of high cholesterol, mainly statins (C10)

27

36

39

40

Anxiolytics and hypnotics (N05B, N05C)

34

33

30

29

Antibacterials (J01)

31

33

30

29

Opioid analgesics (N02A)

20

20

20

20

Other analgesics – mainly paracetamol (N02B)

13

19

23

25

Anti-inflammatory and anti-rheumatic products, (NSAIDs, M01A)

21

20

17

17

Drugs for peptic ulcer and gastroesophageal reflux disease (A02B)

14

19

23

24

Antidepressants (N06A)

11

11

11

11

Thyroid therapy (H03)

9

10

11

11

Corticosteroids, tablets and injections (H02A)

8

10

11

11

Diabetes drugs (A10)

8

9

10

10

Top 30 drugs

The table gives an overview of the most used drugs in Norway in 2017, the proportion and number of people who were dispensed at least one prescription – all ages.

 

ATC-code

Active ingredient

Use

Number of users

Proportion of population (%)

1

N02BE01

paracetamol*

Analgesic

524 901

9.9

2

J01CE02

phenoxymethylpenicillin

Antibacterial

394 344

7.5

3

B01AC06

acetylsalicylic acid

Anti-thrombotic

364 426

6.9

4

N02AJ06

codeine and paracetamol

Opioid analgesics, combinations

351 291

6.7

5

M01AB05

diclofenac*

NSAID/analgesic

323 120

6.1

6

C10AA05

atorvastatin

Lipid-modifying

295 715

5.6

7

N05CF01

zopiclone

Hypnotic

290 210

5.5

8

R06AE07

cetirizin*

Anti-allergic

286 302

5.4

9

C07AB02

metoprolol

Antihypertensive/ cardiovascular disease

283 411

5.4

10

R03AC02

salbutamol

Asthma and COPD

270 499

5.2

11

R05DA01

ethylmorphine

Cough suppressant

265 341

5.1

12

A02BC02

pantoprazole*

Reflux oesophagitis

263 785

5.0

13

R06AX27

desloratadine

Anti-allergic

243 334

4.6

14

M01AE01

ibuprofen*

NSAID/analgesic

230 829

4.4

15

N02AX02

tramadol

Opioid analgesic

225 070

4.3

16

C10AA01

simvastatin

Lipid-modifying

212 312

4.0

17

H03AA01

Levothyroxine sodium

Thyroxine supplement

209 382

4.0

18

S01AA01

chloramphenicol

Antibacterial eye drops

193 942

3.7

19

J01CA08

pivmecillinam

Antibacterial

190 781

3.6

20

H02AB06

prednisolone

Corticosteroid

187 335

3.6

21

A02BC05

esomeprazole

Reflux oesophagitis (proton-pump inhibitor)

176 064

3.3

22

R01AD09

mometasone*

Nosespray for allergy

171 090

3.2

23

G03AA07

levonorgestrel and ethinylestradiol

Hormonal contraception

152 705

2.9

24

A11CC05

colecalciferol   

Vitamin D supplement

147 685

2.8

25

M01AE52

naproxen and esomeprazole

NSAID/analgesic with proton-pump inhibitor

142 741

2.7

26

C08CA01

amlodipine

Antihypertensive/ cardiovascular disease

137 090

2.6

27

N05BA04

oxazepam

Anxiolytic

136 950

2.6

28

G03CA03

estradiol

Hormone therapy for women

136 672

2.6

29

J01AA02

doxycycline

Antibacterial

122 266

2.3

30

A10BA02

metformin

Diabetes

120 061

2.3

* These are also available without prescription. The figures only show drugs dispensed on prescription.

About the report

The report contains a comprehensive table of information about the number of people who were dispensed prescription drugs from pharmacies in Norway in the last five-year period (2013-2017). This year's edition is the eleventh in the series.

The report also has an overview of scientific articles where data from the Norwegian Prescription Database were used between 2001 and March 2018.

The report from the Norwegian Prescription Database can be used together with the Prescription Database's statistics bank (updated March 15th 2018 with numbers for 2017). The statistics bank contains more information about users of prescription drugs.

 

Report