So-called legacy prescribing can contribute to overmedication and adverse drug events
WEDNESDAY, Dec. 19, 2018 (HealthDay News) — Legacy prescribing of certain drugs, such as antidepressants and proton pump inhibitors (PPIs), is common, according to a study published in the November/December issue of the Annals of Family Medicine.
Dee Mangin, M.B.Ch.B., D.P.H., from McMaster University in Hamilton, Ontario, Canada, and colleagues analyzed data from the McMaster University Sentinel and Information Collaboration (MUSIC) Primary Care Practice Based Research Network. The authors used data from 50,813 adult patients from 2010 to 2016 to calculate rates of legacy prescriptions for antidepressants (>15 months), bisphosphonates (>5.5 years), and PPIs (>15 months).
The researchers found that 46 percent of patients had a legacy prescription (3,766 of 8,119) for antidepressants at some time during the study period, 14 percent (228 of 1,592) had legacy prescriptions for bisphosphonates, and 45 percent (2,885 of 6,414) had legacy prescriptions for PPIs. Many patients held current prescriptions. For all legacy prescriptions, the mean duration of prescribing was significantly longer than that for nonlegacy prescriptions. A potential prescribing cascade was seen with concurrent legacy prescriptions for both antidepressants and PPIs.
“These data demonstrate the potential of legacy prescribing to contribute to unnecessary polypharmacy, providing an opportunity for system-level intervention in primary care with enormous potential benefit for patients,” the authors write.
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