Trends of potentially inappropriate prescribing among older outpatients in China between 2015–21

PMCID: PMC12178595

PMID: 40537054

DOI: 10.7189/jogh.15.04190

Journal: Journal of global health

Publication Date: 2025-6-20

Authors: Tian F, Chen Z, Zhang Y, Feng Q

Key Points

• Overall PIP prevalence remained stable at approximately 29%, but multiple PIM-related prescriptions increased (AAPC = 4.45)
• Sedative-hypnotic medications showed significant upward trends: zolpidem (AAPC = 13.51), alprazolam (AAPC = 8.86)
• Urgent need for improved medication review processes and increased awareness of potentially inappropriate medications among clinicians

Summary

This comprehensive epidemiological study examined potentially inappropriate prescriptions (PIP) among older outpatients across six major Chinese cities from 2015-2021, analyzing 982,605 prescriptions to understand medication prescribing trends. While the overall PIP prevalence remained relatively stable (28.09% in 2015 to 29.00% in 2021), the research revealed critical nuances in prescription patterns, particularly an increasing trend in prescriptions involving multiple potentially inappropriate medications (PIMs).

The study highlighted significant variations in PIP prevalence across different cities and demographic groups, with notable increases in sedative-hypnotic medication prescriptions. Particularly concerning was the rising prevalence of benzodiazepines like estazolam, zolpidem, and alprazolam, suggesting potential overprescription and increased risk of adverse drug events among older patients. The findings underscore the urgent need for enhanced medication management strategies, clinical decision support systems, and targeted educational interventions for healthcare professionals.