Objectives: Minimizing the overuse of prescribed drugs among older people is a goal of geriatricians and healthcare policy makers. Indirect evidence indicates that use of prescribed drugs is more common in Japan than in some Western countries, but the actual situation in Japan is unknown. The first aim of this study was to clarify the use of prescribed drugs among older people in Japan. We also tested the hypothesis that using five or more prescribed drugs is associated with a situation that is modifiable and is relatively common in Japan: not having a regular physician.
Design: A cross-sectional survey.
Participants: Subjects representing the Japanese general population aged 65 years and older were selected by two-stage stratified sampling; 617 persons were eligible for the study.
Measurements: Each subject was given a self-report questionnaire about current medications, sociodemographic characteristics, current state of health, health-related quality of life, and whether they had a regular physician. Among users of prescribed drugs, the association between using five or more prescribed drugs and not having a regular physician was assessed by univariate analysis and by stepwise logistic regression.
Results: The questionnaire was returned by 491 (80%) of the eligible subjects, 299 (61%) of whom were taking at least one prescribed drug. Nearly 30% of those subjects were taking at least five prescribed drugs. The distribution of the number of prescribed drugs being taken was positively skewed; the minimum was one and the maximum was 17, the middle 50% of the values ranged from two to five, and the median was three. About half of those who were taking at least five prescribed drugs did not have a regular physician. Compared with those who had a regular physician, those who did not were 2.5 times more likely to be taking at least five prescribed drugs (95% confidence interval, 1.4 - 4.6).
Conclusions: Older people in Japan are less likely to be taking many prescribed drugs if they have the continuity of care provided by a regular physician.