A survey of the use of medication with prolonged oral clearance in the elderly in North East England

Abstract

The elderly are increasingly retaining natural teeth into old age and many require regular long-term medication for chronic medical problems. If these medicines contain sugars and have a prolonged clearance time from the mouth, they may threaten dental health. The extent of regular and long-term use of these medicines in the elderly was the subject of this study comprising five surveys. A general medical practice survey identified 2002 elderly patients aged ≥60 years taking 143 prescribed medicines with prolonged oral clearance (POC) long-term representing a prevalence of use of 9.8%, with females aged ≥75 years more likely to be taking POC medicines long-term (p<0.001). The main medical problems reported were cardiovascular and musculoskeletal, however antacids, laxatives and minor analgesics were the most commonly prescribed POC medicines. The prevalence of over-the-counter POC medicine use long-term was 1.1%. Analysis of prescription numbers and quantities of medicines dispensed in primary care identified 613 POC medicines representing 13% of the 457 million items dispensed in England in 1994, of which 30.4 million items (51%) were for medicines potentially used regularly and longterm by the elderly. POC medicines prescribed in primary care represented the main area of use; secondary care accounted for only 1% of the overall quantities prescribed in the Northern Region and the contribution of OTC medicines to overall consumption of POC medicines was also low (<1 %). The influence of generic prescribing and dose form on the sugar content of the medicines dispensed was substantial; over 80% of generic liquid oral medicines were sugars-containing compared with 7% of proprietary liquid oral medicines. Efforts should be made to draw the attention of government, manufacturers, prescribers and dispensers as well as consumers to the major influences of dose form and specificity of prescribing on the sugars content of medicines. This is crucial in those increasing number of dentate individuals whose dental health is at risk through regular and long-term use of POC medication.