Comparison of first- and second-generation antihistamine prescribing in elderly outpatients: A health insurance database study in 2013

BACKGROUND: This descriptive study analyzed the scale of first- and second-generation antihistamine prescription in elderly outpatients in Korea and the characteristics associated with this prescription. MATERIALS AND METHODS: We conducted a drug utilization study using the Korea Health Insurance Review and Assessment Service-Aged Patient Sample (HIRA-APS) database from January 1 to December 31, 2013. The study subjects were elderly outpatients aged 65 years and older who were prescribed antihistamines. The study drugs included 6 first-generation and 16 second-generation antihistamines. The prescription pattern of first-generation antihistamines was based on region, diagnosis, and clinical specialty. Multivariate logistic regression analysis was used to determine the factors associated with first-generation antihistamine prescription. Odds ratios (ORs) with 95% confidence interval (CI) were calculated. RESULTS: A total of 1,152,556 elderly outpatients were identified as having visited various medical facilities in 2013, of which 23.4% received at least one prescription for first-generation antihistamine monotherapy. First-generation antihistamines were more likely to be prescribed in secondary care hospitals (OR = 1.74; 95% CI 1.69 - 1.78) than in tertiary care hospitals, and in urban areas (OR = 1.21; 95% CI 1.20 - 1.21) than in the Seoul metropolitan area. First-generation antihistamines were also more likely to be prescribed for treating the common cold (OR = 1.06; 95% CI 1.05 - 1.06) than any other disease. CONCLUSION: A large proportion (23.4%) of elderly outpatients in Korea received prescriptions for first-generation antihistamines. Efforts to reduce prescriptions of first-generation antihistamines are recommended, especially prescriptions associated with common cold diagnosis in secondary care hospitals and in urban areas.
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