Propoxyphene prescribing among populations older and younger than age 65 in a tertiary care hospital.

OBJECTIVE: To evaluate the proportion of patients aged 65 years and older who are prescribed propoxyphene (PP) versus those aged 65 and younger. DESIGN: Retrospective cross-sectional study. SETTING: Tertiary care facility. PARTICIPANTS: Adult patients admitted to the hospital between January 1, 2005, and June 30, 2005, and prescribed either hydrocodone (HC) or PP. MAIN OUTCOME MEASURE: The primary outcome measure was the proportion of PP orders prescribed for patients older versus younger than age 65. The secondary outcomes were to identify other variables occurring in higher proportions among patients who were prescribed PP versus HC. RESULTS: Of the 7,910 patients reviewed, 7,295 patients 92.2% were prescribed HC and 615 (7.8%) were prescribed PP. In a random sample of 1,065 patients, the prescribing pattern of PP for subjects > or =65 (221/615, 35.9%), was significantly higher than for HC (128/450, 28.4%), P = 0.0122. In a random selection of the larger sample, there were 44/108 (40.7%) in the PP group and 22/120 subjects (18.3%) > or =65 in the HC group (P = 0.0003). Among PP users, there was a higher percentage of females (P = 0.0150), more subjects with narcotic allergies (P < 0.0001), and more subjects with a history of fractures (P = 0.0232). CONCLUSIONS: Compared with nationally reported data, the rate of PP prescribing is relatively low. However, despite the recommendation to avoid the use of PP in elderly patients, its use occurs in a higher proportion of patients age 65 years or older than in younger patients. Studies evaluating the prescribing rates of potentially inappropriate medications should be put in context by comparing reported data with that of a younger cohort.