DETERMINANTS OF PRESCRIBING FOR THE ELDERLY IN PRIMARY HEALTH CARE
Concerning medications; it was also found that almost one third (31%) of the study sample were using three or more medications.
Poly pharmacy (three or more drugs prescribed per patient) is considered a problem in Saudi Arabia (5) and constitutes a concern in terms of its economic and medical burdens as well as issues relating to its public safety (9). However, in the elderly patients seen in this study, this issue can be due to the presence of two or more diseases in large proportion of the studied group of elderly patients, and the fact that almost half of studied sample were seen in both hospitals and PHC center which mean that they were being seen by two or more doctors and put on regimens with medications prescribed from both the hospital and PHC center.

The study also showed that 95% of medications used by the elderly may be available at times in PHC center and in turn are covered by essential drugs list for PHC centers. 

The lack of geriatrics and personnel as well as specialized facilities for the elderly population might contribute to limiting the diagnosis of diseases in this age group. Those diseases include endocrine diseases other than diabetes such as osteoporosis and menopause, or cardiovascular diseases such as ischemic heart disease, or other health problems including dementia, visual impairment, and hearing disability to name but a few.

These defects and deficiencies might explain low utilization of drugs other than those present in essential drugs list provided by ministry of health in Saudi Arabia. 

Other studies of drug compliance are warranted in the elderly population to better provide a comprehensive health care system targeted towards patients more than 60 years of age.

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Table 5: Types of drugs used by patients involved in the study:
 Type of drug  No. of patients 
(n = 100)		  (%)
 Endocrine system
 (Insulin, OHA.. etc.)		  45  (45%)
 CVS (Beta blockers,
 diuretics.. etc)		  34  (34%)
 Musculoskeletal and
 joint disease
 (NSAIDs.. etc)		  11  (11%)
 GIT (ulcer healing
 drugs, antacids,.. etc)		  4  (4%)
 Respiratory system
 (ventolin, Becotide..
  etc)		  4  (4%)
 Eye, ear and others  2  (2%)

CVS = cardiovascular system, OHA = oral hypoglycemic agents, GIT = gastrointestinal tract, NSAID = nonsteroidal anti-inflammatory drugs.

Conclusions:
Most of elderly patients depend on primary health care for their health needs. Elderly care system or clinic need to be applied in primary health care. 

Training of physicians, nurses and other health care team members on needs of elderly patients is highly needed as well as providing facilities for diagnosis and screening of elderly health problems.