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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Squiggles on September 6, 2006, at 7:31:37
I was reading "The Peace of Mind Prescription"
last night. Contrary to Charles Medawar's
and others' precautions, they say that depression
is common in seniors and with it anxiety--in itself--and should therefore be treated in the same way as it is in younger people.I thought I would bring this up, because there *is* some concern about adverse effects of giving ADs and sedatives to the elderly.
Squiggles
Posted by Squiggles on September 6, 2006, at 9:16:33
In reply to Charney and Nemeroff on the elderly, posted by Squiggles on September 6, 2006, at 7:31:37
A Canadian study on the variability of
prescriptions to the elderly:http://fampra.oxfordjournals.org/cgi/content/full/21/3/244
Prescribing of potentially inappropriate medications to elderly people
Michelle Howarda, Lisa Dolovicha,b, Janusz Kaczorowskia,b,c, Connie Sellorsa,b and John SellorsaDepartments of a Family Medicine and c Clinical Epidemiology and Biostatistics, McMaster University, and b Centre for Evaluation of Medicines, St Joseph's Healthcare, Hamilton, Ontario, Canada
Correspondence to Michelle Howard, Department of Family Medicine, McMaster University, 1200 Main Street W, Room HSC-2V10, Hamilton, Ontario, L8N 3Z5 Canada; E-mail: mhoward@mcmaster.ca
Received 7 May 2003; Revised 16 September 2003; Accepted 7 January 2004.
Howard M, Dolovich L, Kaczorowski J, Sellors C and Sellors J. Prescribing of potentially inappropriate medications to elderly people. Family Practice 2004; 21: 244–247.
AbstractObjective. To estimate the prevalence and predictors of medications deemed potentially inappropriate for the elderly among family physicians' patients aged 65 and older (seniors) taking multiple prescribed medications.
Methods. Forty-eight randomly selected family practices in 16 towns and cities in Southern Ontario, Canada and 889 of their senior patients were recruited into a randomized trial. We conducted a cross-sectional analysis of prescription insurance data from the provincial universal prescription insurance database over 12 months, from the 777 seniors who completed the trial and agreed to have their data released. The prevalence and patient and physician predictors of use of a potentially inappropriate medication (PIM), as defined by published widely accepted criteria, were examined.
Results. The median number of prescriptions filled was 24. Nearly one-fifth (16.3%) of the seniors received at least one prescription for a PIM, with short-acting benzodiazepine prescriptions for longer than 30 days (6.4%) and oxybutynin (3.7%) being the types prescribed most frequently. In univariate and multiple variable analyses, women were found to be statistically significantly more likely to be prescribed a PIM (adjusted OR = 1.6; 95% confidence interval = 1.0–2.4). Age, education, self-rated health, number of health conditions, and number of prescriptions were not associated with PIM use. Physician gender, family medicine certification status, and time since graduation were not significantly associated with PIM prescribing.
Conclusions. Prescribing of PIMs, especially of short-acting benzodiazepines was common in seniors taking multiple medications. Interventions to reduce use of PIM, especially long-term benzodiazepines, are important in primary care.
Keywords. Appropriateness, elderly, medication, prescribing.
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Squiggles
Posted by Phillipa on September 6, 2006, at 10:41:24
In reply to Re: Charney and Nemeroff on the elderly, posted by Squiggles on September 6, 2006, at 9:16:33
I agree they are facing more stresses than we are. And losses. Love Phillipa
This is the end of the thread.
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