The American journal of geriatric pharmacotherapy
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Am J Geriatr Pharmacother · Sep 2006
Medication reconciliation for reducing drug-discrepancy adverse events.
Medication reconciliation is a technique for identifying discrepancies in drug regimens prescribed in different care settings or at different time points to inform prescribing decisions and prevent medication errors. ⋯ Pharmacist medication reconciliation and communication with the physician reduced discrepancy-related ADEs in these patients transferred between the hospital and nursing home. Studies are needed to identify the most efficient ways of carrying out this task and to adapt the reconciliation process to all care settings.
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Published guidelines have identified propoxyphene as an inappropriate medication for use in aged patients. It is no more effective than acetaminophen, yet has been associated with the same adverse effects (AEs) associated with other opioid drugs. In particular, its central nervous system-related AEs, dizziness and sedation, may increase the risk for fracture resulting from falls in older adults. Nonetheless, US studies have reported widespread use of propoxyphene in the elderly US population. ⋯ The results of this cohort database study suggest that propoxyphene use among adults aged > or =65 years is associated with increased risk for hip fracture and suggest a need for interventions to reduce propoxyphene use in older adults. Clinicians should be aware of the risk for hip fracture with other opioids as well and weigh them against potential benefits when prescribing for older adults.