The American journal of geriatric pharmacotherapy
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Am J Geriatr Pharmacother · Dec 2011
ReviewMedication use and functional status decline in older adults: a narrative review.
Functional status is the cornerstone of geriatric care and serves as an indicator of general well-being. A decline in function can increase health care use, worsen quality of life, threaten independence, and increase the risk of mortality. One of several risk factors for decline in functional status is medication use. ⋯ Benzodiazepines and anticholinergics have been consistently associated with impairments in functional status in the elderly. The relationships between suboptimal prescribing, antidepressants, and antihypertensives and functional status decline were mixed. Further research using established measures and methods is needed to better describe the impact of medication use on functional status in older adults.
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Am J Geriatr Pharmacother · Dec 2011
Comparative StudyImpact of a multidisciplinary intervention on antibiotic use for nursing home-acquired pneumonia.
Academic detailing in nursing homes (NHs) has been shown to improve drug use patterns and adherence to guidelines. ⋯ The ability of this multifaceted study to repeatedly remind nursing staff of the importance of timely antibiotic administration contrasts with its limited academic detailing interaction with clinicians. This difference within the intervention may explain the differential impact of the intervention on antibiotic guideline adherence.
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Am J Geriatr Pharmacother · Aug 2011
Randomized Controlled Trial Comparative StudyMedication discrepancies identified at time of hospital discharge in a geriatric population.
It has been reported that 14.1% of geriatric patients experience ≥1 medication discrepancies after hospitalization. ⋯ Medication discrepancies at the time of hospital discharge are a common occurrence for geriatric patients. Physician summaries might be the least reliable source of discharge medication lists. The number of discrepancies appears to not be associated with patient age, but rather with the number of medications at discharge. Discrepancies among medication lists are common, and the presence of a pharmacist may reduce the number that occur.
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Am J Geriatr Pharmacother · Aug 2011
Comparative StudyOut-of-pocket drug costs and drug utilization patterns of postmenopausal Medicare beneficiaries with osteoporosis.
The Medicare Part D coverage gap has been associated with lower adherence and drug utilization and higher discontinuation. Because osteoporosis has a relatively high prevalence among Medicare-eligible postmenopausal women, we examined changes in utilization of osteoporosis medications during this coverage gap. ⋯ Medication discontinuation and OOP costs among beneficiaries with osteoporosis were highest for those enrolled in Part D plans with a coverage gap. Providers should be aware of potential cost-related nonadherence among Medicare beneficiaries taking osteoporosis medications.
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Am J Geriatr Pharmacother · Jun 2011
Primary care providers' perspectives on psychoactive medication disorders in older adults.
Compared with younger adults, older adults consume a disproportionate percentage of pain and sleep medications. Some studies have reported that psychoactive medication misuse and abuse in older populations is a significant problem. ⋯ The lack of a clear definition, absence of well-defined risk factors, and ambiguous clinical manifestations of psychoactive medication misuse and abuse present substantial barriers to diagnosis. A standard, age-appropriate definition could help PCPs establish a diagnosis, clarify what constitutes appropriate psychoactive medication use, define the extent of the problem, and pave the way for the development of effective screening and diagnostic tools.