Inappropriate Drug Prescribing for the Community-Dwelling Elderly
JAMAPublished 27 July 1994
Sharon M. Willcox
Citations489
SJR quartileQ1
SJR score5.35
SNIP10.71
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Physicians prescribe potentially inappropriate medications for nearly a quarter of all older people living in the community, placing them at risk of drug adverse effects such as cognitive impairment and sedation.
Abstract
Physicians prescribe potentially inappropriate medications for nearly a quarter of all older people living in the community, placing them at risk of drug adverse effects such as cognitive impairment and sedation. Although most previous strategies for improving drug prescribing for the elderly have focused on nursing homes, broader educational and regulatory initiatives are needed.
Keywords
MedicineEconomics, Econometrics and Finance
New England Journal of MedicineThe Nature of Adverse Events in Hospitalized Patients
3,750 Citations1991Lucian L. Leape, Troyen A. Brennan +8 more
The high proportion that are due to management errors suggests that many others are potentially preventable now, and reducing the incidence of these events will require identifying their causes and developing methods to prevent error or reduce its effects.
Archives of Internal MedicineExplicit criteria for determining inappropriate medication use in nursing home residents. UCLA Division of Geriatric Medicine
1,113 Citations1991Mark H. Beers
Archives of Internal MedicineThe Role of Medication Noncompliance and Adverse Drug Reactions in Hospitalizations of the Elderly
763 Citations1990Nananda F. Col
Many elderly admissions are drug related; noncompliance accounting for a substantial fraction of these; economic factors were important in predicting admissions due to noncompliance as well as adverse drug reactions.
JAMABenzodiazepines of Long and Short Elimination Half-life and the Risk of Hip Fracture
537 Citations1989Wayne A. Ray
Medical record review for a sample of 189 cases suggested that this finding was not due to confounding by dementia, ambulatory status, functional status, or body mass, and it was not altered by sex, age, calendar year, nursing home residence, or history of hospitalization.
Annals of Internal MedicineNonsteroidal Anti-Inflammatory Drug Use and Death from Peptic Ulcer in Elderly Persons
422 Citations1988Marie R. Griffin, Wayne A. Ray +1 more
The findings of this study add to the growing evidence that NSAIDs can increase the risk for clinically serious peptic ulcer disease in the elderly.
New England Journal of MedicineManagement of Drug Therapy in the Elderly
394 Citations1989S. C. Montamat, Barry J. Cusack +2 more
There has been relatively little investigation of the effects of age at the sites of drug action, and little information is available about drug disposition and response in the elderly.
Age and AgeingInappropriate Medication is a Major Cause of Adverse Drug Reactions in Elderly Patients
389 Citations1992Celeste Lindley, Mary P. Tully +2 more
Much drug-related morbidity in the elderly population may be avoidable, as it is due to inappropriate prescribing, which was found to be significantly higher for inappropriate than for appropriate drugs.
Annals of Internal MedicineInappropriate Medication Prescribing in Skilled-Nursing Facilities
335 Citations1992Mark H. Beers, Joseph G. Ouslander +6 more
Female residents and residents of large nursing homes are at the greatest risk for receiving an inappropriate prescription, and a greater number of inappropriate medication prescriptions were ordered in larger nursing homes.
Journal of the American Geriatrics SocietyDrug‐Associated Hospital Admissions in Older Medical Patients
317 Citations1988Ruby Grymonpre, Paul A. Mitenko +3 more
Females had significantly more adverse drug reactions, although sex was not a predictor for overall DRAPE risk, and age was not correlated with the risk of a DRAPE.
American Journal of EpidemiologyUSE OF MEDICAID DATA FOR PHARMACOEPIDEMIOLOGY
316 Citations1989Wayne A. Ray, Marie R. Griffin
This paper reviews methodological problems and describes pragmatic solutions that have been developed through the ongoing use of these data bases for epidemiologic studies.
PubMedDetailed diagnoses and procedures, National Hospital Discharge Survey, 1994.
315 Citations1997Edmund Graves, B. S. Gillum
This report presents national estimates of the use of non-Federal short-stay hospitals in the United States during 1994, based on data collected through the National Hospital Discharge Survey for 1994.
Annals of Internal MedicineThe Ambiguous Relation between Aging and Adverse Drug Reactions
313 Citations1991Jerry H. Gurwitz, Jerry Avorn
Conventional clinical wisdom suggests that the risk for adverse drug reactions increases with advancing age, but available data do not confirm this "truism" of geriatric medicine.
American Journal of Public HealthA study of antipsychotic drug use in nursing homes: epidemiologic evidence suggesting misuse.
300 Citations1980Wayne A. Ray, Charles F. Federspiel +1 more
The review of prescriptions for Medicaid patients residing continuously for one year in 173 Tennessee nursing homes provides epidemiologic evidence suggesting misuse of antipsychotic drugs in nursing homes and illustrates the need for investigations of techniques for patient management in Nursing homes which rely less upon psychtropic drugs.
Postgraduate MedicineDrug interactions in the elderly
178 Citations1989Roger J. Cadieux
Following the "rule of five" is recommended to minimize interaction in this vulnerable population of elderly people to minimize the incidence of drug interactions.
New England Journal of MedicineUse of Psychoactive Medication and the Quality of Care in Rest Homes
175 Citations1989Jerry Avorn, Paul Dreyer +2 more
A survey of a random sample of 55 rest homes in Massachusetts found that 55 percent of the residents were taking at least one psychoactive medication, and nearly a third had performance deficits on mental-status testing that indicated serious cognitive impairment.
Journal of the American Geriatrics SocietyImproving Medication Prescribing and Utilization in the Nursing Home
158 Citations1990Jerry H. Gurwitz, Stephen B. Soumerai +1 more
The prominent role played by the nursing staff in the utilization of many medications in the nursing home implies that an educational intervention excluding nursing staff would be insufficient to influence drug utilization positively in many situations, including psychoactive medications and laxatives.
Annals of Internal MedicineSelf-Reported Adverse Drug Reactions and Related Resource Use
148 Citations1992Elizabeth A. Chrischilles, Ellen T. Segar +1 more
In this study of noninstitutionalized elderly persons, advanced age did not appear to be associated with increased risk for self-reported ADRs, and the decrease in ADR reports among the oldest respondents represented true diminished ADR occurrence or altered ADR detection and reporting capabilities.
Drugs & AgingAdverse Reactions as a Cause of Hospital Admission in the Aged
139 Citations1992Keith Beard
Some basic guidelines for sensible prescribing would almost certainly result in fewer ADRs in the elderly, including those ADRs severe enough to result in hospital admission.
Archives of Internal MedicineHospital Admissions Caused by Iatrogenic Disease
123 Citations1986Mark Lakshmanan
Though the incidence of iatrogenic admissions in this study is similar to that in previous reports, the profile of the responsible agents is different and there are no relationships with age, number or type of diagnoses, or number of medications on admission.
JAMADrug Use in the United States in 1981
117 Citations1984Carlene Baum
Ranking drug chemicals across different products and therapeutic indications indicated that nearly one of every ten prescriptions in 1981 contained either hydrochlorothiazide or codeine, indicating that overall drug use is increasing.
The GerontologistPsychotropic Drug Use in Long-term Care Facilities: A Review of the Literature
85 Citations1992Charlene Harrington, Connie A. Tompkins +2 more
It is found that a substantial proportion of nursing home residents are taking psychotropic drugs on a regular, long-term basis and this usage is accompanied by prescribing and monitoring problems and many potential adverse risks.
Medical CareCharacterization of the Use and Misuse of Medications by an Elderly, Ambulatory Population
47 Citations1989Linda R. Bernstein, Susan Folkman +1 more
This study provides a more detailed inspection of medications being used and their relationship with reported symptomatology and medical conditions than a similar study by Raffoul et al.
Journal of the Royal College of Physicians of LondonDrug-Related Illness Resulting in Hospital Admission
29 Citations1984Andrew J. Black, K. Somers
A number of hospital admissions appeared likely to be due to drug-related illness, although a causal relationship could not be definitely proven because of lack of data, or because of the ill-defined nature of the suspected adverse reaction.
DICPDrug Prescribing in Residential Homes for Elderly People in the United Kingdom
21 Citations1990Ronald B. Stewart, Peter B. Weedle +2 more
Data relating to the use of medicines from a descriptive epidemiologic study of drug use in 55 residential homes for elderly people in Britain were analyzed and defects were identified in doses, duration, and selection of drugs in certain therapeutic groups.
PubMedAdverse Drug Reactions: Review of the Canadian literature.
11 Citations1991Joel Lexchin
A combined manual and computer search of the literature on the Canadian experience with adverse drug reactions to prescribed drugs yielded a total of 23 articles, which revealed the risk of developing an ADR, factors influencing that risk, and the incidence of ADRs.