Can Overuse of Psychotropic Drugs by the Elderly be Prevented?

1990 ◽  
Vol 24 (1) ◽  
pp. 77-81 ◽  
Author(s):  
Robert W. Lyndon ◽  
Janice D. Russell
Keyword(s):  
Drug Use ◽  
Elderly Patients ◽  
Life Events ◽  
Psychotropic Medication ◽  
Psychotropic Drugs ◽  
Psychiatric Illness ◽  
The Elderly ◽  
Continued Use

Despite increasing awareness of the problems associated with long term psychotropic use, consumption by the elderly remains high. This study examines some of the reasons for this with a view to prevention. Fifty seven elderly patients using psychotropic medication were interviewed to determine the prevalence of psychiatric illness, patterns of drug use, the reasons for the initial prescription and any relationship to life events. Attitudes to continued use were also assessed. The results suggest that levels of psychotropic use by the elderly could be reduced by improved management of life crises and insomnia.

scholarly journals Long-term drug use and polypharmacy among the elderly population in the Republic of Srpska, Bosnia and Herzegovina

2016 ◽  
Vol 73 (5) ◽  
pp. 435-441
Author(s):  
Vanda Markovic-Pekovic ◽  
Ranko Skrbic
Keyword(s):  
Drug Use ◽  
Elderly Patients ◽  
Bosnia And Herzegovina ◽  
Elderly Population ◽  
Age Groups ◽  
The Elderly ◽  
Insurance Fund ◽  
The Republic ◽  
Multiple Drugs

Background/Aim. Prescription of drugs is a fundamental care component of the elderly. Elderly patients often take multiple drugs, and it is known that polypharmacy may lead to drug interactions and adverse events. The aim of this study was to analyze the long-term drug use and the prevalence of polypharmacy among the elderly population in the Republic of Srpska, Bosnia and Herzegovina. Methods. A retrospective study of outpatient drug use in 2005 and 2010 was conducted, analyzing prescriptions for patients aged ? 65 years reimbursed by the Health Insurance Fund. The study population was stratified by gender and age. Long-term drug use was defined as continuous drug dispensing for a whole year or at least two thirds of the year. Polypharmacy was defined as the use of 5 or more different reimbursed drugs. Results. Of all insured people aged ? 65 years, long-term drug use was identified in 10% (2005) and in 19% (2010), of whom 62% were women. Two to four different drugs were used by almost 49% (2005) and 54% (2010) of the elderly patients. The polypharmacy prevalence increased from 1.4% (2005) to 3.6% (2010); it increased in all the age groups of both genders. The largest increase was observed in the age group 65-74 years. Polypharmacy prevalence increase was higher in women. The most commonly used drugs were those for to treatment of cardiovascular diseases, in particular drugs for hypertension and cardiac treatment. Conclusion. The study findings point out to the increase of elderly population with a long-term drug use. Over a half of elderly patients use 2-4 different drugs on the long-term basis. The polypharmacy prevalence was low. It increased in the period of 5 years in both genders. The increase was more prominent in women of all the age groups. The use of multiple drugs and polypharmacy increased with ageing.

French patterns of psychotropic drug use

1990 ◽  
Vol 5 (5) ◽  
pp. 301-308
Author(s):  
V Kovess ◽  
M Ortun
Keyword(s):  
Drug Use ◽  
General Practitioners ◽  
Psychotropic Drug ◽  
Psychotropic Drugs ◽  
Elderly Population ◽  
The Elderly ◽  
Population Surveys ◽  
Minor Tranquilizers ◽  
French People ◽  
Few Data

SummaryFrench publications on psychotropics are curiously few. Data are available and French consumption of psychotropics, at least minor tranquilizers has been consistently reported as being higher than that found in other countries. The authors attempt to answer three questions: is French consuption of psychotropics really higher than other countries? Who is consuming those drugs? In which context? After having reviewed comparative data on sales, data from population surveys are analysed together with samples of prescriptions by different categories of physicians. It seems likely that French people consume more anxiolytics but this does not apply to other psychotropic drugs. Given the fact that drugs are almost free of charge in France, it is always difficult to discriminate between what has been prescribed and what has been taken. Overconsumption of anxiolytics is due to the overconsumption of the elderly population (over 60). Minor tranquilizers are mainly prescribed by general practitioners for psychological reasons.

scholarly journals Effects of 3-year GH replacement therapy on bone mineral density in younger and elderly adults with adult-onset GH deficiency

2012 ◽  
Vol 166 (2) ◽  
pp. 181-189 ◽  
Author(s):  
Mariam Elbornsson ◽  
Galina Götherström ◽  
Celina Franco ◽  
Bengt-Åke Bengtsson ◽  
Gudmundur Johannsson ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Elderly Patients ◽  
Bone Mineral ◽  
The Elderly ◽  
Marginal Effect ◽  
Adult Onset ◽  
Mineral Density ◽  
Gh Replacement ◽  
Femur Neck

ObjectiveLittle is known of the effects of long-term GH replacement on bone mineral content (BMC) and bone mineral density (BMD) in elderly GH-deficient (GHD) adults.Design/patients/methodsIn this prospective, single-center, open-label study, the effects of 3-year GH replacement were determined in 45 GHD patients >65 years and in 45 younger control GHD patients with a mean age of 39.5 (s.e.m.1.1) years. All patients had adult-onset disease and both groups were comparable in terms of number of anterior pituitary hormonal deficiencies, gender, body mass index, and waist:hip ratio.ResultsThe mean maintenance dose of GH was 0.24 (0.02) mg/day in the elderly patients and 0.33 (0.02) mg/day in the younger GHD patients (P<0.01). The 3 years of GH replacement induced a marginal effect on total body BMC and BMD, whereas femur neck and lumbar (L2–L4) spine BMC and BMD increased in both the elderly and the younger patients. The treatment response in femur neck BMC was less marked in the elderly patients (P<0.05 vs younger group). However, this difference disappeared after correction for the lower dose of GH in the elderly patients using an analysis of covariance. There were no between-group differences in responsiveness in BMC or BMD at other skeletal locations.ConclusionsThis study shows that GH replacement increases lumbar (L2–L4) spine and femur neck BMD and BMC in younger as well as elderly GHD patients. This supports the notion that long-term GH replacement is also useful in elderly GHD patients.

scholarly journals Liver and Pancreatic Resection in the Elderly

HPB Surgery ◽  
1997 ◽  
Vol 10 (4) ◽  
pp. 259-261 ◽  
Author(s):  
O. J. Garden
Keyword(s):  
Survival Rate ◽  
Liver Resection ◽  
Mortality Rate ◽  
Elderly Patients ◽  
Complication Rate ◽  
Pancreatic Resection ◽  
The Elderly ◽  
Term Survival ◽  
Pancreatic Resections

Background: Liver resection, or pancreaticoduodenectomy, has traditionally been thought to have a high morbidity and. mortality rate among the elderly. Recent improvements in surgical and anesthetic techniques, an increasing number of elderly patients, and an increasing need to justify use of limited health care resources prompted an assessment of recent surgical outcomes.Methods: Five hundred seventy-seven liver resections (July 1985–July 1994) performed for metastatic colorectal cancer and 488 pancreatic resections (October 1983–July 1994) performed for pancreatic malignancies were identified in departmental data bases. Outcomes of patients younger than age 70 years were compared with those of patients age 70 years or older.Results: Liver resection for 128 patients age 70 years or older resulted in a 4% perioperative. mortality rate and a 42% complication rate. Median hospital stay was 13 days, and 8% of the patients required admission to the intensive care unit (ICU). Median survival was 40 months, and the 5-year survival rate was 35%. No difference were found between results for the elderly and those for younger patients who had undergone liver resection, except for a minimally shorter hospital stay fortheyoungerpatients (median, 12 days vs. 13 days p=0.003). Pancreatic resection for 138 elderly patients resulted in a mortality rate of 6% and a complication rate of 45%. Median stay was 20 days, and 19% of the patients required ICU admission, results identical to those for the younger cohort. Long-term survival was poorer for the elderly patients, with a 5-year survival rate of 21% compared with 29% for the younger cohort (p=0.03).Conclusions: Major liver or pancreatic resections can be performed for the elderly with acceptable morbidity and mortality rates and possible long-term survival. Chronologic age alone is not a contraindication to liver or pancreatic resection for malignancy.

PRN Medication for Psychiatric Inpatients

1987 ◽  
Vol 32 (3) ◽  
pp. 199-203 ◽  
Author(s):  
John L. Craven ◽  
Peter M. Voore ◽  
George Voineskos
Keyword(s):  
Personality Disorder ◽  
Drug Use ◽  
Psychotropic Drug ◽  
Teaching Hospital ◽  
Psychotropic Medication ◽  
Psychotropic Drugs ◽  
Psychiatric Inpatient ◽  
Psychiatric Inpatients ◽  
Psychotropic Medications ◽  
Inpatient Units

Little is known about the extent of the use of prn psychotropic medication in psychiatric inpatient units. A survey of the prn prescription and administration of psychotropic drugs in a psychiatric teaching hospital revealed that a large number of inpatients were prescribed and administered such drugs on a prn basis. Although 50% of the prescriptions were never administered, only 25% were actively discontinued by physicians. A diagnosis of personality disorder was the factor most frequently associated with the rate of prn prescriptions and of administrations. A large number of prn prescriptions had no instructions for indications, minimum time spacing between doses or maximum daily dosage. It is suggested that hospitals monitor the prn use of psychotropic medications in their inpatient units, and explore the reasons for such use. Psychotropic drug use on a prn basis should preferably be reserved for emergencies, and the instructions of prn prescriptions should be clear and detailed.

scholarly journals Neurologic and Neuroscientific Evidence in Aged COVID-19 Patients

2021 ◽  
Vol 13 ◽  
Author(s):  
Shraddha Mainali ◽  
Marin E. Darsie
Keyword(s):  
Elderly Patients ◽  
Systemic Disease ◽  
Respiratory Illness ◽  
The Elderly ◽  
Cerebrovascular Diseases ◽  
Medical Comorbidities ◽  
Viral Illness ◽  
Atypical Presentations ◽  
Severe Systemic Disease

The COVID-19 pandemic continues to prevail as a catastrophic wave infecting over 111 million people globally, claiming 2. 4 million lives to date. Aged individuals are particularly vulnerable to this disease due to their fraility, immune dysfunction, and higher rates of medical comorbidities, among other causes. Apart from the primary respiratory illness, this virus is known to cause multi-organ dysfunction including renal, cardiac, and neurologic injuries, particularly in the critically-ill cohorts. Elderly patients 65 years of age or older are known to have more severe systemic disease and higher rates of neurologic complications. Morbidity and mortality is very high in the elderly population with 6–930 times higher likelihood of death compared to younger cohorts, with the highest risk in elderly patients ≥85 years and especially those with medical comorbidities such as hypertension, diabetes, heart disease, and underlying respiratory illness. Commonly reported neurologic dysfunctions of COVID-19 include headache, fatigue, dizziness, and confusion. Elderly patients may manifest atypical presentations like fall or postural instability. Other important neurologic dysfunctions in the elderly include cerebrovascular diseases, cognitive impairment, and neuropsychiatric illnesses. Elderly patients with preexisting neurologic diseases are susceptibility to severe COVID-19 infection and higher rates of mortality. Treatment of neurologic dysfunction of COVID-19 is based on existing practice standards of specific neurologic condition in conjunction with systemic treatment of the viral illness. The physical, emotional, psychologic, and financial implications of COVID-19 pandemic have been severe. Long-term data are still needed to understand the lasting effects of this devastating pandemic.

Psychotropic Drug Use Among the Elderly: Risk Factors Involved in Long-Term Use

2010 ◽  
Vol 45 (7-8) ◽  
pp. 1050-1059 ◽  
Author(s):  
Valérie Aubron ◽  
Vincent Camus ◽  
Badiâa Bouazzaoui ◽  
Antoine Pélissolo ◽  
Grégory Michel
Keyword(s):  
Risk Factors ◽  
Drug Use ◽  
Psychotropic Drug ◽  
The Elderly ◽  
Psychotropic Drug Use

scholarly journals Comparison of Outcomes Between McKeown and Sweet Esophagectomy in the Elderly Patients for Esophageal Squamous Cell Carcinoma: A Propensity Score-Matched Analysis

2020 ◽  
Vol 27 (1) ◽  
pp. 107327482090470
Author(s):  
Dongni Chen ◽  
Yihuai Hu ◽  
Youfang Chen ◽  
Jia Hu ◽  
Zhesheng Wen
Keyword(s):  
Squamous Cell Carcinoma ◽  
Propensity Score ◽  
Esophageal Squamous Cell Carcinoma ◽  
Elderly Patients ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
The Elderly ◽  
Perioperative Outcomes ◽  
Term Survival

The aim of this study was to compare the perioperative outcomes and long-term survival rates of the McKeown and Sweet procedures in patients with esophageal cancer younger than 70 years or older than 70 years. A total of 1432 consecutive patients with esophageal squamous cell carcinoma (ESCC) who received surgery at Sun Yat-sen University Cancer Center from January 2009 to October 2012 were analyzed. Propensity score matching was used to balance the clinical characteristics of the patients who underwent different surgical approaches, and 275 and 71 paired cases were matched among those younger and older than 70 years, respectively. The prognosis and postoperative outcomes were compared between the McKeown and the Sweet esophagectomy. For patients younger than 70 years, those who underwent the McKeown procedure had better overall survival (OS) than those in the Sweet group (log rank = 4.467; P = .035). However, no significant difference in disease-free survival and OS was observed between two approaches for the elderly patients (log rank = 1.562; P = .211 and log rank = 0.668; P = .414, respectively). Cox regression analysis revealed that McKeown approach was a positive prognostic factor compared to the Sweet approach for patients younger than 70 years in univariable analysis (HR = 0.790; 95% CI, 0.625-0.997; P = .047), whereas the surgical approach was not significantly related to the prognosis in the elderly patients. For patients older than 70 years, the occurrence of anastomotic fistula increased in those who underwent the McKeown procedure (23.9% vs 11.3%, P = .038, for the McKeown and Sweet esophagectomy, respectively). The McKeown approach increases the OS in younger patients with ESCC. However, for patients older than 70 years, the Sweet approach was proven to be an effective therapy, given the better perioperative outcomes and similar long-term survival compared with patients in the McKeown group.

Associate Members: A Life Worth Living

1986 ◽  
Vol 49 (11) ◽  
pp. 362-364 ◽  
Author(s):  
Jean Parker
Keyword(s):  
Elderly Patients ◽  
Long Term Care ◽  
The Elderly ◽  
Worth Living ◽  
Term Care ◽  
Life Worth Living ◽  
Meaningful Existence ◽  
Time And Energy

Long-term care patients need a meaningful existence. It is our responsibility to ensure that time and energy are channelled into purposeful solutions for the disease of ‘time with nothing to do’. The author has taken up this challenge. Working as an activities organizer with the elderly for 11 years, she was determined never to take the role of a baby-sitter. The recreation unit has grown from its first eight guests to a purpose-built unit with approximately 1,500 attendances per month. A busy happy atmosphere now prevails where once there was a sea of dead faces. The choice to retain a sense of dignity and purpose should be available to all elderly patients who require long-term care.

Sign in / Sign up

Export Citation Format

Share Document