Objectives We aimed to assess the prevalence of opioid and benzodiazepine prescription drug misuse in older adults, the risk factors associated with misuse, and age-appropriate interventions. Methods Following PRISMA guidelines, we conducted a literature search for reports on misuse of prescription benzodiazepines and opioids in older adults. We searched PubMed, PsycINFO, and EMBASE for peer reviewed journal articles in English through April 2014 with updates through November 2015. We reviewed relevant publications that included participants ≥ 65 years of age. We also manually searched reference lists of key identified articles and geriatric journals through April 2016. Information on the study design, sample, intervention, comparators, outcome, time frame, and risk of bias were abstracted for each article. Results Of 4932 reviewed reports, 15 were included in this systematic review. Thirteen studies assessed the prevalence of prescription drug misuse and included studies related to opioid shopping behavior, assessment of morbidity and mortality associated with opioid and/or benzodiazepine use, frequency and characteristics of opioid prescribing, frequency of substance use disorders and non-prescription use of pain relievers, and the health conditions and experiences of long-term benzodiazepine users. One study identified risk factors for misuse and one study described the effects of provider education and an electronic support tool as an intervention. Discussion There is a dearth of high quality research on prescription drug misuse in older adults. Existing studies are heterogeneous, making it difficult to draw broad conclusions. We discuss the need for further research specific to prescription drug misuse among older adults.

These results support that treating insomnia in patients with depression has a positive effect on mood. Future trials are needed to identify the subtypes of patients whose depression improves during treatment with insomnia-specific interventions, and to identify the mechanisms by which treating insomnia improves mood.

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BackgroundFamilies of children at the worst end of the congenital heart disease endure a significant burden which is often not clearly delineated in the clinical literature. We examined the greatest concerns of parents whose children have a Fontan circulation.MethodsParents (N = 107) of children in the Australian and New Zealand Fontan Registry completed online surveys with open-ended and closed questions. A qualitative method approach incorporating thematic analyses was used.ResultsThe greatest concerns for parents of a child with a Fontan circulation were centered on fear of death for their child and psychosocial well-being, followed by lesser themes around anti-coagulation use, pregnancy and financial burdens.ConclusionsFear of death and the psychological well-being of their children were the main parental concerns. It highlights the need to clearly communicate information on outcomes to families, and the need for family-focused psychological interventions to improve the psychosocial functioning of both parents and young people.