Polypharmacy in the Elderly: A Fait Accompli?

Stewart, Ronald B.

doi:10.1177/106002809002400320

Cited by 43 publications

(25 citation statements)

References 11 publications

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“…The average number of items prescribed by individual physicians in Saudi Arabia was positively related to the physician's age, average daily patient load, and negatively to the physician's educational background [21]. Although there is a trend toward decreasing the number of drugs prescribed per prescription, current figures remain relatively high, especially when compared with an average of 2-3 medications per patient prescribed for elderly patients with multiple and chronic conditions in the United States [22]. This polypharmacy may be explained by a governmental system which provides free medical service including drugs, a view which is substantiated by a positive correlation between prescription frequency and free medication for the public in the United Kingdom [23] and third-party insurance patients in the United States [24].…”

Section: Discussionmentioning

confidence: 99%

Prescribing Patterns of Ambulatory Care Physicians in Saudi Arabia

Bawazir

1993

Ann Saudi Med

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The drug prescribing patterns of ambulatory care physicians in the Ministry of Health (MOH) hospitals were studied by examining 10,291 systematically sampled prescriptions obtained from 22 general hospitals covering the various health regions within Saudi Arabia. An audit of prescription information revealed that documentation was not generally complete. Information relating to patient age and diagnosis was missing in 18.6% and 9.8% of the prescriptions, respectively. The average number of drugs per prescription was 2.1 ± 0.95. The most frequently prescribed drug categories were systemic anti-infectives, analgesics/antipyretics, and vitamin preparations, respectively. Paracetamol, ampicillin, antacid preparations, and vitamin B complex were the specific drugs that ranked high in the frequency of prescription. The patterns of drug use observed in this study indicate a trend for the overprescribing of certain categories of drugs. The need to improve current drug policy and drug prescribing is discussed with a recommendation for the establishment of a Pharmacoepidemiology Unit to monitor drug use in Saudi Arabia. Arabia. 1993; 13(2): 172-177 Since its establishment in the mid 1950s, the health care system within the Kingdom of Saudi Arabia (KSA) has undergone tremendous changes. The process of modernization and expansion of the system was very rapid by all standards [1]. Although the Ministry of Health (MOH) is the main authority responsible for the provision of health care in the country, other government sectors such as the Ministry of Defense, National Guard, and the Ministry of Interior have started providing health care for their employees and dependents. The government health care policy is to provide free health service, including drugs, to all its citizens and resident expatriates. The provision of drugs on a large scale, in addition to ensuring their subsequent proper use, is a massive undertaking for the MOH. Due to this, proper guidelines and adequate controls for drug distribution and appropriate usage need to be developed. SA Bawazie, Prescribing Patterns of Ambulatory Care Physicians in SaudiThe need to develop a national drug policy and promote rational drug use in Saudi Arabia was recognized early and effective measures to address these issues were undertaken by the passage of two important laws governing the profession of pharmacy and the registration of pharmaceuticals in 1978 [2]. Legislation alone, however, cannot ensure the proper use of drugs. Documentation of drug utilization information is an essential step in the process of instituting rational drug use. This issue is a global priority.The rapid expansion of the pharmaceutical industry in the developed countries in the late 1960s has been responsible for developing countries being flooded with products of both proven and questionable qualities. This, coupled with the industry's intensive advertising campaign in these countries which have weak health education programs, has adversely influenced the pattern of drug use among the population...

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Section: Discussionmentioning

confidence: 99%

Prescribing Patterns of Ambulatory Care Physicians in Saudi Arabia

Bawazir

1993

Ann Saudi Med

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“…17 Polypharmacy was defined as concurrent use of ≥5 medications. [18][19][20] Potentially inappropriate medication (PIM) use was categorized by three evidence-based, clinically validated criteria and screening tools. [21][22][23][24][25] Demographic and clinical patient information was collected from medical records including age, sex, and race; cancer type and cancer stage; comorbidities (number and type); Eastern Cooperative Oncology Group (ECOG) performance status 26 and functional status using stages of aging 26 described as fit, vulnerable, or frail which was assessed and determined by core geriatricians at the center.…”

Section: Design and Methodsmentioning

confidence: 99%

A pharmacist-led medication assessment used to determine a more precise estimation of the prevalence of complementary and alternative medication (CAM) use among ambulatory senior adults with cancer

Nightingale

Hajjar

Guo

et al. 2015

Journal of Geriatric Oncology

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“…An older patient is more likely to have multiple diseases, which may require several medications [3,4,5]. However, multiple medication use was reported to increase the risk of adverse drug events and noncompliance [6,7].…”

Section: Introductionmentioning

confidence: 99%

Is cognitive impairment a risk factor for poor compliance among Japanese elderly in the community?

Okuno

Yanagi

Tomura

2001

European Journal of Clinical Pharmacology

127

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We found that cognitive impairment was one of the predictors for poor compliance among the elderly who are functionally independent in the community. Intentional noncompliance was the strongest predictor for poor compliance, which was influenced by the relationship between patient and physician. Physicians should establish good communication with their elderly patients and provide some support to compensate for cognitive impairment.

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Polypharmacy in the Elderly: A Fait Accompli?

Cited by 43 publications

References 11 publications

Prescribing Patterns of Ambulatory Care Physicians in Saudi Arabia

Prescribing Patterns of Ambulatory Care Physicians in Saudi Arabia

A pharmacist-led medication assessment used to determine a more precise estimation of the prevalence of complementary and alternative medication (CAM) use among ambulatory senior adults with cancer

Is cognitive impairment a risk factor for poor compliance among Japanese elderly in the community?

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