Abstract:
:High drug consumption among the elderly and inappropriate prescribing practices increase the risk of adverse drug effects in this population. This risk may be decreased by conducting, for example, a medication review alone or as part of a comprehensive geriatric assessment (CGA); however, little is known about the fate of the changes in medication made as a result of the CGA or medication review. To study the performance of the CGA with regards to medication changes and to determine the persistence of these changes over a 1-year period. This study was a population-based intervention study. A random sample of 1000 elderly (age > or =75 years) was randomized either to a CGA group or to a control group. Home-dwelling patients from these groups (n = 331 and n = 313 for intervention and control groups, respectively) were analysed in this study. Study nurses collected information on medication at study entry and 1 year later in both groups; in the intervention group, study physicians assessed, and changed when appropriate, the medication at study entry. The medication changes and their persistence over 1 year were then evaluated. Medication changes were more frequent in the intervention group than in the control group. Regular medication was changed during follow-up in 277 (83.7%) and in 228 (72.8%) [odds ratio (OR) 1.9; 95% CI 1.3, 2.8] patients in the intervention and control groups, respectively. In the intervention group, study physicians were responsible for 35.4% of all new prescriptions and for 15.6% of all drug terminations. Changes took place particularly in the prescription of CNS drugs. About 58% of the drugs initiated by study physicians were still in use 1 year later, and 25.5% of those terminated by study physicians had been reintroduced. Drug intervention as part of a CGA can be used to rationalize the drug therapy of a patient. However, its effectiveness is subsequently partly counteracted by other physicians working in the healthcare system.
journal_name
Drugs Agingjournal_title
Drugs & agingauthors
Lampela P,Hartikainen S,Lavikainen P,Sulkava R,Huupponen Rdoi
10.2165/11536650-000000000-00000subject
Has Abstractpub_date
2010-06-01 00:00:00pages
507-21issue
6eissn
1170-229Xissn
1179-1969pii
7journal_volume
27pub_type
杂志文章,随机对照试验相关文献
DRUGS & AGING文献大全abstract::Elderly people with renal impairment are at high risk for venous thromboembolism (VTE) and acute coronary syndromes (ACS); however, they are also at increased risk for bleeding complications. Evidence-based data for the management of anticoagulation in elderly patients with severe renal impairment, in particular, are ...
journal_title:Drugs & aging
pub_type: 杂志文章,评审
doi:10.2165/11586730-000000000-00000
更新日期:2011-03-01 00:00:00
abstract::Polymyalgia rheumatica (PMR) is a disease of unknown aetiology that occurs in elderly patients, predominantly affecting the Caucasian population. The disease has a slightly higher prevalence in women than in men. There is ongoing discussion regarding the relationship between PMR and giant cell arteritis; an increasing...
journal_title:Drugs & aging
pub_type: 杂志文章,评审
doi:10.2165/00002512-199813020-00003
更新日期:1998-08-01 00:00:00
abstract::Lithium salts have a well-established role in the treatment of major affective disorders. More recently, experimental and clinical studies have provided evidence that lithium may also exert neuroprotective effects. In animal and cell culture models, lithium has been shown to increase neuronal viability through a combi...
journal_title:Drugs & aging
pub_type: 杂志文章,评审
doi:10.2165/11599180-000000000-00000
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Improvement in renal function and decreases in serum uric acid (SUA) have been reported following prolonged high-intensity statin (HMG-CoA reductase inhibitor) therapy. This post hoc analysis of the SAGE trial examined the effect of intensive versus less intensive statin therapy on renal function, safety, an...
journal_title:Drugs & aging
pub_type: 杂志文章,随机对照试验
doi:10.1007/s40266-015-0328-z
更新日期:2015-12-01 00:00:00
abstract::Cardiovascular disease has been inseparable from aging in developed societies and, as a result, it is the commonest cause of mortality in elderly populations. Atherosclerosis is associated with the progressive vascular accumulation of cholesterol-laden lipoproteins, and is linearly associated with the plasma level of ...
journal_title:Drugs & aging
pub_type: 杂志文章,评审
doi:10.2165/00002512-199710060-00005
更新日期:1997-06-01 00:00:00
abstract::Chronic obstructive pulmonary disease (COPD) has considerable morbidity and mortality in the older adult population. The role of antibiotics in the management of acute exacerbations of COPD (AECOPD) is currently evolving. Despite only mild benefits, most patients with AECOPD in ambulatory settings receive antibiotics ...
journal_title:Drugs & aging
pub_type: 杂志文章,评审
doi:10.1007/s40266-020-00786-7
更新日期:2020-09-01 00:00:00
abstract::The focus of this review is hormone replacement therapy (HRT) with continuous oral 17 beta-estradiol (herein referred to as estradiol) 2 mg/day plus sequential oral dydrogesterone 10 or 20 mg/day for 14 days of each 28-day cycle. According to data from nonblind trials, this regimen relieves climacteric symptoms, prese...
journal_title:Drugs & aging
pub_type: 杂志文章,评审
doi:10.2165/00002512-199711040-00006
更新日期:1997-10-01 00:00:00
abstract::The fluoroquinolones are antibiotics frequently used in infections that affect elderly individuals. The physiological aging process can profoundly affect the pharmacokinetics of drugs, necessitating adjustment of dosage regimens in the elderly. Changes in pharmacokinetics with age are mainly due to the progressive det...
journal_title:Drugs & aging
pub_type: 杂志文章,评审
doi:10.2165/00002512-199101040-00004
更新日期:1991-07-01 00:00:00
abstract::Despite the availability of angiotensin converting enzyme (ACE) inhibitors for patients with congestive heart failure (CHF), mortality and morbidity remains unacceptably high. CHF is thought to progress as a result of activation of endogenous neurohormonal systems which are activated by the initial myocardial injury. ...
journal_title:Drugs & aging
pub_type: 杂志文章,评审
doi:10.2165/00002512-200016010-00001
更新日期:2000-01-01 00:00:00
abstract::Rheumatoid arthritis (RA) and osteoarthritis are chronic diseases that result in cartilage degradation and loss of joint function. Currently available drugs are predominantly directed towards the control of pain and/or the inflammation associated with joint synovitis but they do little to reduce joint destruction. In ...
journal_title:Drugs & aging
pub_type: 杂志文章,评审
doi:10.2165/00002512-200118020-00002
更新日期:2001-01-01 00:00:00
abstract::Giant cell arteritis (GCA) is an inflammatory vasculopathy that involves large- and medium-sized arteries and can cause vision loss, stroke and aneurysms. GCA occurs in people aged >50 years and is more common in women. A higher incidence of the disease is observed in populations from Northern European countries. Poly...
journal_title:Drugs & aging
pub_type: 杂志文章,评审
doi:10.2165/11592500-000000000-00000
更新日期:2011-08-01 00:00:00
abstract::In contrast with the earlier stages and, in particular, the predementia stage, of Alzheimer's disease (AD), severe dementia is often neglected. However, the advanced stages of dementia are just as important as the earlier stages because of their frequency, their impact on the lives of patients and their caregivers, an...
journal_title:Drugs & aging
pub_type: 杂志文章,评审
doi:10.2165/0002512-200926020-00005
更新日期:2009-01-01 00:00:00
abstract::Felodipine is a dihydropyridine calcium antagonist which may be administered once daily in an extended release (ER) formulation. As monotherapy in older patients with mild to moderate essential hypertension, felodipine ER once daily provides effective control of blood pressure (BP). The drug has also been effective, e...
journal_title:Drugs & aging
pub_type: 杂志文章,评审
doi:10.2165/00002512-199202050-00002
更新日期:1992-09-01 00:00:00
abstract::Attempts to control pneumococcal infection by vaccination, undertaken initially in 1911, have gone through 3 phases during the subsequent 8 decades. Initially, vaccines of killed pneumococcal cells prepared in a variety of ways were used in epidemic settings with inconclusive results, although administered to approxim...
journal_title:Drugs & aging
pub_type: 历史文章,杂志文章
doi:10.2165/00002512-199915001-00001
更新日期:1999-01-01 00:00:00
abstract::High fasting plasma homocysteine levels (> 12 to 15 mumol/L) are commonly encountered in clinical practice and are associated with increased risk of atherothrombotic disease. Treatment with folic acid (1 to 5 mg/day) is inexpensive and effective in normalising plasma homocysteine levels. High plasma homocysteine level...
journal_title:Drugs & aging
pub_type: 杂志文章,评审
doi:10.2165/00002512-200016040-00001
更新日期:2000-04-01 00:00:00
abstract::In contrast with women, who experience a complete and abrupt cessation of ovarian function during the menopause, aging men largely maintain their testicular androgen production. Nevertheless, most cross-sectional studies indicate that there is a partial decrease in testosterone levels with aging, although this has not...
journal_title:Drugs & aging
pub_type: 杂志文章,评审
doi:10.2165/00002512-199711010-00005
更新日期:1997-07-01 00:00:00
abstract::Cyproterone (cyproterone acetate) is a steroidal antiandrogenic agent that inhibits the action of adrenal and testicular androgens on prostatic cells. Additionally, its progestogenic activity causes a centrally mediated reduction in testicular secretion of androgens. Studies have demonstrated the effectiveness of cypr...
journal_title:Drugs & aging
pub_type: 杂志文章,评审
doi:10.2165/00002512-199405010-00006
更新日期:1994-07-01 00:00:00
abstract::Hyperuricaemia is an independent risk factor for renal function decline. Evidence is emerging that urate-lowering therapy might be beneficial in subjects with renal impairment. We review the association between renal impairment and gout, some of the related pathogenic processes and the possible impact of gout treatme...
journal_title:Drugs & aging
pub_type: 杂志文章,评审
doi:10.1007/s40266-018-0517-7
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Over three-quarters of the older population take medications that can potentially cause dry mouth. Physicians or pharmacists rarely inform patients about this adverse effect and its potentially severe damage to the teeth, mouth and general health. OBJECTIVES:The objectives of this study were to (1) identify...
journal_title:Drugs & aging
pub_type: 杂志文章
doi:10.1007/s40266-013-0141-5
更新日期:2014-01-01 00:00:00
abstract::Streptococcus pneumoniae has been recognised as a major cause of pneumonia since the time of Sir William Osler. Drug-resistant S. pneumoniae (DRSP), which have gradually become resistant to penicillins as well as more recently developed macrolides and fluoroquinolones, have emerged as a consequence of indiscriminate u...
journal_title:Drugs & aging
pub_type: 杂志文章,评审
doi:10.2165/00002512-200421130-00003
更新日期:2004-01-01 00:00:00
abstract:PURPOSE:To determine the association between changes in complete blood counts and grade 3 or 4 toxicities from cycle 1 to cycle 2 during adjuvant chemotherapy in women > or =65 years of age with breast cancer. DESIGN AND METHODS:A retrospective review was performed on 1405 patients > or =65 years of age who were treat...
journal_title:Drugs & aging
pub_type: 杂志文章
doi:10.2165/00002512-200522080-00007
更新日期:2005-01-01 00:00:00
abstract::Primary hyperparathyroidism is a common metabolic bone disease and currently presents a significant management dilemma. Most of the patients have few relevant symptoms and surgical parathyroidectomy offers the prospect of cure with freedom from the risk of long-term complications or the need for a follow-up. However, ...
journal_title:Drugs & aging
pub_type: 杂志文章,评审
doi:10.2165/00002512-200421150-00004
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Older people are often prescribed multiple drugs with sedative properties. Most research has focused on specific classes of sedative and psychotropic drugs. The cumulative effect of taking multiple drugs with sedative properties has been termed 'sedative load'. Few previous studies have investigated the seda...
journal_title:Drugs & aging
pub_type: 临床试验,杂志文章
doi:10.2165/11317080-000000000-00000
更新日期:2009-01-01 00:00:00
abstract::Unfortunately the sections were published incorrectly in the original article. ...
journal_title:Drugs & aging
pub_type: 已发布勘误
doi:10.1007/s40266-020-00807-5
更新日期:2020-11-01 00:00:00
abstract::It is inevitable that publicly funded, technically sophisticated medical treatments will be increasingly rationed. Other things being equal, there is a greater duty to use them to prolong the lives of younger than older people. Age is therefore an ethical rationing criterion. Denial of this may actually harm older peo...
journal_title:Drugs & aging
pub_type: 杂志文章
doi:10.2165/00002512-199609060-00003
更新日期:1996-12-01 00:00:00
abstract::Mild hypertension (grade 1 or stage 1 hypertension) is defined as a systolic blood pressure of 140-159 mm Hg or a diastolic pressure of 90-99 mm Hg. According to current guidelines, patients with mild hypertension can be at low, medium, high or very high risk depending on the presence of other risk factors, target org...
journal_title:Drugs & aging
pub_type: 杂志文章,评审
doi:10.2165/00002512-200421010-00001
更新日期:2004-01-01 00:00:00
abstract::Although a significant proportion of patients receiving nitrates are elderly, surprisingly little published work is available describing the pharmacokinetics and pharmacodynamics of these agents in elderly patients. The lack of pharmacokinetic data is related to the difficulty in assaying nitrates and there are at pre...
journal_title:Drugs & aging
pub_type: 杂志文章,评审
doi:10.2165/00002512-199202010-00003
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Although compelling evidence exists supporting statins (HMG-CoA reductase inhibitors) for secondary prevention in older patients with clinical atherosclerotic diseases, the same cannot be said for primary prevention. OBJECTIVES:The objectives of this study were to estimate the frequency of potential statin ...
journal_title:Drugs & aging
pub_type: 杂志文章
doi:10.1007/s40266-019-00695-4
更新日期:2019-10-01 00:00:00
abstract::Melatonin prolonged release (PR) 2 mg is approved for the treatment of primary insomnia characterized by poor sleep quality in patients aged ≥55 years in the EU and elsewhere. Patients may receive treatment with melatonin PR for up to 13 weeks. Production of endogenous nocturnal melatonin, which helps regulate circadi...
journal_title:Drugs & aging
pub_type: 杂志文章,评审
doi:10.1007/s40266-012-0018-z
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:The public health burden of osteoporosis is high, principally because of increased risk of fractures and associated morbidity, handicap and mortality. Osteoporotic fracture prevention is therefore an important public health goal. General practitioners (GPs) play a key role in the management of osteoporosis, ...
journal_title:Drugs & aging
pub_type: 杂志文章
doi:10.2165/00002512-200724070-00007
更新日期:2007-01-01 00:00:00