Healthy Skepticism Library item: 12968

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Journal Article

Kosińska K, Brandys J.
[Potentially inappropriate drugs for geriatric patients].
Przegl Lek. 2007; 64:(1):19-23
http://www.ncbi.nlm.nih.gov/pubmed/18183827

Abstract:

OBJECTIVE: Drug-related mortality and morbidity concern mainly older people because of frequent poly-pathology and polytherapy among them. The objective of this study was to estimate the scale of taking potentially inappropriate prescription drugs (PIPDs) by home-dwelling, elderly patients in the Polish environment and to evaluate the influence of age/gender of the patient and the specialty/place of practice of the practitioner and their choice of them. METHODS: Data were collected in pharmacies in Cracow and Gorlice and their vicinity. We analyzed PIPDs as revised by Beers et al. in 1997 and 2002. RESULTS: We analyzed data on 5086 prescriptions (10340 drugs). We observed buying the 19 types of PIPDs. The most common PIPDs were doxazosin (23.73% out of all PIPDs), hydroxyzine (16%), doxepin (9.33%), ticlopidine (9.06%), amiodarone (7.47%) and chlorazepate (7.2%). Other drugs were bought rarely. The prevalence of inappropriate choice of drugs was 3.6% (95% CI: 0.037-0.04, SD: 0.187). General practitioners and family medicine specialists prescribed PIPDs much more seldom than others. We did not observe exceeding of maximum daily doses of analyzed PIPDs. CONCLUSION: The analysis confirms the hypothesis that older patients, especially with polytherapy including psychotropic drugs, should be embraced by careful care of interdisciplinary medical teams.

Keywords:
Age Factors Aged Drug Utilization Review* Female Humans Male Medication Errors/mortality* Prescriptions, Drug/statistics & numerical data* Psychotropic Drugs/adverse effects* Psychotropic Drugs/therapeutic use*

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909