Drugs and Aging
Adverse Drug Reactions, Adverse Drug Reactions And Health Care Utilization, Medication Use In The Older PopulationConclusion
Medication use by older people continues to receive attention in the lay media and in medical literature. People age sixty-five and over make up approximately 13 percent of the total population, yet they consume about 40 percent of all medications (Jones-Grizzle et al.). This rate of medication use among seniors coincides with the rate of many chronic diseases, which rise sharply with age. For example, arthritis, high blood pressure, and angina are reported by 47 percent, 43 percent, and 31 percent, respectively, by people age sixty-five years or older.
Patterns of medication use by seniors living at home or in nursing homes have previously been described (Avorn et al.; Chrischilles et al; and Cooper). In general, seniors living at home consume three to eight medications, with an increase in use with increasing age, for females, and for those with poor self-reported health (Chrischilles and Cooper). In the nursing home the number of ordered medications ranges from four to nine (Beers 1992).
The most commonly used classes of medications generally reflect the types of diseases that seniors have (Table 1). For example, the most commonly used medication classes are drugs for high blood pressure, arthritis, and stomach or intestinal diseases, and blood thinners and drugs such as antidepressants or tranquilizers (Chrischilles et al.).
The older population is growing rapidly, bringing various challenges to the health care system. One of the major challenges is that of ensuring safe and effective medication use in older people. The unique needs and characteristics of this population must be taken into account by health care professionals involved in the care of older people in order to prevent drug-related problems.
CARLOS H. ROJAS-FERNANDEZ
See also ALCOHOLISM; ARTHRITIS; BRAIN; DRUG REGULATION; HERBAL THERAPY; KIDNEY; AGING.
AVORN, J., and GURWITZ, J. H. "Drug Use in the Nursing Home." Annals of Internal Medicine 123 (1995): 195–204.
BEERS, M. H.; OUSLANDER, J. G.; FINGOLD, S. F.; MORGENSTERN, H.; REUBEN, D. B.; ROGERS, W., et al. "Inappropriate Medication Prescribing in Skilled-Nursing Facilities." Annals of Internal Medicine 117 (1992): 684–689.
BOOTMAN, J. L.; HARRISON, D. L.; and COX, E. "The Health Care Cost of Drug Related Morbidity and Mortality in Nursing Facilities." Archives of Internal Medicine 157 (1997): 2089–2096.
CHRISCHILLES, E. A.; SEGAR, E. T.; and WALLACE, R. B. "Self-Reported Adverse Drug Reactions and Related Resource Use. A Study of Community Dwelling Persons 65 Years of Age and Older." Annals of Internal Medicine 117 (1992): 634–640.
CHRISCHILLES, E. A.; FOLEY, D. J.; WALLACE, R. B.; LEMKE, J. H.; SEMLA, T. P.; HANLON, J. T., et al. "Use of Medications by Persons 65 and Over: Data from the Established Populations for Epidemiologic Studies of the Elderly." Journal of Gerontology 47 (1992): M137–M144.
CLASSEN, D. C.; PESTOTNIK, S. L.; EVANS, R. S.; LLOYD, J. F.; and BURKE, J. P. "Adverse Drug Events in Hospitalized Patients. Excess Length of Stay, Extra Costs, and Attributable Mortality." Journal of the American Medical Association 277, no. 4 (1997): 301–306.
COL, N.; FANALE, J. E.; and KRONHOLM, P. "The Role of Medication Non-compliance and Adverse Drug Reactions in Hospitalization of the Elderly." Archives of Internal Medicine 150 (1990): 841–845.
COLT, H. G., and SHAPIRO, A. P. "Drug-induced Illness as a Cause for Admission to a Community Hospital." Journal of the American Geriatrics Society 37 (1989): 323–326.
COOPER, J. W. "Probable Adverse Drug Reactions in a Rural Geriatric Nursing Home Population: A Four Year Study." Journal of the American Geriatrics Society 44 (1996): 194–197.
DRACHMAN, D. "Aging and the Brain: A New Frontier." Annals of Neurology 42 (1997): 819–828.
GORDON, J.; ROJAS-FERNANDEZ, C.; and ROCKWOOD, K. "Practical Solutions to Polypharmacy Problems in the Elderly." Canadian Journal of Diagnosis 15, no. 4 (1998): 78–90.
GURWITZ, J. H., and AVORN, J. "The Ambiguous Relation Between Aging and Adverse Drug Reactions." Annals of Internal Medicine 114 (1991): 956–966.
HANLON, J. T.; SCHMADER, K. E.; and LEWIS, I. K. "Adverse Drug Reactions." In Therapeutics in the Elderly. Edited by J. C. Delafuente and R. B. Stewart. Cincinnati: Harvey Whitney Books, 1995. Pages 212–227.
HANLON, J. T.; SCHMADER, K. E.; KORONKOWSKI, M. J., et al. "Adverse Drug Events in High Risk Older Outpatients." Journal of American Geriatrics Society 45 (1997): 945–948.
JONES-GRIZZLE, A. J., and DRAUGALIS, J. R. "Demographics." In Geriatric Pharmacology. Edited by R. Bressler and M. D. Katz. New York: McGraw-Hill, 1993. Pages 1–8.
LINDLEY, C. M.; TULLY, M. P.; PARAMSOTHY, V.; and TALLIS, R. C. "Inappropriate Medication is a Major Cause of Adverse Drug Reactions in Elderly Patients." Age and Aging 21 (1992): 294–300.
MATZKE, G. R., and MILIKIN, S. P. "Influence of Renal Function and Dialysis on Drug Disposition." In Applied Pharmacokinetics: Principles of Therapeutic Drug Monitoring. Edited by W. E. Evans, J. J. Schentag, and W. J. Jusko. Vancouver, Wash.: Applied Therapeutics, 1992. Secs. 8.1–8.49.
MAYERSOHN, M. B. "Special Considerations in the Elderly." In Applied Pharmacokinetics: Principles of Therapeutic Drug Monitoring. Edited by W. E. Evans, J. J. Schentag, and W. J. Jusko. Vancouver, Wash.: Applied Therapeutics, 1992. Secs. 9.1–9.43.
SOTANIEMI, E. A.; ARRANTO, A. J.; PELKONEN, O., et al. "Age and Cytochrome P450-linked Drug Metabolism in Humans: An Analysis of 226 Subjects with Equal Histopathologic Conditions." Clinical Pharmacology and Therapeutics 61 (1997): 331–339.
DURABLE POWER OF ATTORNEY
See ADVANCE DIRECTIVES FOR HEALTH CARE
- Drug Regulation - Discovery, Preclinical Testing, Phase I, Phase Ii, Phase Iii, Review By The U.s. Food And Drug Administration - Phase IV, Time and cost
- Drugs and Aging - Adverse Drug Reactions
- Drugs and Aging - Adverse Drug Reactions And Health Care Utilization
- Drugs and Aging - Medication Use In The Older Population
- Drugs and Aging - Pharmacokinetics, Pharmacodynamics, And Aging
- Drugs and Aging - Aging And The Brain: Drug Effects
- Drugs and Aging - General Principles Of Drug Therapy
- Other Free Encyclopedias