Ambulatory Care: Medication Use Characteristics in an Ambulatory Elderly Population in Taiwan

1997 ◽  
Vol 31 (3) ◽  
pp. 308-314 ◽  
Author(s):  
Rou-Yee Chen Hsu ◽  
Min-Shung Lin ◽  
Mei-Huei Chou ◽  
Ming-Fang Lin
Keyword(s):  
Hormone Replacement ◽  
The Elderly ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Prescribing Patterns ◽  
Cross Sectional Survey ◽  
Antiinflammatory Drugs ◽  
Cross Sectional ◽  
Therapeutic Category ◽  
Prescribing Trends ◽  
Drug Expenditures

Objective To compare prescribing patterns between the elderly and nonelderly in 1994, to disclose prescribing trends in the elderly between 1992 and 1994, to explore whether drug utilization is in agreement with disease prevalence, and to identify suboptimal prescribing by drug category for ambulatory elderly patients. Design Cross-sectional survey at two separate time intervals. Setting All public group practice centers (GPCs) in Taiwan. Patients Ambulatory adults who visited GPCs during 1 random week. Those 65 years or over were classified as the elderly group, and those 20-64 years were the nonelderly group. Main Outcome Measures Mean diagnosis, drug use, and expenditure; frequency of diagnosis; and prescribing by therapeutic category. Results Data on 30 777 elderly and 38 184 nonelderly patients were collected in 1994. There was widespread use of antacids. Compared with nonelderly adults, the elderly were diagnosed with more diseases (1.3 vs. 1.2, respectively; p < 0.01), received more medications (4.7 vs. 4.1, respectively; p < 0.01), and had higher drug expenditures (5.4 vs. 4.6, respectively; p < 0.01). Chronic illness was more prevalent in the elderly, which accounted for the extensive use of cardiovascular drugs (32.1%), nonsteroidal antiinflammatory drugs (25.9%), and anxiolytics (15.9%). The upward trend in the elderly from 1992 to 1994 with hypertension (18.6% vs. 20.0%) or diabetes (9.2% vs. 10.9%) did not result in more cases of cerebrovascular disease (7.1% vs. 4.9%). There was a substantial increase in use of antispasmodic and gastroprokinetic agents (4.5% to 10.7%); the use of antacids decreased (73.6% to 63.4%) in the elderly. Conclusions Compared with the prevalence of disease, there was extensive nonspecific use of anxiolytics and antacids. However, lessened use of antidepressants and postmenopausal hormone replacement may have an impact on morbidity and mortality and deserves particular attention.

Oxaprozin-Induced Fulminant Hepatitis

1994 ◽  
Vol 28 (10) ◽  
pp. 1159-1161 ◽  
Author(s):  
Preston P. Purdum ◽  
Stacey L. Shelden ◽  
John W. Boyd ◽  
Mitchell L. Shiffman
Keyword(s):  
Fulminant Hepatic Failure ◽  
Hepatic Failure ◽  
Fulminant Hepatitis ◽  
The Elderly ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Antiinflammatory Drugs ◽  
Drug Induced ◽  
Hepatic Transaminase ◽  
Long Acting ◽  
Work Up

OBJECTIVE: To report oxaprozin-induced fulminant hepatic failure. CASE SUMMARY: A 56-year-old woman was admitted with fulminant hepatic failure. Work-up for potential etiologies was negative except for the use of oxaprozin for the preceding two months. Results of premortem liver biopsy were consistent with drug-induced hepatic injury similar to that previously reported with diclofenac. DISCUSSION: Although the literature describes elevation in hepatic transaminase concentrations associated with oxaprozin, fulminant hepatic failure has not been described previously. CONCLUSIONS: Elevations in hepatic transaminase concentrations and now fulminant hepatic failure have been shown to occur with oxaprozin, as previously seen with other nonsteroidal antiinflammatory drugs (NSAIDs). Transaminitis is a known adverse effect of NSAID use, but is usually mild and reversible with discontinuation of drug. Transaminitis may be more likely to occur in the elderly, in patients receiving concurrent potentially hepatotoxic medications, and possibly with the newer long-acting NSAIDs. The existence of fulminant hepatitis, although rare, supports the need for monitoring liver function enzymes during NSAID therapy.

Association of socioeconomic and lifestyle factors with chronic non-communicable diseases and multimorbidity among the elderly in rural southwest China

2019 ◽  
Vol 42 (2) ◽  
pp. 239-246 ◽  
Author(s):  
Xiao Li ◽  
Le Cai ◽  
Wen-long Cui ◽  
Xu-ming Wang ◽  
Hui-fang Li ◽  
...  
Keyword(s):  
Older Adults ◽  
Low Income ◽  
Southwest China ◽  
Communicable Disease ◽  
Fasting Blood Glucose ◽  
The Elderly ◽  
Lifestyle Factors ◽  
Medical Services ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Background This study estimates the prevalence of five chronic non-communicable disease (NCDs) (hypertension, diabetes, CHD, COPD and stroke) and its multimorbidity, and examines the relationship between SES and lifestyle factors and multimorbidity among older adults in rural southwest China. Methods A cross-sectional survey of 4833 consenting adults aged ≥60 years was conducted in 2017. Data on the demographics, smoking, drinking, height, weight, blood pressure and fasting blood glucose were collected. Results Among the participants, the overall prevalence of hypertension, diabetes, stroke, COPD and CHD was 50.6, 10.2, 6.4, 5.4 and 5.5%, respectively, and of multimorbidity was 16.1%. Females had a higher prevalence of hypertension, diabetes and multimorbidity of chronic NCDs, but a lower prevalence of COPD than males (P &lt; 0.05). Older adults with good household assets and access to medical services were less likely to experience multimorbidity, whereas obese and centrally obese participants, current smokers, current drinkers and those with a family history of chronic NCDs had a greater probability of multimorbidity. Conclusions The findings suggest that effective strategies for prevention and control of chronic NCDs and its multimorbidity are urgently needed, especially for low-income, elderly, ethnic minority adults with poor access to medical services.

scholarly journals Burden and Disease Characteristics of Patients with Psoriatic Arthritis: A Population-based Cross-sectional Study

2019 ◽  
Vol 46 (7) ◽  
pp. 716-720 ◽  
Author(s):  
Hasan G. Tekin ◽  
Jashin J. Wu ◽  
Russel Burge ◽  
Julie Birt ◽  
Alexander Egeberg
Keyword(s):  
Psoriatic Arthritis ◽  
Population Based ◽  
Cross Sectional Study ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Considerable Proportion ◽  
Antiinflammatory Drugs ◽  
Cross Sectional ◽  
Disease Characteristics ◽  
Systemic Corticosteroids ◽  
Comorbid Diseases

Objective.To describe the prevalence and treatment regimes, disease characteristics, and comorbid diseases among patients with psoriatic arthritis (PsA) in Denmark.Methods.All Danish individuals aged ≥ 18 years with rheumatologist-diagnosed PsA were linked in nationwide administrative registers.Results.Among 4.7 million individuals in Denmark, 10,577 patients with PsA had been diagnosed by a rheumatologist. A female predominance (54.5–59.8%) was seen among patients with PsA, and about half of the patients (53.0%) had received no treatment or treatment only with nonsteroidal antiinflammatory drugs/systemic corticosteroids, while 32.9% had received nonbiological disease-modifying antirheumatic drugs (DMARD) and 14.1% had been treated with biologicals. Cutaneous psoriasis was recorded in 66.2–72.3% of patients with PsA, and patients with severe PsA had the highest prevalences of distal interphalangeal arthropathy, spondylitis, and arthritis mutilans. Smoking and comorbid diseases such as hypertension, diabetes, depression, and anxiety were seen frequently in patients with PsA, but did not significantly differ across severities of PsA.Conclusion.Disease burden appeared to be significant in patients with PsA across all severities. A considerable proportion of patients with PsA did not receive active antipsoriatic treatment, and about 1 out of 3 patients was not diagnosed with psoriasis. Cutaneous symptoms of psoriasis in patients with PsA might be either underreported or undertreated.

Population-based cardiovascular risk factors in the elderly in Turkey: a cross-sectional survey

Open Medicine ◽  
2008 ◽  
Vol 3 (2) ◽  
pp. 173-178 ◽  
Author(s):  
Adem Ozkara ◽  
Faruk Turgut ◽  
Mehmet Kanbay ◽  
Yusuf Selcoki ◽  
Ali Akcay
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Risk Factors ◽  
Past History ◽  
Public Health Problem ◽  
The Elderly ◽  
Cross Sectional Survey ◽  
Important Public Health Problem ◽  
Cross Sectional

AbstractHypertension, diabetes, hyperlipidaemia, obesity and smoking are known to be the most important modifiable risk factors for cardiovascular disease (CVD). Because the elderly population has been increasing globally, CVD may become a more important public health problem in the future. This report examines the prevalence of cardiovascular risk factors in the elderly in Ankara, Turkey. This was a cross-sectional survey and included a total of 2720 individuals living in the Ankara district. Trained research staff administered a standard questionnaire in the participants’ homes and worksites. The questionnaire collected information on clinical and demographic characteristics and a self-reported medical history, including past history of hypertension, diabetes, hyperlipidemia, coronary artery disease, coronary artery by-pass graft operation, and cerebrovascular accident. The mean age of the study participants was 69.5 ± 7.2 years. The study identified 1298 women (78.1%) and 753 men (71.2%) with hypertension, and the overall prevalence of hypertension was 75.4%. A total of 739 (27.2%) people had diabetes mellitus, and, of these people, 603 (81.6%) were hypertensive. A total of 1361 people had hyperlipidemia, and 1103 of these patients were also hypertensive. The overall prevalence of obesity was 27.2%. A total of 553 (20.3%) people were smokers. Our findings indicate that cardiovascular risk factors are very common in the elderly. To maximize risk reduction, physicians must take aggressive measures to decrease cardiovascular risk factors.

Oncologists’ perspectives on medical marijuana for the elderly.

2019 ◽  
Vol 37 (31_suppl) ◽  
pp. 78-78
Author(s):  
Desiree Rachel Azizoddin ◽  
Andrea Catherine Enzinger ◽  
Alexi A. Wright ◽  
Miryam Yusufov ◽  
Fangxin Hong ◽  
...  
Keyword(s):  
Older Adults ◽  
Cancer Patients ◽  
Medical Marijuana ◽  
The Elderly ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Elderly Cancer Patients ◽  
Treatment Side Effects ◽  
Nationally Representative

78 Background: Cancer patients are increasingly using medical marijuana (MM) to manage symptoms and treatment side effects. Although cancer disproportionately affects the elderly, little is known about oncologists’ attitudes toward MM in this population. We surveyed US oncologists’ beliefs about the benefits of MM for older adults, and examined their associations with oncologists’ perceptions of MM efficacy and safety. Methods: 232 out of 400 randomly selected U.S. oncologists (63% response rate) completed a cross-sectional survey about their beliefs and recommendations regarding MM for cancer patients. Using Chi-square tests, we examined associations between oncologists’ demographics, their perceptions of geriatric MM use, as well as beliefs about comparative effectiveness of MM for cancer related symptoms, and comparative risks of MM to prescription opioids. Results: Among 232 oncologists included in this cohort, 109 (47.0%) reported that MM had at least some benefit for elderly cancer patients, 66 (28.4%) responded it was rarely or never beneficial, and 57 (24.6%) reported not knowing. There were no significant associations between oncologists’ beliefs about MM’s benefit for older adults and their sociodemographic characteristics. Those who believed MM was beneficial for the elderly were significantly more likely to report that MM was at least as effective as standard treatments for the following indications: coping (58.3% vs. 26.6%), appetite (83.3% vs 58.5%), depression (46.3% vs 25.0%), and nausea (66.7% vs 33.9%), respectively ( p < 0.001). In contrast, oncologists’ beliefs about MM for the elderly were not significantly associated with perceptions of the comparative risks of MM ( p > 0.05). Conclusions: In this nationally-representative sample of US oncologists, about half thought MM was beneficial for older adults with cancer. Oncologists’ support of MM for older adults was associated with perceptions of MM’s efficacy but was not associated with perceptions of MM’s risks. More research is needed regarding the safety and efficacy of MM to guide oncologists’ recommendations about its use in older adults.

Assessing Physician Choice of Nonsteroidal Antiinflammatory Drugs in a Health Maintenance Organization

1993 ◽  
Vol 27 (11) ◽  
pp. 1393-1399 ◽  
Author(s):  
Barbara Kaplan ◽  
Karen B. Farris ◽  
Duane M. Kirking
Keyword(s):  
Large Population ◽  
Health Maintenance Organization ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Nsaid Therapy ◽  
Prescribing Patterns ◽  
Utilization Review ◽  
Antiinflammatory Drugs ◽  
Potential Cost ◽  
Health Maintenance ◽  
Acute Patients

OBJECTIVE: To develop a categorization scheme for grouping various nonsteroidal antiinflammatory drugs (NSAIDs) by relative safety; to develop a method to quantify the appropriateness of the initial and subsequent choices of NSAID therapy; to assess whether NSAID prescribing was consistent with the developed criteria; to examine the cost of inappropriate, acute NSAID use as defined by the established criteria. DESIGN: Retrospective drug utilization review focusing on NSAIDs. SETTING/PARTICIPANTS: Members aged age⩾18 years of a 40 000-person southeastern Michigan health maintenance organization MAIN OUTCOME MEASURES: (1) Appropriateness of therapy using a four-level safety classification system for the NSAIDs developed by a consensus process; criteria based on safety under the assumption that any particular NSAID is equally likely to be effective when dosed appropriately; (2) evaluation of progression of NSAID therapy using the NSAID Therapy Progression Formula. RESULTS: For acute patients, almost half of the prescriptions were for ibuprofen and 33 percent were for naproxen. Ibuprofen usage accounted for 16 percent of total NSAID cost and naproxen agents accounted for over 50 percent of that cost. Potential cost savings of approximately $82 000 probably would have occurred had a 50 percent interchange rate for ibuprofen been acceptable. For chronic patients, 85 percent were treated with one or two NSAIDs; treatments were of reasonable high quality when compared by safety profiles. There was low use of ibuprofen in patients who only received one NSAID. CONCLUSIONS: NSAID usage assessment in a large population was achieved by developing a classification and scoring system based on NSAID safety; in this population, prescribing patterns were generally consistent with established criteria; however, when considering cost, improvement in initial NSAID selection for acute patients was possible.

Public knowledge about dementia in South Korea: a community-based cross-sectional survey

2014 ◽  
Vol 27 (3) ◽  
pp. 463-469 ◽  
Author(s):  
Hyun-Ju Seo ◽  
Dong Young Lee ◽  
Mi Ra Sung
Keyword(s):  
South Korea ◽  
Quantitative Methods ◽  
The Elderly ◽  
Population Based ◽  
Cross Sectional Study ◽  
Public Knowledge ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Cross Sectional ◽  
General Populations

ABSTRACTBackground:The highest increase in the prevalence of dementia in the elderly population is expected in South Korea than in any other country in the world. However, there is no assessment of the community-based general populations’ understanding of dementia in South Korea, in spite of the increasing burden of dementia. Thus, this study assessed the public knowledge about dementia.Methods:This is a population-based, cross-sectional study of 2,189 participants, aged 10 years or older, and living in Seoul, South Korea. A 12-item questionnaire with true/false responses was used to assess the knowledge about dementia from June to November 2011. The data obtained were analyzed using quantitative methods.Results:The mean score for the knowledge about dementia was 9.0 ± 2.1 points out of 12 points. More than half of the respondents (52.7%) reported that dementia is not treatable, and one-third of the participants did not know that Alzheimer's disease is the most common cause of dementia. The level of dementia knowledge was negatively associated with increasing age, and positively associated with higher education level.Conclusions:Our results suggest that although laypersons had a fair knowledge about dementia, further educational programs and campaigns are needed to improve knowledge about dementia, more focusing on elderly adults as the target audience and emphasizing the causes and treatments of dementia as educational contents.

Factors Associated with Suboptimal Analgesic use in Community-Dwelling Elderly

1996 ◽  
Vol 30 (7-8) ◽  
pp. 739-744 ◽  
Author(s):  
Joseph T Hanlon ◽  
Gerda G Fillenbaum ◽  
Stephanie A Studenski ◽  
Thandi Ziqubu-Page ◽  
William E Wall
Keyword(s):  
Functional Status ◽  
White Women ◽  
The Elderly ◽  
Epidemiologic Studies ◽  
Community Dwelling ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Financial Status ◽  
Factors Associated ◽  
Analgesic Use

OBJECTIVE: To examine patterns and factors associated with overall and suboptimal analgesic use among community-dwelling elderly. DESIGN: Cross-sectional survey. SETTING: Five-county urban and rural region in Piedmont, NC. PARTICIPANTS: A stratified random sample from the Duke Established Populations for Epidemiologic Studies of the Elderly of 3973 participants aged 65 years or older. MAIN OUTCOME MEASURES: Use of any analgesic medication, suboptimal analgesic use (taking 2 or more analgesics from the same class, using 3 or more analgesics concurrently, or use of an analgesic that has a major interaction with another drug). RESULTS: Analgesics were used by 60.4% of the participants. Use was more likely for those who had physical functional impairment, a history of cardiovascular disease, one or more health visits in the previous year, or were female. Use was less likely for older participants and for African-Americans with adequate financial status. Suboptimal use occurred for 9.2% of analgesic users. Therapeutic duplication was more likely in those who were depressed, needed help with basic activities of daily living, or used alcohol, and was less likely in those with adequate financial status. Multiple analgesic use was more likely in those who were depressed, had impaired physical functional status, had one or more health visits in the previous year, were African-American (of either sex), or were white women. Only two persons had a potential major analgesic-drug interaction. CONCLUSIONS: Suboptimal analgesic use is common in community-dwelling elderly, and its risk is consistently increased in those who are depressed or have impaired functional status.

Differences in Association of Walking for Recreation and for Transport With Maximum Walking Speed in an Elderly Japanese Community Population

2011 ◽  
Vol 8 (6) ◽  
pp. 841-847 ◽  
Author(s):  
Masamitsu Kamada ◽  
Jun Kitayuguchi ◽  
Kuninori Shiwaku ◽  
Shigeru Inoue ◽  
Shimpei Okada ◽  
...  
Keyword(s):  
Functional Ability ◽  
Walking Speed ◽  
The Elderly ◽  
Community Dwelling ◽  
Functional Abilities ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Promotion Strategies ◽  
Elderly Japanese ◽  
Walking Time

Background:Physical activity contributes to maintaining functional ability later in life. Specific relationships between walking for particular purposes (eg, recreation or transport) and functional ability are not clear. It is useful for planning health promotion strategies to clarify whether walking time for recreation, or walking time for transport has the stronger relationship with maximum walking speed (MWS), a determinant of functional ability later in life in the elderly.Methods:A cross-sectional survey was conducted in 2007 using a sample of 372 community-dwelling elderly people aged 60 to 87 years in Mitoya Town, Unnan City, rural Japan. Associations with MWS were examined for self-reported weekly times of walking for recreation and for transport using multiple linear regression analyses.Results:Both in men and women, walking time for recreation was significantly associated with MWS after controlling for age, height, weight, hip and knee pain, and a number of chronic diseases (men: β = 0.18, P = .024; women: β = 0.17, P < .01). However, walking time for transport was not significantly associated with MWS (men: β = −0.094, P = .24; women: β = −0.040, P = .50).Conclusions:Walking for recreation may contribute to maintaining functional abilities such as MWS in the elderly.

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