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Prescribing for Seniors
Neither Too Much nor Too Little
Paula A. Rochon, MD, MPH, FRCPC;
Jerry H. Gurwitz, MD
JAMA. 1999;282:113-115.
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INTRODUCTION
Over the past few years the pendulum has swung from concern about the risks of excessive prescribing of inappropriate or unnecessary drug therapy to concerns about the consequences of underprescribing of potentially beneficial therapies to seniors (65 years and older). Concerns about excess drug use are for good reason. Use of greater numbers of drug therapies, rather than age alone, has been associated with an increased risk of developing adverse drug reactions.1 Furthermore, prescribing additional drugs to treat drug-induced symptoms can lead to prescribing cascades that develop when an adverse drug reaction is misinterpreted as a new medical problem.2 However, prescribing strategies that seek to limit the number of drugs prescribed to elderly patients in the name of improving quality of care may be seriously misdirected. A broader view of prescribing for seniors recognizes that problems occur from both the . . . [Full Text of this Article]
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Factors That Limit Use of Beneficial Drug Therapy in Older People
COMMENT
Author Affiliations: Kunin-Lunenfeld Applied Research Unit, Baycrest Centre for Geriatric Care, Institute for Clinical Evaluative Sciences, and Clinical Epidemiology and Health Care Research Program, Departments of Medicine and Public Health Sciences, University of Toronto, Toronto, Ontario (Dr Rochon); Meyers Primary Care Institute, the Fallon Healthcare System and University of Massachusetts Medical School, Worcester (Dr Gurwitz).
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