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At least 19 recordsLinked to original sources

Multiple medication use in the elderly. Use of prescription and non-prescription drugs in an Australian community setting.

OBJECTIVE: To document the extent of polypharmacy or multiple medication use in the elderly. DESIGN: Cross-sectional examination of an age cohort of a community. SETTING: Community-based study in Dubbo, NSW, in 1988-1989. SUBJECTS: All non-institutionalised residents aged 60 years and over, numbering 1237 men and 1568 women. MAIN OUTCOME MEASURES: Assessment of use of prescription and non-prescription drugs, recent hospitalisation, years of education, psychosocial variables. RESULTS: 18% of men and 25% of women were currently using three or more classes of prescription drugs. The corresponding values for two or more classes of non-prescription drugs were 29% and 44%. Of those who were using multiple prescription drugs 56% of men and 76% of women were also using multiple non-prescription drugs. In a multiple logistic model, the following possible predictors of multiple drug use were included: hospitalisation in the last six months, age, sex, depression, life satisfaction and education. Multiple prescription drug use was significantly predicted by recent hospitalisation (odds ratio [OR] = 2.40; 95% confidence interval [CI], 1.63-3.56), increasing age (e.g. 70-79 years versus 60-69 years; OR = 2.54; CI, 1.97-3.25), female sex (OR = 1.59; CI, 1.25-2.01) and increasing depression (e.g. highest tertile of depression scale versus lowest; OR = 2.52; CI, 1.84-3.42). Multiple non-prescription drug use was significantly predicted by female sex (OR = 2.38; CI, 1.95-2.92) and increasing depression (OR = 2.77; CI, 2.16-3.56). For prescription items, non-prescription items, and both categories in combination levels of use 20% above the population average have been documented. CONCLUSIONS: Polypharmacy in the elderly population appears to be predicted by recent hospitalisation, increasing age, female sex and increasing depression. There is potential for drug-drug interaction to occur, but the findings suggest target areas for preventive action.

Aged

Purchasing prescription medication in Mexico without a prescription. The experience at the border.

Prescription medication can often be purchased in Mexico without a physician's prescription. United States residents living along the border may have access to dangerous medications by crossing the border and purchasing them in Mexican pharmacies. We sought to determine the extent and frequency of this behavior in a sample of our ambulatory clinic population. Patients from the Texas Tech University Internal Medicine Clinic were surveyed to collect information about their use of medications, use of alternative sources of health care in Mexico, and purchasing of prescription medication in Juarez, Mexico. More than 80% of patients stated they had purchased prescription-type medication at a pharmacy without a physician's prescription. The most common reasons for buying prescription medication in Mexico were because it was less expensive or because a prescription was not necessary. These data indicate a potential for US residents along the border to take medications in an unregulated manner, a practice that could pose problems for health care providers on both sides of the border.

Adult

[Prescription profile in French speaking Switzerland and in the Tessin. Analysis of 2006 medical prescriptions].

Analysis of 2006 prescriptions given to 641 unselected patients by 360 doctors in the French- and Italian-speaking parts of Switzerland provides a wealth of information on prescription trends and the cost of medicine. The patients ordinarily received medication belonging to several therapeutic groups, usually 2 or 3 but up to 9 different groups. Each prescription averaged 2.08 drugs with a mean cost of 18.90 Swiss francs. The price varied considerably according to the group of drugs. Those related to the cardiovascular system were the most expensive closely followed by antibiotics, while the ophthalmological prescriptions were the least expensive. Hydergine is the most-sold drug in Switzerland, followed by Bactrim; however, if the various benzodiazepines were grouped together their sale would exceed the others. There are 62 different drugs for rheumatic conditions and 47 penicillins in Switzerland. The abundance of drugs and the prescription of medication with dubious action contribute to the inflationary cost of illness. For any given drug there is a striking parallelism between the number of pages publicizing it in 4 medical journals and total sales. This clearly demonstrates the influence of advertising on prescription trends. Doctors should be aware of this fact and rely on more objective sources of their information about drugs.

Drug Prescriptions

[The study of Chinese herbal medicinal prescription with enzyme inhibitory activity. IV. The study of the prescription containing mineral drug with adenosine 3',5'-cyclic monophosphate phosphodiesterase].

Twenty five Chinese herbal medicinal prescriptions containing gypsum, kaolin, longgu, oyster shell and sodium sulfate were studied for the inhibitory activity of adenosine 3',5'-cyclic monophosphate phosphodiesterase. The inhibitory activity of 15 prescriptions without mineral drug was higher than that of each original prescription. On the contrary, four were lower and six were not recognized to be different. All 11 prescriptions containing gypsum with an exception increased the inhibitory activity by removing gypsum. The half prescriptions containing kaolin or sodium sulfate also increased the inhibitory activity by removing the drug.

3',5'-Cyclic-AMP Phosphodiesterases

Planning stereotactic surgery using the graphic prescription and explicit prescription MRI programs.

A method is described for planning stereotactic approaches to central nervous system lesions utilizing specialized programs contained within the GE sigma Magnetic Resonance Imaging scanner software. The graphic prescription program creates oblique scans relative to a localizer scan made in any standard orthogonal plane and the explicit prescription program creates slices perpendicular to any two chosen points. Using these programs to advantage, one can create an oblique coronal scan that contains the entry point, the approach tract and the target plus a series of cross sectional oblique scans perpendicular to and progressing along the approach track to the target. These scans can then be employed to modify a proposed approach so as to avoid blood vessels and other vital structures.

Brain

[General practitioners' training in psychiatry and prescription of psychotropic drugs. 2. Attitudes of physicians to training in psychotherapy and the extent of their prescriptions].

The object of this investigation was to describe and analyse differences in psychiatric training and attitudes to and employment of psychotropic drugs among general practitioners with and without training in psychotherapy, respectively. The investigation was carried out as a multicentre questionnaire investigation in the County of Aarhus with participation of 192 out of 215 (89%) doctors who were invited. Thirty-nine of the participating general practitioners (20%) had participated in a supervised course in psychoanalytically orientated psychotherapy. Doctors who were trained in psychotherapy had more rarely had appointments in psychiatric departments than other doctors. Doctors trained in psychotherapy prescribed fewer benzodiazepines than other doctors (p less than 0.05) and there was psychotherapy chose psychotherapy more frequently (p = 0.02) and more rarely tendency to a lower total prescription of psychotropic drugs. Doctors trained in a psychotropic drugs (p = 0.004) than doctors without this training as treatment for patients with psychosocial conflicts and they more rarely chose psychotropic drugs to supplement psychotherapy (p less than 0.0001). It is concluded that one of the ways of reducing the massive use of psychotropic drugs in Denmark is to improve general practitioners' training in psychotherapy.

Anti-Anxiety Agents

[Drug prescription in myocardial postinfarction: results of the EPPI (étude de prescription postinfarctus). A French cooperative study].

An enquiry into the prescribing behaviour in patients discharged from hospital after myocardial infarction was performed in 36 hospital departments in France and included 528 patients. Each patient was prescribed an average of 3.6 drugs. The most commonly prescribed drug was Aspirin (63.3%) followed by the calcium antagonists (61.7%) long acting nitrate derivatives (49.5%) and betablockers (41.5%). These results suggest that many post-infarction prescriptions disregard recently acquired scientific knowledge.

Adrenergic beta-Antagonists