Drug Misuse in Older People

Raffoul, Paul R.; Cooper, James; Love, David W.

doi:10.1093/geront/21.2.146

Cited by 37 publications

(11 citation statements)

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“…Misuse of drugs has been attributed to problems in doctor to patient communication and to unclear explanations of how the medicine is to be taken, 10,11 as well as to patient noncompliance, interactions between drugs or adverse reactions, and the prescribing patterns of physicians 12 . Various studies have found medication errors among two fifths to three fifths of elderly people studied 12,13 . Two reports conclude that almost 20 per cent of patients entering the geriatric service of a general hospital show evidence of disorders directly attributable to the effects of prescription drugs 9 .…”

Section: Discussionmentioning

confidence: 99%

What Older People Do About Their Day‐to‐day Mental and Physical Health Symptoms

Brody

Kleban

Moles

1983

J American Geriatrics Society

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In four detailed "yesterday" interviews, old people (n = 132) were studied to identify their day-to-day mental and physical symptoms. Previous reports have described the nature, frequency, and severity of the symptoms reported. This paper describes the actions taken by old people to alleviate discomfort from their symptoms. Some action was taken to treat four fifths of the complaints but virtually none of the symptoms were reported to health care professionals. Among the authors' findings are that about 20 per cent of the drug doses taken by the interviewees could not be identified and the remaining 80 per cent were divided equally between prescription drugs and over-the-counter medications. It is evident that there is a world of day-to-day health experiences and practices of which health care professionals are unaware. Sensitive questioning is needed to elicit information about that world from elderly patients, who in turn are often in considerable need of health education from professional sources.

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Section: Discussionmentioning

confidence: 99%

What Older People Do About Their Day‐to‐day Mental and Physical Health Symptoms

Brody

Kleban

Moles

1983

J American Geriatrics Society

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“…Hour‐long interviews were conducted in the subjects’ homes by specially trained pharmacy and social work graduate‐student teams or a registered nurse 2,3 . All subjects were asked to show the interviewers their drugs and were questioned about each individually.…”

Section: Methodsmentioning

confidence: 99%

Intentional Prescription Nonadherence (Noncompliance) by the Elderly

Cooper

Love

Raffoul

1982

J American Geriatrics Society

153

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Prescription drugs are not always taken as directed. When there is a discrepancy between the use of a drug and the prescription directions, the drug-taking behavior is considered "nonadherent." To determine the extent of prescription non adherence by old persons and the reasons for nonadherence, an in-home survey was made of 111 elderly subjects who were taking prescription drugs. Drug-taking behavior was compared with the behavior implied by the prescription instructions, the reasons for the differences were sought. Of the study sample, 43 per cent showed such differences in use of one or more prescription drugs. The chief type of discrepancy was underuse (90 per cent of nonadherence). No difference was observed in most of the psychosocial variables studied between those who took drugs as directed and those who did not. Hypertensive subjects did not differ from those without hypertension. A large proportion of nonadherence (73 per cent) was intentional. Intentional nonadherence was more likely to occur in subjects who used two or more pharmacies and two or more physicians. Traditional efforts aimed at reducing the incidence of forgetting to take medicines would not seem to be helpful in cases of intentional nonadherence.

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“…As people who use opioids are surviving longer than 40 years, the cut-off point of 40 years has been used to define the 'older' population (Crome et al, 2009). There is no consensus in the literature on what 'old' is; it ranges from 37 to 55, 40+, 45+, 50+, 60+, 65+, 49 to 61, 50 to 59, and 50 to 74 Beynon et al, 2007;Boeri et al, 2011;Crome et al, 2011b;Doukas, 2011;European Monitoring Centre for Drugs and Drug Addiction, 2010;Han et al, 2009;Han et al, 2015;Institute of Medicine, 2012;Lofwall et al, 2008;Outlaw et al, 2012;Raffoul et al, 1981;Roe et al, 2010;Rosen et al, 2011;Schonfeld et al, 2000;Wu and Blazer, 2011).…”

Section: Defining Ageing Based On Current Literaturementioning

confidence: 99%

Treatment for opioid use and outcomes in older adults: a systematic literature review

Carew

Comiskey

2018

Drug and Alcohol Dependence

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A B S T R A C TBackground: Historically, issues relating to problem substance use among older people have received little attention, and have only recently been recognised. Methods: A literature review of relevant material was conducted in November 2015 to assess current outcome research among older adults treated for opioid dependence. Multiple electronic databases were searched and results were supplemented by grey literature, library and online searches, and relevant references within selected articles. Retrieved articles were assessed for relevance against the inclusion and exclusion criteria. Results were reviewed to identify major findings and recommendations. Results: A total of 76 titles were included in the review. Most research conducted on older adults involves alcohol and prescription medications. Older drug users are growing in number and have a unique profile, with many presenting for treatment for the first time aged 50-70 years. Findings reveal (1) opioid treatment numbers are decreasing, however the average age of treatment admissions is increasing, (2) there is no consensus on what old is (3) two distinct types of older opioid substance users exist (early/late onset), (4) older clients achieve better treatment outcomes than younger counterparts, and (5) older women achieve better treatment outcomes than men. Conclusions: Findings suggest that little is known about treatment outcomes among older people. Problematic drug use (of which opioids make up the largest proportion) had been incorrectly assumed to end as patients age. Defining an age limit for 'older' is important. Addiction and healthcare services must anticipate and prepare for increased demand by this group.

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Drug Misuse in Older People

Cited by 37 publications

References 0 publications

What Older People Do About Their Day‐to‐day Mental and Physical Health Symptoms

What Older People Do About Their Day‐to‐day Mental and Physical Health Symptoms

Intentional Prescription Nonadherence (Noncompliance) by the Elderly

Treatment for opioid use and outcomes in older adults: a systematic literature review

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