Elderly patients in general practice: diagnoses, drugs and inappropriate prescriptions. A report from the More &amp; Romsdal Prescription Study

Straand, Jørúnd; Rokstad, K

doi:10.1093/fampra/16.4.380

Cited by 78 publications

(71 citation statements)

References 31 publications

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“…Consensus is by definition achieved if the inter-quartile range (IQR) falls within any one-third of the rating scale. 3 Centrally acting analgesics, antipsychotics, antidepressants, and/or benzodiazepines. Abbreviations: NSAID0non-steroid anti-inflammatory drug.…”

Section: Discussionmentioning

confidence: 99%

The Norwegian General Practice (NORGEP) criteria for assessing potentially inappropriate prescriptions to elderly patients

Rognstad

Brekke

Fetveit

et al. 2009

Scandinavian Journal of Primary Health Care

210

204

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Section: Discussionmentioning

confidence: 99%

The Norwegian General Practice (NORGEP) criteria for assessing potentially inappropriate prescriptions to elderly patients

Rognstad

Brekke

Fetveit

et al. 2009

Scandinavian Journal of Primary Health Care

210

204

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“…Although antidepressants can be indicated for long-term treatment, 38 hypnotics are not recommended for longer than 1 month, and anxiolytics are recommended for no longer than 3 months. 16,21,[39][40][41][42] GPs' opinions and knowledge about psychotropic drug prescription in older patients have rarely been explored. In the present study, 91% of GPs were optimistic about the possibility of reducing or stopping anxiolytics and hypnotics.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…15,16 Potential barriers to reducing psychotropic prescription were previously reported, such as GPs' lack of agreement regarding interpretation or implementation of the clinical guidelines, or difficulty reconciling patients' preferences. 16 The present study was undertaken to provide more insight into GPs' prescribing patterns for older people. The aim was to investigate GPs' knowledge and opinions about prescription of psychotropics for individuals aged ≥65 years, and to collect patient-based data to describe 'real-life' prescription patterns for psychotropics in this population.…”

Section: Introductionmentioning

confidence: 99%

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Psychotropic drug use among older people in general practice: discrepancies between opinion and practice

Lasserre

Younès

Blanchon³

et al. 2010

Br J Gen Pract

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The use of psychotropic drugs has increased over recent years in France. GPs are the first prescribers, especially for older patients. AimTo analyse discrepancies between GPs' opinions and practice when prescribing psychotropic drugs to older patients. SettingPostal surveys sent to GPs all over mainland France. Design of studyCross-sectional postal study. MethodA questionnaire collected data on characteristics of GPs' practices, their opinions about psychotropic drug consumption in older people, and a full description of their last older patient receiving a psychotropic drug and seen last by the GP on that particular day. ResultsA total of 350 participating GPs saw 2498 patients aged ≥65 years. Among these patients, the prevalence of psychotropic use was 32.1% (803/2498) for anxiolytics/hypnotics, and 17.5% for antidepressants (438/2498). A total of 91% of GPs agreed that it was possible to reduce or stop psychotropic drugs for these patients. Characteristics of 339 patients taking psychotropic drug were reported: 85.8% (291/339) received at least one anxiolytic/hypnotic and 56.9% (193/339) received at least one antidepressant; there were prescribed for more than 1 year in 68.4% (199/291) and 43.5% (84/193) of the cases respectively. GPs stated that it was possible to reduce or stop anxiolytic/hypnotic drugs for only 27% (79/291) of these patients. Barriers to doing this were patients' refusal (79%), and the absence of any local offer of psychotherapy (73%) or alternative therapy (70%). ConclusionA mismatch exists between GPs' intent (91%) and practice (27%) regarding reduction of psychotropic prescription in individuals aged ≥65 years. The barriers encountered should be examined further to help physicians improve management of psychotropic prescription.

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“…A unique code linking prescriptions issued over time to the same individual is a prerequisite for doing longitudinal studies, e.g., in the study of inappropriate drug combinations 26 and polypharmacy. 27 For example, in the MRPS we were only able to study multiple ordinations when they were written on the same prescription sheet (up to three ordinations were possible on each prescription sheet).…”

Section: Linking Multiple Prescriptions To Right Individualsmentioning

confidence: 99%

Diagnosis-prescription studies – important steps towards a national drug prescription statistics in Norway

Straand¹

2009

Nor J Epidemiol

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ABSTRACTIn the first part of this article, drug utilization and prescribing practice is discussed as seen from aNorwegian general practice perspective. Which are the data sources available? What kind of studieshave been performed? Prescription-diagnosis studies are reviewed, in particular the Møre & RomsdalPrescription Study (MRPS). Because the wholesales drug statistics do not include information aboutneither patients, prescribers or diagnoses, there is a current need for establishing a more comprehensivestatistics giving wider and deeper insights into the prescribing and utilization of drugs in the Norwegiansociety. The proposed Norwegian prescription statistics is discussed in relation to previous experiencesfrom prescription-diagnosis studies and current needs for research and statistics in the field. Someexamples are given illustrating why the 11-digit person number probably should be included in thedatabase. Lack of diagnostic information may to some extent be compensated for by introducing a moredifferentiated list of diagnoses for the drugs reimbursed. The use of data from this statistics for qualityassurance in e.g. general practice is discussed. Finally, some suggestions are given for how the Norwegianprescription statistics may be organised.

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Elderly patients in general practice: diagnoses, drugs and inappropriate prescriptions. A report from the More & Romsdal Prescription Study

Abstract: Inappropriate drug prescriptions for elderly patients are common in general practice. Since the majority of the prescribing practice is made up by rather few diagnoses and drugs, improved practice for only a few may nevertheless have a large impact on the total profile.

Cited by 78 publications

References 31 publications

The Norwegian General Practice (NORGEP) criteria for assessing potentially inappropriate prescriptions to elderly patients

The Norwegian General Practice (NORGEP) criteria for assessing potentially inappropriate prescriptions to elderly patients

Psychotropic drug use among older people in general practice: discrepancies between opinion and practice

Diagnosis-prescription studies – important steps towards a national drug prescription statistics in Norway

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