Need for supervision in the elderly receiving long-term prescribed medication.

Shaw, S M; Opit, L. J.

doi:10.1136/bmj.1.6008.505

Cited by 51 publications

(22 citation statements)

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“…Applying cut-points used in other studies [12,13], this places the group within the range of low to medium dependency. Individually, 15% (n = 45) were 'high dependency' (score 0-4), 17% (n = 52) 'medium dependency' (score 5-8), 18% (n = 56) 'low/ medium dependency' (score 9-12) and 50% (n = 155) 'low dependency' (score [13][14][15][16][17][18][19][20]. Table 2 shows the proportion of cohort residents with specific dependency needs, using the bathing item from the Crichton Royal Behaviour Rating Scale rather than the Barthel because it records greater detail about the assistance required.…”

Section: Resultsmentioning

confidence: 99%

“…Central nervous system medication was the most common category, prescribed for 67% of residents, followed by cardiovascular and gastrointestinal drugs, prescribed for 59% and 48% respectively. The mean number of drugs per person was 4.05 (SD 2.75, range 0-13), with 52% of residents on four or more drugs, the level at which adverse reactions are more common [12,13].…”

Section: Diagnoses and Medicationmentioning

confidence: 99%

“…For the 46 self-funding residents, mean Barthel and MMSE scores were 11.4 (SD 4.9) and 15.9 (SD 7.3) respectively. Of those known to have paid in full for their nursing-home care, 67% (31/46) were in the lowdependency (Barthel [13][14][15][16][17][18][19][20] group. This situation was not observed in the residential homes.…”

Section: Number Of Diagnosed Disorders (One Counted For Each Of the Amentioning

confidence: 99%

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Dependency in older people recently admitted to care homes

Challis

Mozley

Sutcliffe³

et al. 2000

Age and Ageing

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Objective: to investigate dependency and general health status of a cohort of older people admitted to residential or nursing homes for long-term care. Method: we assessed 308 people aged over 65 years within 2 weeks of admission for long-term care to one of 30 nursing or residential homes in north-west England. Dependency was assessed using the Barthel activities of daily living index and the Crichton Royal Behaviour Rating Scale. We collected information from the homes' records on diagnosed conditions and current medication. Results: 50% of the cohort were in a 'low dependency' band (Barthel score 13-20): 31% of those in nursing homes and 71% of those in residential homes. In nursing homes, low-dependency residents were more likely to be selffunding than those with higher dependency. Of a number of broad diagnostic groupings, only a diagnosis of dementia was associated with nursing-rather than residential-home admission. Of 47 residents who scored 9 or less on the Mini-Mental State Examination (indicating severe cognitive impairment), 85% had no diagnosis of dementia, neurological disorder or other psychiatric disorder. Discussion: the high proportion of new admissions of subjects with low dependency needs raises questions about the effective targeting of resources and about management of the boundary between home-based and institutional care. The existence of an important group of self-funded, low-dependency new admissions to nursing homes suggests a need to provide better assessment and placement services for those who are financially independent of local authorities. Many new admissions had conditions which might benefit from rehabilitation but there were almost no therapy staff in the studied homes. In some cases where severe cognitive impairment was evident, there was no evidence that the result of any formal pre-admission psychiatric evaluation had been communicated to nursing or care staff.

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Section: Resultsmentioning

confidence: 99%

Section: Diagnoses and Medicationmentioning

confidence: 99%

Section: Number Of Diagnosed Disorders (One Counted For Each Of the Amentioning

confidence: 99%

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Dependency in older people recently admitted to care homes

Challis

Mozley

Sutcliffe³

et al. 2000

Age and Ageing

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“…Les diurétiques, surtout ceux de type thiazide comme l'Hydrodiuril® , font partie des médicaments les plus prescrits aux personnes âgées, d'après les rapports annuels de la Régie de l'assurance-maladie du Québec, en GrandeBretagne (Shaw et Opit, 1976), et du Manitoba Pharmacare (Mitenko, 1978). On pense qu'ils agissent au niveau des réflexes vasculaires et entraînent une diminution de la réactivité des muscles lisses.…”

Section: Lesantihypertenseurs A) Les Diurétiquesunclassified

La sexualité de la personne âgée et les médicaments

Barbeau¹

2006

smq

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De nombreux médicaments ont été mentionnés comme ayant des effets adverses sur les fonctions sexuelles. L'interférence avec l'éjaculation chez l'homme, l'échec à atteindre l'orgasme chez la femme, la libido diminuée peuvent survenir avec n'importe quel médicament ayant une action centrale ou qui agit sur le système nerveux sympathique. En fait, l'incidence des effets sexuels aversifs n'est pas bien documentée. Les effets qui mènent à un dysfonctionnement sexuel sont rapportés par les patients même s'ils sont eux-mêmes réticents à en discuter avec leur médecin. Antihistaminiques, antihypertenseurs, anticholinergiques, antidépresseurs, antipsychotiques et tranquillisants mineurs peuvent avoir un effet négatif sur la fonction sexuelle. Parce que les personnes âgées sont sensibles aux effets adversifs des médicaments, on s'attend à ce qu'elles vivent plus d'effets secondaires avec leur vie sexuelle avec des médicaments communément prescrits, que les jeunes. Restreindre l'usage des médicaments et une écoute attentive pourraient aider les patients à restaurer une vie sexuelle normale.A lot of drugs have been reported to have adverse effects on sexual functions. Interference with ejaculation in man, failure to reach orgasm in women, decreased libido can occur with any centrally acting drugs or drugs that act on the sympathetic nervous system. In fact, the incidence of adverse sexual effects of drugs is not well documented. The effects which lead to sexual dysfunction are mostly reported by patients which are themselves reluctant to discuss with their physician. Antihistaminics, antihypertensives, anticholinergics, antidepressants, antipsychotics and minor tranquilizer may have an adverse effect on sexual function. Because elderly people are prone to adverse drug effects, they arc expected to experience more side effects on their sexual life with commonly prescribed drugs than younger ones are to. Refraining drug use and attentive listening may help the patient restore his normal sexual life

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“…It was decided to eliminate self-chosen drugs such as laxa- Rcccivcd: February 18, 1977. tives, 'aspirin' and 'alcohol' although these can contribute to drug interactions as noted by Beeley (2). It was also decided not to test patients for mental function although previously Shaw and Opit (3) and Tyndall (4) have used simple tests for this purpose, the former relying on the Set Test devised by Isaacs (5). This decision was simple as the patients knew they were within 1 week of discharge home and optimum rehabilitation had been achieved.…”

mentioning

confidence: 99%

An Investigation into the Ability of Elderly Patients Continuing to Take Prescribed Drugs after Discharge from Hospital and Recommendations Concerning Improving the Situation

Atkinson¹,

Gibson²,

Andrews³

1978

Gerontology

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An investigation was made by an Occupational Therapist into the problems encountered by 50 elderly patients in the self-administration of drugs prior to discharge home. The questions asked the patients are enumerated and recommendations are made concerning how improvements can take place so that many more of the elderly will take the prescribed drugs in the right doses at the right time on discharge home.

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Need for supervision in the elderly receiving long-term prescribed medication.

Cited by 51 publications

References 3 publications

Dependency in older people recently admitted to care homes

Dependency in older people recently admitted to care homes

La sexualité de la personne âgée et les médicaments

An Investigation into the Ability of Elderly Patients Continuing to Take Prescribed Drugs after Discharge from Hospital and Recommendations Concerning Improving the Situation

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