PHP88 National Patterns and Trends of Off-Label Use of Antipsychotic Medications in the Elderly Following FDA Black Box Warnings

Abstract

about concepts and practices of the CHW in some countries of South America. That information will be useful to design a questionnaire addressed to healthcare managers in those countries. METHODS: Publications review about CHW. The searching has been done through the data bases LILACS and MEDLINE since 1970 till now. The used keywords were: Agente Comunitário de Saúde, Agente Comunitario de Salud, Community Health Aides, Community Health Workers, Lay Health Worker. The countries included were Bolivia, Brazil, Colombia, Ecuador, and Peru RESULTS: There were founded out 254 articles, 63% are later than 2000 and 62% come from Brazil. Besides that, there were an previous literature review and reports of national and international organizations. The publications raise different issues related to CHW: roles and activities (generalist and specialist), recruitment and selection, training, supervision and support, relationships with the formal health services, incentives. The CHW may improve the access and the coverage of the basic public healthcare services. Unlike, Bolivia, Colombia, Ecuador and Peru, where most of the participation is voluntary and supported by NGO, in Brazil the CHW are members of the Nacional Health System through the Family Health Program. CONCLUSIONS: Literature have reported that CHW carry out a variety of health tasks, and that CHW deliver a wide range of interventions in such areas as maternal and child health, primary health care, malaria, tuberculosis and HIV/ AIDS prevention and control. OBJECTIVES:To evaluate the current national trends in Vitamin D prescribing among the elderly seeking care in office-based physician provider settings. METHODS: Cross-sectional study was conducted using the National Ambulatory Medical Care Survey (NAMCS) data from 2000 to 2009. All ambulatory office visits made by the elderly aged Ն65 years of age were included in the study. Bivariate associations between vitamin D and study variables such as patient demographics, region, physician's specialty, insurance status, and osteoporosis diagnosis were evaluated using chi square tests. Logistic regression analyses were conducted to determine the predictive factors associated with a vitamin D. All analyses were performed with SAS statistical software, version 9.1, at an alpha of 0.05. RESULTS: Of the 279,819 office-based physician visits made by the NAMCS participants from 2000 through 2009, there were 74,904(26.7%) visits that met the inclusion criteria. This estimate represented 2.4 billion physician-office visits from the elderly in the United States during the 10-year period. Of the included visits, 1,112 (1.91%) were associated with a vitamin D. Race was a significant predictor in both the adjusted and unadjusted models. Visits from other races were two times more likely to include vitamin D when compared to white race (Adjusted OR ϭ 1.54; 95% CI 1.17-2.03), while visits made by black patients were less likely to include vitamin D therapy (Adjusted OR ϭ 0.43; 95% CI 0.38-0.50). The visits made by osteoporosis patie...