Underuse of Medications for Chronic Diseases in the Oldest of Community‐Dwelling Older Frail Japanese

Kuzuya, Masafumi; Masuda, Yoshika; Hirakawa, Yoshihisa; Iwata, Mitsunaga; Enoki, Hiromi; Hasegawa, Jun; Cheng, Xian Wu; Iguchi, Akihisa

doi:10.1111/j.1532-5415.2006.00659.x

Cited by 57 publications

(53 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is generally recognized that health care inequalities exist, which may be classifiable using socioeconomic measures, or by ethnic group or gender [6], but it is important to consider whether such inequalities exist for different age groups too. Some studies, for example, have identified an “under-prescription” phenomenon for the chronically ill among the oldest old [7], and this also relates to cases of coronary heart disease (CHD) [8]. The differences identified could represent an excellent starting point for efforts to better define optimum care or best practices, to design care processes that meet patients’ needs [3], and to improve the quality of primary health care in terms of an equitable management of chronic diseases.…”

Section: Introductionmentioning

confidence: 99%

Systematic Age-Related Differences in Chronic Disease Management in a Population-Based Cohort Study: A New Paradigm of Primary Care Is Required

et al. 2014

View full text Add to dashboard Cite

BackgroundOur interest in chronic conditions is due to the fact that, worldwide, chronic diseases have overtaken infectious diseases as the leading cause of death and disability, so their management represents an important challenge for health systems. The aim of this study was to compare the performance of primary health care services in managing diabetes, congestive heart failure (CHF) and coronary heart disease (CHD), by age group.MethodsThis population-based retrospective cohort study was conducted in Italy, enrolling 1,948,622 residents ≥16 years old. A multilevel regression model was applied to analyze compliance to care processes with explanatory variables at both patient and district level, using age group as an independent variable, and adjusting for sex, citizenship, disease duration, and Charlson index on the first level, and for District Health Unit on the second level.ResultsThe quality of chronic disease management showed an inverted U-shaped relationship with age. In particular, our findings indicate lower levels for young adults (16–44 year-olds), adults (45–64), and oldest old (+85) than for patients aged 65–74 in almost all quality indicators of CHD, CHF and diabetes management. Young adults (16–44 y), adults (45–64 y), the very old (75–84 y) and the oldest old (+85 y) patients with CHD, CHF and diabetes are less likely than 65–74 year-old patients to be monitored and treated using evidence-based therapies, with the exceptions of echocardiographic monitoring for CHF in young adult patients, and renal monitoring for CHF and diabetes in the very old.ConclusionOur study shows that more effort is needed to ensure that primary health care systems are sensitive to chronic conditions in the young and in the very elderly.

show abstract

Section: Introductionmentioning

confidence: 99%

Systematic Age-Related Differences in Chronic Disease Management in a Population-Based Cohort Study: A New Paradigm of Primary Care Is Required

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Medication underutilization is defined as the omission of an indicated and potentially beneficial medication for the treatment or prevention of a disease or condition 1,2,4,7,8. Most previous studies in older adults have focused on omission of medications for specific conditions using explicit criteria 5,6,9,10. Some examples of underuse from these studies included not prescribing platelet inhibitors for patients with a history of stroke or calcium supplements for those at risk of osteoporotic fracture 3,6,8.…”

Section: Introductionmentioning

confidence: 99%

Underuse of indicated medications among physically frail older US veterans at the time of hospital discharge: Results of a cross-sectional analysis of data from the Geriatric Evaluation and Management Drug Study

Wright

Sloane

Pieper

et al. 2009

The American Journal of Geriatric Pharmacotherapy

View full text Add to dashboard Cite

show abstract

“…In the oldest group of elderly patients the prescription of preventive therapy is often omitted (30,31). Surprisingly, results of multivariate analysis showed that the oldest patients of our study group (≥ 85 years) had higher probability of receiving gastroprotective medication in comparison with younger elderly (< 85 years).…”

Section: Discussionmentioning

confidence: 65%

Suboptimal use of gastroprotective medication in elderly antiplatelet users

Slezakova¹,

Varga²,

Murı́n³

et al. 2014

BLL

View full text Add to dashboard Cite

Abstract:Background: Use of acetylsalicylic acid (ASA) or thienopyridines in monotherapy or combination of both drugs is associated with increased risk of gastrointestinal (GI) bleeding. The administration of drugs inhibiting gastric acid production represents an effective way to avoid GI disorders associated with antiplatelet therapy. Objectives: The aim of our study was to evaluate the use of gastroprotective medication in elderly antiplatelet users in relation to risk factors for GI bleeding. Methods: Patients (n = 428) aged ≥ 65 years who were prescribed low dose ASA or clopidogrel in monotherapy or combination at hospital discharge were enrolled in the study. Results: Only 39.7 % of patients with 2 or more risk factors for GI bleeding were prescribed gastroprotective medication at hospital discharge. The probability of elderly antiplatelet drug user for prescription of gastroprotective medication was improved with following risk factors: age ≥ 85 years (OR = 2.99); history of peptic ulcer disease/ GI bleeding (OR = 15.79); other GI disorders (OR = 15.48); concomitant therapy with drugs increasing the risk of GI bleeding -systemic corticosteroids (OR = 29.03) and NSAIDs (OR = 4.79). Conclusion: Results of our study indicate the necessity to increase the awareness of GI bleeding risk in longterm antiplatelet users among prescribing physicians (Tab. 3, Ref. 36). Text in PDF www.elis.sk.

show abstract

Underuse of Medications for Chronic Diseases in the Oldest of Community‐Dwelling Older Frail Japanese

Abstract: Among community-dwelling frail older people, the rate of polypharmacy is lower in the oldest members than in the younger ones. The underuse of prescribed medications for chronic diseases/conditions of frail older people is common but not for all conditions.

Cited by 57 publications

References 25 publications

Systematic Age-Related Differences in Chronic Disease Management in a Population-Based Cohort Study: A New Paradigm of Primary Care Is Required

Systematic Age-Related Differences in Chronic Disease Management in a Population-Based Cohort Study: A New Paradigm of Primary Care Is Required

Underuse of indicated medications among physically frail older US veterans at the time of hospital discharge: Results of a cross-sectional analysis of data from the Geriatric Evaluation and Management Drug Study

Suboptimal use of gastroprotective medication in elderly antiplatelet users

Contact Info

Product

Resources

About