Monday, March 28, 2011

Journal 24

Answers to previous questions:
I looked into the list of potentially inappropriate prescriptions and didn't find anything about drug-to-drug interactions. The lists I found were just for drugs that have been found to have adverse effects in elderly patients in general. I need to keep looking for a list of potentially inappropriate prescription combinations for older adults specifically because of drug-to-drug interactions.

New Information:
I decided to pull back from researching the list of drug-to-drug combinations. Finding that list would be helpful, but I think it would be a time consuming tangent.
I found a new article that brought up some new points on the problems caused by polypharmacy in older patients. The background information contained in this article stated that polypharmacy in older adults reduces the quality of drug treatment. It was found that 50% of older patients that were prescribed more than five drugs were taking prescriptions that were unnecessary, ineffective, or therapeutic duplicates of other drugs they were already taking. Also, when patients experienced adverse reactions to drugs they were taking it was often interpreted as a new illness and more medications were prescribed to treat it. I don't think this can totally be blamed on physicians since incidence of polypharmacy is often an indicator of a patient requiring complex treatment combinations that would be difficult to balance.
The main finding of this article was that polypharmacy is an indicator of mortality in the patient within five years. Their definition of polypharmacy was different than many other studies that I have seen since they defined it as taking at least six drugs simultaneously. So with that definition of polypharmacy, yes, it is going to be an indicator for mortality within five years more than with a person taking two or three medications simultaneously. This finding has some interesting implications.

Questions from this information:
Do doctors need to be telling patients that polypharmacy (by their definition in the article) is an indicator of mortality in the next five years? If a person is very likely to die from a disease (for example) in the next five years their physician would tell them I think.
The information about loss in the quality of drug treatment was interesting. How could I find a doctors perspective on treating elderly patients with multiple conditions? Can I get a hold of a geriatric physician to interview? Who do I know that could help me with that?

Keywords: doctors telling patients polypharmacy is an indicator or conditions

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