| Potentially inappropriate prescribing in elderly: assessing doctor knowledge, confidence and barriers. | |
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MedLine Citation:
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PMID: 20630004 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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INTRODUCTION: Inappropriate medication prescribing by doctors is an important preventable cause of morbidity and mortality in the elderly. This study investigates doctor knowledge about potentially inappropriate prescribing (PIP) in elderly, their confidence in prescribing for the elderly and explores perceived barriers. METHODS: Family and Internal Medicine resident and attending doctors at three teaching hospitals were asked to complete a survey. Six clinical vignettes based on the 2003 Beers criteria were used to evaluate doctor knowledge about medications to avoid in the elderly. Confidence in prescribing for the elderly and perceived barriers to appropriate prescribing in elderly was assessed using a 5-point Likert scale. RESULTS: Eighty-nine doctors completed the survey, for a response rate of 45%. Forty-four per cent of surveyed doctors estimated that over 25% of their practice consisted of patients 65 years or older. When knowledge of PIP was assessed via vignettes, the mean correct response was 3.9 (SD: 1.1, min = 1, max = 6). Only 14% of those doctors scoring ≤4 vignettes correctly had used the Beers criteria for prescribing; 31% of the doctors answering ≥5 vignettes correctly had used the Beers criteria (P = 0.08). Overall, 75% of doctors felt confident about their prescribing irrespective of their knowledge scores. Seventy per cent of surveyed doctors cited at least seven different barriers to appropriate prescribing in elderly. CONCLUSIONS: Many primary care doctors possess a poor knowledge of PIP and are unaware of prescribing guidelines such as the Beers criteria. Our survey indicates that doctor usage of the Beers criteria might correlate with improved judgement in prescribing for the elderly. Most doctors report multiple barriers to appropriate prescribing in the elderly. Lack of formal education about prescribing guidelines was the only barrier that correlated with the doctors' level of training. |
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Authors:
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Ravishankar Ramaswamy; Vittorio Maio; James J Diamond; Amy R Talati; Christine W Hartmann; Christine Arenson; Barbara Roehl |
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Publication Detail:
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Type: Journal Article Date: 2010-07-13 |
Journal Detail:
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Title: Journal of evaluation in clinical practice Volume: 17 ISSN: 1365-2753 ISO Abbreviation: J Eval Clin Pract Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-11-04 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9609066 Medline TA: J Eval Clin Pract Country: England |
Other Details:
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Languages: eng Pagination: 1153-9 Citation Subset: IM |
Copyright Information:
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© 2010 Blackwell Publishing Ltd. |
Affiliation:
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Underwood-Memorial Hospital, Woodbury, New Jersey, USA. ravishankar.ramaswamy@gmail.com |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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