| Primary care providers' perspectives on psychoactive medication disorders in older adults. | |
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MedLine Citation:
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PMID: 21550858 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Compared with younger adults, older adults consume a disproportionate percentage of pain and sleep medications. Some studies have reported that psychoactive medication misuse and abuse in older populations is a significant problem. OBJECTIVES: The aim of this study was to understand the perspective of primary care providers (PCPs) regarding the extent and clinical presentations of misuse and abuse of psychoactive medications in older patients and to explore PCPs' perceived barriers to identifying affected individuals. METHODS: Seventeen physicians and 5 nurse practitioners from 2 ambulatory care practices serving older adults in New York City participated in this study. Six focus group discussions were audiotaped and transcribed. Two raters coded transcripts to identify recurring themes. Qualitative analysis software was employed for data coding and sorting purposes. RESULTS: Although PCPs indicated that only a small percentage of older patients were actively misusing or abusing their psychoactive medications (average estimate given by providers, 8%), they felt that these patients placed significant time burdens on them. Perceived risk factors included psychiatric disorders, previous substance abuse history, and cognitive impairment, but many PCPs found it impossible to predict which patients were at increased risk. PCPs identified multiple barriers to identifying affected patients, including lack of communication (between provider and patient, provider and patients' caregivers, and between different providers), nonspecific symptoms, and the lack of a clear definition of misuse and abuse. CONCLUSIONS: The lack of a clear definition, absence of well-defined risk factors, and ambiguous clinical manifestations of psychoactive medication misuse and abuse present substantial barriers to diagnosis. A standard, age-appropriate definition could help PCPs establish a diagnosis, clarify what constitutes appropriate psychoactive medication use, define the extent of the problem, and pave the way for the development of effective screening and diagnostic tools. |
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Authors:
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Monica Payne; Megan Gething; Alison A Moore; M Carrington Reid |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2011-05-08 |
Journal Detail:
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Title: The American journal of geriatric pharmacotherapy Volume: 9 ISSN: 1876-7761 ISO Abbreviation: Am J Geriatr Pharmacother Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-06-03 Completed Date: 2011-09-23 Revised Date: 2012-04-24 |
Medline Journal Info:
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Nlm Unique ID: 101190325 Medline TA: Am J Geriatr Pharmacother Country: United States |
Other Details:
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Languages: eng Pagination: 164-72 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 Elsevier HS Journals, Inc. All rights reserved. |
Affiliation:
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Division of Geriatrics and Gerontology, Weill Cornell Medical College, New York, New York 10065, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Age Factors Ambulatory Care / statistics & numerical data Attitude of Health Personnel Data Collection Female Focus Groups Humans Male Middle Aged New York City Primary Health Care / statistics & numerical data* Professional-Patient Relations Psychotropic Drugs / administration & dosage, adverse effects* Risk Factors Substance-Related Disorders / diagnosis, epidemiology* |
| Grant Support | |
ID/Acronym/Agency:
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1 P30 AG022845-07/AG/NIA NIH HHS; K24 AA15957/AA/NIAAA NIH HHS; P30 AG022845/AG/NIA NIH HHS; P30 AG022845-07/AG/NIA NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Psychotropic Drugs |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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