Mismedicating the elderly - says who? - Editorial

Journal of Family Practice, Oct, 1995 by August E. Miller, Jr.

(*) Like Persantine, propranolol no longer ranks among the top-200 prescribed drug products. It is literally impossible for 1,774,370 home-dwelling senior citizens to have received propranolol prescriptions in the year 1994, as alleged by the Harvard researchers.

References

[1.] Willcox SM, Himmelstein DU, Woolhandler S. Inappropriate drug prescribing for the community-dwelling elderly. JAMA 1994; 272: 292-6. [2.] Gurwitz JH. Suboptimal medication use in the elderly. JAMA 1994-,272:316-7. [3.] Kolata G. Wrong drugs given to 1 in 4 of elderly. The New York Times 1994 Jul 27:C8. [4.] Gorman C. Overdosing the elderly, many older Americans are taking the wrong drugs. Time 1994 Aug 8:47. [5.] Coleman B. Many elderly suffer from inappropriate medications, study shows 6.6 million received drugs that cause serious, harmful side effects. Morning News (Blackfoot, Idaho) 1994 Jul 27:6B. [6.] Friend T. Education on prescribing is "terrible." Ask, "Do I really need to be on all these pills?" and push your doctor hard. USA Today 1994 Jul 27:Al. [7.] Hoehn JB; Krinsky D; Beary JF; Baughan DM; Lederle FA; Klonoff DC; Wiskocil RL; Maher JC. Inappropriate drug prescribing [letters]. JAMA 1995; 273:455-7. [8.] Beers MH, Ouslander JG, Rillingher I, Reuben DB, Brooks J, Beck JC. Explicit criteria for determining inappropriate medication use in nursing homes. Arch Intern Med 1991; 151:1825-32. [9.] Moeller J, Maithowetz N. Prescribed medicines--a summary of use and expenditures by Medicare beneficiaries: National Medical Expenditure Survey Research Findings 3. Rockville, Md: US Public Health Service, 1989. US Department of Health and Human Services publication No. PHS 89-3448. [10.] Annual listings of "top 200 drugs of the year. Pharmacy Times 1970-1995; April issues. [11.] Physicians' desk reference. Montvale, NJ: Medical Economics, 1995:49. [12.] Physicians' desk reference. Montvale, NJ: Medical Economics, l987; 41:717-2160. [13.] Physicians' desk reference. Montvale, NJ: Medical Economics, 1988; 42:725. [14.] Physicians' desk reference. Montvale, NJ: Medical Economics, 1986; 40:1129. [15.] Materson BJ, Cushman WC, Goldstein G, et al. Treatment of hypertension in the elderly: results of a Department of Veterans Affairs Cooperative Study. Hypertension 1990; 15:348-60. [16.] Lederle FA, Applegate WB, Grimm RH. Reserpine and the medical marketplace. Arch Intern Med 1993- 153:705-6. [17.] Chobanian AV, Alderman MH, DeQuattro V, et al. The 1988 report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Bethesda Md: US Department of Health and Human Services; Public Health Service, 1988. NIH publication No. 88-1088. [18.] Rx: beware the risks in prescription drugs [editorial]. USA Today 1994 Jul 28:12A. [19.] Wolfe SM. Worst pills best pills. Washington, DC: Public Citizen Health Research Group, 1988.

Submitted, revised, July 19, 1995.

From Blackfoot, Idaho. Requests for reprints should be addressed to A. E. Miller, Jr, MD, 9 Airport Rd, Blackfoot, ID 83221.