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Physicians' Non-Uniform Approach to Prescribing Drugs to Older Patients - A Qualitative Study

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DOI

  • Line Due Christensen
  • Janne Petersen, Optimized Senior Patient Program (Optimed), Clinical Research Center, Amager-Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark., Københavns Universitet
  • ,
  • Ove Andersen, Optimized Senior Patient Program (Optimed), Clinical Research Center, Amager-Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark.
  • ,
  • Susanne Kaae, Section for Social and Clinical Pharmacy, Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark.

Multi-morbidity and polypharmacy are common in older patients and increase their susceptibility to adverse drug events and hospitalizations. Rational drug prescription is critical; however, little is known about physicians' perspectives on how to prescribe drugs for older patients. The aim of this study was to explore physicians' approach to prescribe drugs to older patients, including identifying the drugs that physicians perceive to be risk drugs for older patients and comparing them with established lists of potentially inappropriate medications. Short semi-structured interviews were conducted with 50 medical specialists in 23 different specialities throughout Denmark who had contact with older patients. Content analysis was performed to identify the relevant themes. Regardless of their medical or surgical background and how often they prescribed drugs for older patients in daily work, all physicians expressed a cautious approach when prescribing risk drugs. Despite their shared caution, physicians had different strategies for prescribing drugs to older patients. The following strategies were identified: (1) 'Start low, go slow', (2) 'Trial and error', (3) 'Dose reduction', and (4) 'Never prescribe'. The most frequently mentioned risk drugs considered to cause hospitalization were vitamin K antagonists, opioids and diuretics; these drugs are relatively highly consistent with established lists of PIMs. Physicians were relatively knowledgeable about risk drugs. Although the physicians agreed that a cautious approach was needed when prescribing drugs for older people, there was no consensus about how to best accomplish this in practice.

OriginalsprogEngelsk
TidsskriftBasic & Clinical Pharmacology & Toxicology
Vol/bind121
Nummer6
Sider (fra-til)505-511
Antal sider7
ISSN1742-7835
DOI
StatusUdgivet - dec. 2017
Eksternt udgivetJa

Bibliografisk note

© 2017 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

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