Læknablaðið

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Læknablaðið - 15.01.2009, Page 16

Læknablaðið - 15.01.2009, Page 16
FRÆÐIGREINAR RANNSÓKNIR mikilvægar upplýsingar um tengsl lyfjanotkunar við heilbrigði, heilbrigðisþjónustu og félagslega þætti. Til dæmis mætti kanna tengsl lyfjanotkunar og byltna hjá öldruðum með tengingu lyfjagagna- grunns við slysaskráningu. Rannsókn af þessu tagi leggur einnig grunn að hagkvæmnigreiningu tiltekinna lyfjameðferða sem verður að teljast verð- ugt framtíðarverkefni ekki síst í ljósi ört stækkandi hóps aldraðra og fjölveikra. Ályktun Niðurstöður þessarar úttektar gefa til kyrtna að geðlyfjanotkun eldri íslendinga sé almenn, sér- staklega hvað varðar notkun kvíðastillandi lyfja og svefnlyfja. Samanborið við upplýsingar úr sambærilegum dönskum lyfjagagnagrunni virð- ist ávísun á geðlyf umtalsvert meiri hér á landi. Höfundar telja þörf fyrir frekari umræðu og rann- sóknir á undirliggjandi orsökum, gagnsemi og afleiðingum almennrar notkunar geðlyfja meðal aldraðra Islendinga. Þakkir Þakkir fær Kristinn Jónsson, kerfisfræðingur, Landlæknisembættinu. Heimildir 1. Shah RR. Drug development and use in the elderly: Search for the right dose and dosing regimen. Br J Clin Pharmacol 2004; 58:452-69. 2. Jyrkka J, Vartiainen L, Hartikainen S, et al. Increasing use of medicines in elderly persons: a five-year follow-up of the Kuopio 75+ Study. Eur J Clin Pharmacol 2006; 62:151-8. 3. Medicines consumption in the Nordic Countries 1999-2003: Nordic Medico Statistical Committee (NOMESCO)2004. 4. Wettermark B, Hammar N, Ford CM, et al. The New Swedish Prescribed Drug Register - Opportunities for pharmacoepidemiological research and experience from the first six months. Pharmacoepidemiol and Drug Saf 2007; 16: 726-35. 5. Indikatorer för utvárdering av kvaliteten I alders lákemedelsterapi: Svenska Socialstyrelsen 2003. 6. Lernfelt B, Samuelsson O, Skoog I, Landahl S. Changes in drug treatment in the elderly between 1971 and 2000. Eur C Pharmacol 2003; 59: 637-3. 7. Gurwitz JH, Field TS, Harrold LR, et.al. Incidence and Preventability of Adverse Drug Events Among Older Persons in the Ambulatory Setting. JAMA 2003; 289:1107-16. 8. Piette JD, Heisler M, Wagner TH. Cost-Related Medication Underuse Among Chronically 111 Adults. Am J Public Health 2004; 94:1782-1787. 9. Solomon D. Underuse of osteoporosis medications in elderly patients with fractures: American J Med 2003; 115: 398-400. 10. Fialová D, Topinková E, Gambassi G, et al. Potentially Inappropriate Medication Use Among Elderly Home Care Patients in Europe. JAMA 2005; 293:1348-58. 11. Samúelsson O, Björnsson S, Jóhannsson B, Jónsson PV. Lyfjanotkun aldraðra á bráðasjúkrahúsi: Aukaverkanir og gæðavísar. Læknablaðið 2000; 86:11-6. 12. Giron MS, Forsell Y, Bernsten C, et al. Sleep problems in a very old population: drug use and clinical correlates. J Gerontol A Biol Sci Med Sci 2002; 57: M236-40. 13. Buysse DJ. Insomnia, depression and aging. Assessing sleep and mood interactions in older adults. Geriatrics 2004; 59: 47-51. 14. Skoog I. Psychiatric epidemiology of old age: the H70 study - the NAPE Lecture 2003. Acta Psychiatr Scand 2004; 109: 4- 18. 15. Hanlon JT, Schmader KE, Koronkowski MJ, et al.; Adverse drug events in high risk older outpatients. J Am Geriatr Soc 1998; 46: 252-3. 16. Moore AR, O'Keeffe ST. Drug-Induced Cognitive Impairment in the Elderly Drugs Aging 1999; 15(1): 15-28. 17. Sigfússon E. Notkun svefnlyfja og róandi lyfja síðustu 26 árin. Heilbrigðis- og tryggingaráðuneytið 2004. 18. Helgason T, Tómasson K, Zoéga T. Algengi og dreifing notkunar geðdeyfðar-, kvíða- og svefnlyfja. Læknablaðið 2003; 89:15-22. 19. SigurðssonJÁ. Notkunróandilyfjaogsvefnlyfja: upplýsingar frá apóteki og úr sjúkraskrám í Egilsstaðalæknishéraði 1986- 1989. Læknablaðið 1994; 80: 99-103. 20. Kamel NS. Gammack JK. Insomnia in the elderly: cause, approach, and treatment. Am J Med 2006; 119(6): 463-9. 21. Evans ME, Mottram P. Diagnosis of depression in elderly patients. Advances in Psychiatric Treatment 2000; 6: 49-56. 22. Sorock GS and Shimkin EE. Benzodiazepine sedatives and the risk of falling in a community-dwelling elderly cohort. Arch Int Med 1988; 148: 2441-4. 23. Ray A, Griffin MR, Downey W. Benzodiazepines of long and short elimination half-life and the risk of hip fracture. JAMA 1989; 262: 3303-7. 24. Swift C. Falls in late life and their consequences— implementing effective services. BMJ 2001; 322 : 855-7. 25. Campbell AJ, Robertson MC, Gardner MM, et al. Psychotropic medication withdrawal and a home-based exercise program to prevent falls: a randomised, controlled trial. J Am Geriatr Soc 1999; 47 : 850-3. 26. Paulose-Ram R, Jonas BC, Orwig D, et al. Prescription psychotropic medication use among the U.S. adult population: results from the third National Health and Nutrition Examination Survey, 1988-1994. J Clin Epidemiol 2003; 57: 309-17. 27. Simoni-Wastila L. Gender and Psychotropic Drug Use. Med Care 1998; 36: 88-94. 28. Roe CM, McNamara AM, and Motheral BR. Gender- and age- related prescription drug use pattems. Anna Pharmacother 2002: 36: 30-9. 29. Öppna jámförelser av hálso- och sjukvárdens kvalitet och effektivitet. Jámförelser mellan landsting 2007. Sveriges kommuner och landsting. Stockholm 2007. 30. Hayes B, Klein-Schwartz W , Barrueto F. Polypharmacy and the Geriatric Patient. Clin Geriatr Med 2007; 23: 371-90. 31. Johnell K, Klarin I. The Relationship between Number of Drugs and Potential Drug-Drug Interactions in the Elderly: A Study of Over 600.000 Elderly Patients from the Swedish Prescribed Drug Register. Drug Saf 2007; 30: 911-8. 32. Beers MH. Explicit criteria for determining potentially inappropriate medication use by the elderly. Arch Int Med 1997; 157:1531-6. 33. Fick DM, Cooper JW, Wade WE, et al. Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts. Arch Intern Med 2003; 163: 2716-24. 34. Fastbom J, Claesson CB, Comelius C, Thorslund M, Winblad B. The use of medicines with anticholinergic effects in oider people. J Am Geriatr Soc 1995; 43:1135-40. 35. Salzman C. Medication compliance in the elderly. J Clin Psychiatryl995; Suppl 1:18-22. 36. MacLaughlin EJ, Raehl CL, Treadway AK, et al. Assessing medication use in the elderly: Which tools to use in clinical practice. Drugs and Aging 2005; 22: 231-55. 37. Ásgeirsson ÁG, Almarsdóttir AB. Umfang og ástæður sóunar lyfja á íslandi - skil almennings. Rannsóknarstofnun um lyfjamál við Háskóla íslands, Reykjavík: 2008. 38. Tybjerg J, Gulmann NC. Use of psychopharmaceuticals in municipal nursing homes. A nationwide survey. Ugeskr Laeger 1992; 154: 3126-9. 39. Hughes CM, Lapane KL, Mor V, et al. The Impact of Legislation on Psychotropic Dmg Use in Nursing Homes: A Cross-National Perspective. J Am Geriatr Soc 2000; 48: 931-7. 16 LÆKNAblaðið 2009/95

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