The ethics of prescribing medications to older people

Medication Management in Older Adults: A Concise Guide for Clinicians

Volumn , Issue , 2010, Pages 29-42

  Le Couteur, David G ^a,b   Kendig, Hal ^a   Naganathan, Vasi ^a   McLachlan, Andrew J ^a  

^a UNIVERSITY OF SYDNEY   (Australia)

^b ANZAC Research Institute   (Australia)

Author keywords

Aging; Bioethics; Elderly; Evidence based medicine; Geriatric pharmacology; Medical ethics; Older people; Prescribing

Indexed keywords

EID: 84871146319     PISSN: None     EISSN: None     Source Type: Book    
DOI: 10.1007/978-1-60327-457-9_3     Document Type: Chapter

References (95)

1. Anderson G, Kerluke K (1996) Distribution of prescription drug exposures in the elderly: description and implications. J Clin Epidemiol 49:929-935.
2. Jorgensen T, Johansson S, Kennerfalk A, Wallander MA, Svardsudd K (2001) Prescription drug use, diagnoses, and healthcare utilization among the elderly. Ann Pharmacother 35:1004-1009.
3. Kennerfalk A, Ruigomez A, Wallander MA, Wilhelmsen L, Johansson S (2002) Geriatric drug therapy and healthcare utilization in the United Kingdom. Ann Pharmacother 36:797-803.
4. Shi S, Morike K, Klotz U (2008) The clinical implications of ageing for rational drug therapy. Eur J Clin Pharmacol 64:183-199.
5. Ebrahim S (2002) The medicalisation of old age. Br Med J 324:861-863.
6. Abernethy DR (1999) Aging effects on drug disposition and effect. Geriatr Nephrol Urol 9:15-19.
7. Le Couteur DG, Naganathan V, Cogger VC, Cumming RG, McLean AJ (2006) Pharmacotherapy in the elderly: clinical issues and perspectives. In: Kohli K, Gupta M, Tejwani S (eds) Contemporary perspectives on clinical pharmacotherapeutics. Elsevier, New Delhi, pp 709-722.
8. Hilmer SN, McLachlan A, Le Couteur DG (2007) Clinical pharmacology in geriatric patients. Fundam Clin Pharmacol 21:217-230.
9. Cumming RG (1998) Epidemiology of medication-related falls and fractures in the elderly. Drugs Aging 12:43-53.
10. Walker J, Wynne H (1994) The frequency and severity of adverse drug reactions in elderly people. Age Ageing 23:255-259.
11. Denham MJ (1990) Adverse drug reactions. Br Med Bull 46:53-62.
12. Mannesse CK, Derkx FH, de Rigger MA, Man in't Veld AJ, van der Cammen TJ (1997) Adverse drug reactions in elderly patients as contributing factor for hospital admissions: cross sectional study. Br Med J 315:1057-1058.
13. McLean AJ, Le Couteur DG (2004) Aging biology and geriatric clinical pharmacology. Pharmacol Rev 56:163-184.
14. Spinewine A, Schmader KE, Barber N et al (2007) Appropriate prescribing in elderly people: how well can it be measured and optimised? Lancet 370:173-184.
15. Routledge PA, O'Mahony MS, Woodhouse KW (2004) Adverse drug reactions in elderly patients. Br J Clin Pharmacol 57:121-126.
16. Bordet R, Gautier S, Le Louet H, Dupuis B, Caron J (2001) Analysis of the direct cost of adverse drug reactions in hospitalised patients. Eur J Clin Pharmacol 56:935-941.
17. Carbonin P, Pahor M, Bernabei R, Sgadari A (1991) Is age an independent risk factor of adverse drug reactions in hospitalized medical patients? J Am Geriatr Soc 39:1093-1099.
18. Hurwitz N (1969) Predisposing factors in adverse reactions to drugs. Br Med J 1:536-539.
19. Kellaway GS, McCrae E (1973) Intensive monitoring for adverse drug effects in patients discharged from acute medical wards. N Z Med J 78:525-528.
20. Pouyanne P, Haramburu F, Imbs JL, Begaud B (2000) Admissions to hospital caused by adverse drug reactions: cross sectional incidence study. French Pharmacovigilance Centres. Br Med J 320:1036.
21. Roughead EE, Gilbert AL, Primrose JG, Sansom LN (1997) Drug-related hospital admissions: a review of Australian studies published 1988-1996. Med J Aust 168:405-408.
22. Ebbesen J, Buajordet I, Erikssen J et al (2001) Drug-related deaths in a department of internal medicine. Arch Intern Med 161:2317-2323.
23. Hilmer SN, Mager DE, Simonsick EM et al (2007) A drug burden index to define the functional burden of medications in older people. Arch Intern Med 167:781-787.
24. Cao YJ, Mager DE, Simonsick EM et al (2008) Physical and cognitive performance and burden of anticholinergics, sedatives, and ACE inhibitors in older women. Clin Pharmacol Ther 83:422-429.
25. Bugeja G, Kumar A, Banerjee AK (1997) Exclusion of elderly people from clinical research: a descriptive study of published reports. Br Med J 315:1059.
26. Do doctors short-change people. Lancet 342:1-2.
27. Mueller PS, Hook CC, Fleming KC (2004) Ethical issues in geriatrics: a guide for clinicians. Mayo Clin Proc 79:554-562.
28. World Medical Association (2005) WMA medical ethics manual. WMA, Ferney-Voltaire.
29. Kluge EW (2002) Ethical issues in geriatric medicine: a unique problematic. Health Care Anal 10:379-390.
30. Fenech FF (2003) Ethical issues in ageing. Clin Med 3:232-234.
31. Kaufman SR, Shim JK, Russ AJ (2004) Revisiting the biomedicalization of aging: clinical trends and ethical challenge. Gerontologist 44:731-738.
32. Gillon R (2003) Ethics needs principles - four can encompass the rest - and respect for autonomy should be first among equals. J Med Ethics 29:307-312.
33. Beauchamp TL, Childress J (1979) Principles of biomedical ethics, 1st edn. Oxford University Press, New York.
34. Gillon R (1994) Medical ethics: four principles plus attention to scope. Br Med J 309:184-187.
35. Harris J (2003) In praise of unprincipled ethics. J Med Ethics 23:303-306.
36. Campbell AV (2003) The virtues (and vices) of the four principles. J Med Ethics 29:292-296.
37. Le Couteur DG, Hilmer SN, Glasgow N, Naganathan V, Cumming RG (2004) Prescribing in older people. Aust Fam Physician 33:777-781.
38. Martin FC, O'Mahony MS, Schiff R (2007) Complexity of treatment decisions with older patients: who, when and what to treat? Clin Med 7:505-508.
39. Gurnee MC, Hansen JM, Sylvestri MF (1992) Portrayal of the elderly in drug product advertisements: relationship to dosing recommendations and pharmacokinetic data in the geriatric population. J Pharm Mark Manage 7:17-31.
40. Adhiyaman V, Kamalakannan D, Oke A, Shah IU, White AD (2000) Underutilization of antithrombotic therapy in atrial fibrillation. J R Soc Med 93:138-140.
41. Mangoni AA, Jackson SH (2006) The implications of a growing evidence base for drug use in elderly patients Part 2. ACE inhibitors and angiotensin receptor blockers in heart failure and high cardiovascular risk patients. Br J Clin Pharmacol 61:502-512.
42. Le Couteur DG, Kendig H (2008) Pharmaco-epistemology for the prescribing geriatrician. Aust J Ageing 27:3-7.
43. Le Couteur DG, Bailey L, Naganathan V (2006) Beta-blockers and heart failure in older people. Eur Heart J 27:887-888.
44. Fonarow GC, Abraham WT, Albert NM et al (2007) Carvedilol use at discharge in patients hospitalized for heart failure is associated with improved survival: an analysis from Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF). Am Heart J 153:82.e1-82.e11.
45. Mangin D, Sweeney K, Heath I (2007) Preventive health care in elderly people needs rethinking. BMJ 335:285-287.
46. Welch HG, Albertsen PC, Nease RF, Bubolz TA, Wasson JH (1996) Estimating treatment benefits for the elderly: the effect of competing risks. Ann Intern Med 124:577-584.
47. Leipzig RM, Cumming RG, Tinetti ME (1999) Drugs and falls in older people: a systematic review and meta-analysis: II. Cardiac and analgesic drugs. J Am Geriatr Soc 47:40-50.
48. Leipzig RM, Cumming RG, Tinetti ME (1999) Drugs and falls in older people: a systematic review and meta-analysis: I. Psychotropic drugs. J Am Geriatr Soc 47:30-39.
49. Green JL, Hawley JN, Rask KJ (2007) Is the number of prescribing physicians an independent risk factor for adverse drug events in an elderly outpatient population? Am J Geriatr Pharmacother 5:31-39.
50. Lazarou J, Pomeranz BH, Corey PN (1998) Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA 279:1200-1205.
51. Juurlink DN, Mamdani MM, Lee DS et al (2004) Rates of hyperkalemia after publication of the Randomized Aldactone Evaluation Study. N Engl J Med 351:543-551.
52. Mamdani M, Juurlink DN, Kopp A, Naglie G, Austin PC, Laupacis A (2004) Gastrointestinal bleeding after the introduction of COX 2 inhibitors: ecological study. BMJ 328:1415-1416.
53. Aguilar MI, Hart R (2005) Oral anticoagulants for preventing stroke in patients with nonvalvular atrial fibrillation and no previous history of stroke or transient ischemic attacks. Cochrane Database Syst Rev CD001927.
54. Buckingham TA, Hatala R (2002) Anticoagulants for atrial fibrillation: why is the treatment rate so low? Clin Cardiol 25:447-454.
55. Gurwitz JH, Field TS, Radford MJ et al (2007) The safety of warfarin therapy in the nursing home setting. Am J Med 120:539-544.
56. Hylek EM, Evans-Molina C, Shea C, Henault LE, Regan S (2007) Major hemorrhage and tolerability of warfarin in the first year of therapy among elderly patients with atrial fibrillation. Circulation 115:2689-2696.
57. Mant J, Hobbs FD, Fletcher K et al (2007) Warfarin versus aspirin for stroke prevention in an elderly community population with atrial fibrillation (the Birmingham Atrial Fibrillation Treatment of the Aged Study, BAFTA): a randomised controlled trial. Lancet 370:493-503.
58. Fick DM, Cooper JW, Wade WE, Waller JL, Maclean JR, Beers MH (2003) Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts. Arch Intern Med 163:2716-2724.
59. Gurwitz JH, Field TS, Avorn J et al (2000) Incidence and preventability of adverse drug events in nursing homes. Am J Med 109:87-94.
60. Gurwitz JH, Field TS, Harrold LR et al (2003) Incidence and preventability of adverse drug events among older persons in the ambulatory setting. JAMA 289:1107-1116.
61. Laroche ML, Charmes JP, Nouaille Y, Picard N, Merle L (2007) Is inappropriate medication use a major cause of adverse drug reactions in the elderly? Br J Clin Pharmacol 63:177-186.
62. Stuart B, Kamal-Bahl S, Briesacher B et al (2003) Trends in the prescription of inappropriate drugs for the elderly between 1995 and 1999. Am J Geriatr Pharmacother 1:61-74.
63. Zuckerman IH, Langenberg P, Baumgarten M et al (2006) Inappropriate drug use and risk of transition to nursing homes among community-dwelling older adults. Med Care 44:722-730.
64. Mallet L, Spinewine A, Huang A (2007) The challenge of managing drug interactions in elderly people. Lancet 370:185-191.
65. Field TS, Mazor KM, Briesacher B, Debellis KR, Gurwitz JH (2007) Adverse drug events resulting from patient errors in older adults. J Am Geriatr Soc 55:271-276.
66. Bjorkman IK, Fastbom J, Schmidt IK, Bernsten CB (2002) Drug drug interactions in the elderly. Ann Pharmacother 36:1675-1681.
67. Zhan C, Correa-de-Araujo R, Bierman AS et al (2005) Suboptimal prescribing in elderly outpatients: potentially harmful drug-drug and drug-disease combinations. J Am Geriatr Soc 53:262-267.
68. Simons LA, Tett S, Simons J et al (1992) Multiple medication use in the elderly. Use of prescription and non-prescription drugs in an Australian community setting. Med J Aust 157:242-246.
69. Bjerrum L, Sogaard J, Hallas J, Kragstrup J (1999) Polypharmacy in general practice: differences between practitioners. Br J Gen Pract 49:195-198.
70. Rochon PA, Gurwitz JH (1997) Optimising drug treatment for elderly people: the prescribing cascade. Br Med J 315:1096-1099.
71. Gill SS, Mamdani M, Naglie G et al (2005) A prescribing cascade involving cholinesterase inhibitors and anticholinergic drugs. Arch Intern Med 165:808-813.
72. Treloar A, Beats B, Philpot M (2000) A pill in the sandwich: covert medication in food and drink. J R Soc Med 93:408-411.
73. Treloar A, Philpot M, Beats B (2001) Concealing medication in patients' food. Lancet 357:62-64.
74. MacDonald AJ, Roberts A, Carpenter L (2004) De facto imprisonment and covert medication use in general nursing homes for older people in South East England. Aging Clin Exp Res 16:326-330.
75. Bullock R (2005) Treatment of behavioural and psychiatric symptoms in dementia: implications of recent safety warnings. Curr Med Res Opin 21:1-10.
76. Ballard C, Waite J (2006) The effectiveness of atypical antipsychotics for the treatment of aggression and psychosis in Alzheimer's disease. Cochrane Database Syst Rev CD003476.
77. Secker B (1999) Labeling patient (in)competence: a feminist analysis of medico-legal discourse. J Soc Philos 30:295-314.
78. Schneidermann LJ, Kronick R, Kaplan RM, Anderson JP, Langer RD (1992) Effects of offering advance directives on medical treatments and costs. Ann Intern Med 117:599-606.
79. Davis MW, Le Couteur DG, Trim G, Buchanan J, Rubenach S, McLean AJ (1999) Older people in hospital. Aust J Ageing 18(Suppl):26-31.
80. Clegg A, Bryant J, Nicholson T et al (2001) Clinical and cost-effectiveness of donepezil, rivastigmine and galantamine for Alzheimer's disease: a rapid and systematic review. Health Technol Assess 5:1-137.
81. Kaduszkiewicz H, Zimmermann T, Beck-Bornholdt HP, van den Bussche H (2005) Cholinesterase inhibitors for patients with Alzheimer's disease: systematic review of randomised clinical trials. BMJ 331:321-327.
82. Giordano S (2005) Respects for the equality and treatment of the elderly: declarations of human rights and age-based rationing. Camb Q Healthc Ethics 14:83-92.
83. Howe EG, Lettieri CJ (1999) Health care rationing in the aged: ethical and clinical perspectives. Drugs Aging 15:37-47.
84. Harris J (2005) The age-indifference principle and equality. Camb Q Healthc Ethics 14:93-99.
85. Angell M (2005) The truth about drug companies. Scribe, Melbourne.
86. Mulrow C, Lau J, Cornell J, Brand M (2000) Pharmacotherapy for hypertension in the elderly. Cochrane Database Syst Rev CD000028.
87. Dhesi JK, Allain TJ, Mangoni AA, Jackson SH (2006) The implications of a growing evidence base for drug use in elderly patients. Part 4. Vitamin D and bisphosphonates for fractures and osteoporosis. Br J Clin Pharmacol 61:521-528.
88. Nguyen ND, Eisman JA, Nguyen TV (2006) Anti-hip fracture efficacy of biophosphonates: a Bayesian analysis of clinical trials. J Bone Miner Res 21:340-349.
89. Flather MD, Yusuf S, Kober L et al (2000) Long-term ACE-inhibitor therapy in patients with heart failure or left-ventricular dysfunction: a systematic overview of data from individual patients. ACE-Inhibitor Myocardial Infarction Collaborative Group. Lancet 355:1575-1581.
90. Costa J, Borges M, David C, Vaz Carneiro A (2006) Efficacy of lipid lowering drug treatment for diabetic and non-diabetic patients: meta-analysis of randomised controlled trials. BMJ 332:1115-1124.
91. Antithrombotic Triallists Collaboration (2002) Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 324:71-86.
92. Deedwania PC, Gottlieb S, Ghali JK, Waagstein F, Wikstrand JC (2004) Efficacy, safety and tolerability of beta-adrenergic blockade with metoprolol CR/XL in elderly patients with heart failure. Eur Heart J 25:1300-1309.
93. Flather MD, Shibata MC, Coats AJ et al (2005) Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS). Eur Heart J 26:215-225.
94. Dobre D, DeJongste MJ, Lucas C et al (2007) Effectiveness of beta-blocker therapy in daily practice patients with advanced chronic heart failure; is there an effect-modification by age? Br J Clin Pharmacol 63:356-364.
95. US product information for Inspra. Accessed at http://www.pfizer.com/ files/products/uspi-inspra.pdf.