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Community prevalence of alcohol use and concomitant use of medication--a source of possible risk in the elderly aged 75 and older?

https://arctichealth.org/en/permalink/ahliterature173826
Source
Int J Geriatr Psychiatry. 2005 Jul;20(7):680-5
Publication Type
Article
Date
Jul-2005
Author
Marja Aira
Sirpa Hartikainen
Raimo Sulkava
Author Affiliation
Inner-Savo Health Centre, Finland. marja.aira@uku.fi
Source
Int J Geriatr Psychiatry. 2005 Jul;20(7):680-5
Date
Jul-2005
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alcohol Drinking - adverse effects - blood - epidemiology
Drug Interactions
Drug-Related Side Effects and Adverse Reactions
Epidemiologic Methods
Erythrocyte Indices - drug effects
Female
Finland - epidemiology
Humans
Male
Nonprescription Drugs - administration & dosage - adverse effects
Pharmaceutical Preparations - administration & dosage
Abstract
To explore alcohol use and concomitant use of prescription and over the counter (OTC) medicines in people aged 75 years or over.
Community-based randomized survey of home-dwelling elderly persons, Setting: the City of Kuopio, Finland.
Population-based random sample of 700 persons aged 75 years or over, of whom 601 participated (86%). Only home-dwellers (n = 523) were included in this study.
Alcohol use based on responses to questions concerning quantity and frequency, and CAGE questions. Use of prescription and non-prescription medicines. Mean corpuscular volume.
Of the participants, 44% used alcohol. Most alcohol drinkers used medications on a regular basis (86.9%) or as needed (87.8%), among them medicines known to have some potential interactions with alcohol. Elevated mean corpuscular volume was more widespread among alcohol drinkers than non drinkers.
Theoretical risks posed by alcohol use are not minimal in the older elderly, though the quantity of alcohol use is not considerable. Physicians and nurses should pay attention to chronic diseases and medications when counselling aged people about alcohol consumption. The question of clinical importance of alcohol-medication interactions needs to be studied further.
PubMed ID
16021662 View in PubMed
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Drinking alcohol for medicinal purposes by people aged over 75: a community-based interview study.

https://arctichealth.org/en/permalink/ahliterature154930
Source
Fam Pract. 2008 Dec;25(6):445-9
Publication Type
Article
Date
Dec-2008
Author
Marja Aira
Sirpa Hartikainen
Raimo Sulkava
Author Affiliation
School of Public Health and Clinical Nutrition, University of Kuopio, Kuopio, Finland. marja.aira@uku.fi
Source
Fam Pract. 2008 Dec;25(6):445-9
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alcohol Drinking - adverse effects - epidemiology - psychology
Cardiovascular Diseases - drug therapy
Drug Interactions
Ethanol - administration & dosage - adverse effects
Female
Finland - epidemiology
Humans
Interviews as Topic
Male
Mental Disorders - drug therapy
Self Medication - psychology - statistics & numerical data
Sleep Disorders - drug therapy
Abstract
Physicians often encounter patients using alcohol as self-medication, but studies on community level are scarce. Because of alcohol-medicine interactions, it is important to know also all self-medication used.
To describe alcohol use as self-medication by people aged over 75 years.
The home-dwelling elderly (n = 699) among a random sample of 1000 subjects from the total population of individuals aged 75 years or more in the city of Kuopio, Finland, were interviewed about their alcohol consumption and use as self-medication and also about their lifestyle habits, medicaments and diseases. A geriatrician checked their medical records for medical conditions.
Half of the subjects consumed alcohol, and 40% of them used alcohol for medicinal purposes. This was equally common in females and males. The quantity used was half a unit or less in 68% of cases. Brandy and other spirits were the most commonly used beverages, and heart and vascular disorders (38%), sleep disorders (26%) and mental problems (23%) were the commonest reasons for use. The study found altogether 84 persons who responded negatively to the question about alcohol consumption but later reported using alcohol as self-medication.
Drinking alcohol for medicinal purposes is common among the aged in Finland. Some people, especially older women, may find it easier to discuss their alcohol consumption in the context of medicinal use. Physicians have to consider the possible risks of alcohol associated with concomitant medical conditions and interactions of alcohol with medicines.
PubMed ID
18826990 View in PubMed
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Effects of medication assessment as part of a comprehensive geriatric assessment on drug use over a 1-year period: a population-based intervention study.

https://arctichealth.org/en/permalink/ahliterature143062
Source
Drugs Aging. 2010 Jun 1;27(6):507-21
Publication Type
Article
Date
Jun-1-2010
Author
Pasi Lampela
Sirpa Hartikainen
Piia Lavikainen
Raimo Sulkava
Risto Huupponen
Author Affiliation
Department of Pharmacology and Toxicology, University of Kuopio, Kuopio, Finland. Pasi.Lampela@uku.fi
Source
Drugs Aging. 2010 Jun 1;27(6):507-21
Date
Jun-1-2010
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Drug Interactions
Drug Prescriptions
Drug Therapy
Drug Utilization Review - methods
Drug-Related Side Effects and Adverse Reactions
Finland
Geriatric Assessment - methods
Humans
Intervention Studies
Interviews as Topic
Medical Records
Outpatients
Polypharmacy
Abstract
High drug consumption among the elderly and inappropriate prescribing practices increase the risk of adverse drug effects in this population. This risk may be decreased by conducting, for example, a medication review alone or as part of a comprehensive geriatric assessment (CGA); however, little is known about the fate of the changes in medication made as a result of the CGA or medication review. To study the performance of the CGA with regards to medication changes and to determine the persistence of these changes over a 1-year period. This study was a population-based intervention study. A random sample of 1000 elderly (age > or =75 years) was randomized either to a CGA group or to a control group. Home-dwelling patients from these groups (n = 331 and n = 313 for intervention and control groups, respectively) were analysed in this study. Study nurses collected information on medication at study entry and 1 year later in both groups; in the intervention group, study physicians assessed, and changed when appropriate, the medication at study entry. The medication changes and their persistence over 1 year were then evaluated. Medication changes were more frequent in the intervention group than in the control group. Regular medication was changed during follow-up in 277 (83.7%) and in 228 (72.8%) [odds ratio (OR) 1.9; 95% CI 1.3, 2.8] patients in the intervention and control groups, respectively. In the intervention group, study physicians were responsible for 35.4% of all new prescriptions and for 15.6% of all drug terminations. Changes took place particularly in the prescription of CNS drugs. About 58% of the drugs initiated by study physicians were still in use 1 year later, and 25.5% of those terminated by study physicians had been reintroduced. Drug intervention as part of a CGA can be used to rationalize the drug therapy of a patient. However, its effectiveness is subsequently partly counteracted by other physicians working in the healthcare system.
PubMed ID
20524710 View in PubMed
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