Primary care providers' perspectives on psychoactive medication disorders in older adults. Academic Article uri icon

Overview

MeSH

  • Adult
  • Age Factors
  • Ambulatory Care
  • Attitude of Health Personnel
  • Data Collection
  • Female
  • Focus Groups
  • Humans
  • Male
  • Middle Aged
  • New York City
  • Professional-Patient Relations
  • Risk Factors

MeSH Major

  • Primary Health Care
  • Psychotropic Drugs
  • Substance-Related Disorders

abstract

  • Compared with younger adults, older adults consume a disproportionate percentage of pain and sleep medications. Some studies have reported that psychoactive medication misuse and abuse in older populations is a significant problem. The aim of this study was to understand the perspective of primary care providers (PCPs) regarding the extent and clinical presentations of misuse and abuse of psychoactive medications in older patients and to explore PCPs' perceived barriers to identifying affected individuals. Seventeen physicians and 5 nurse practitioners from 2 ambulatory care practices serving older adults in New York City participated in this study. Six focus group discussions were audiotaped and transcribed. Two raters coded transcripts to identify recurring themes. Qualitative analysis software was employed for data coding and sorting purposes. Although PCPs indicated that only a small percentage of older patients were actively misusing or abusing their psychoactive medications (average estimate given by providers, 8%), they felt that these patients placed significant time burdens on them. Perceived risk factors included psychiatric disorders, previous substance abuse history, and cognitive impairment, but many PCPs found it impossible to predict which patients were at increased risk. PCPs identified multiple barriers to identifying affected patients, including lack of communication (between provider and patient, provider and patients' caregivers, and between different providers), nonspecific symptoms, and the lack of a clear definition of misuse and abuse. The lack of a clear definition, absence of well-defined risk factors, and ambiguous clinical manifestations of psychoactive medication misuse and abuse present substantial barriers to diagnosis. A standard, age-appropriate definition could help PCPs establish a diagnosis, clarify what constitutes appropriate psychoactive medication use, define the extent of the problem, and pave the way for the development of effective screening and diagnostic tools. Copyright © 2011 Elsevier HS Journals, Inc. All rights reserved.

publication date

  • June 2011

has subject area

  • Adult
  • Age Factors
  • Ambulatory Care
  • Attitude of Health Personnel
  • Data Collection
  • Female
  • Focus Groups
  • Humans
  • Male
  • Middle Aged
  • New York City
  • Primary Health Care
  • Professional-Patient Relations
  • Psychotropic Drugs
  • Risk Factors
  • Substance-Related Disorders

Research

keywords

  • Journal Article

Identity

Language

  • eng

PubMed Central ID

  • PMC3109734

Digital Object Identifier (DOI)

  • 10.1016/j.amjopharm.2011.04.004

PubMed ID

  • 21550858

Additional Document Info

start page

  • 164

end page

  • 172

volume

  • 9

number

  • 3