Development and reliability testing of the clinical pharmacist recommendation taxonomy.

Study Objective: To evaluate the reliability of a newly developed taxonomy--the Clinical Pharmacist Recommendation (CPR) taxonomy--to classify clinical pharmacy interventions.

Design: The CPR taxonomy was developed and refined in three phases. In each phase, reviewers independently reviewed recommendations made by a clinical pharmacist-physician team and categorized them into mutually exclusive categories: priority, problem, and response.

Anticholinergic medications in community-dwelling older veterans: prevalence of anticholinergic symptoms, symptom burden, and adverse drug events.

Background: The use of drugs with anticholinergic adverse effects is often deemed inappropriate in elderly (aged > or = 65 years) patients, yet studies continue to show extensive use in this population at high risk for adverse drug events (ADEs). The burden of drug-related anticholinergic symptoms in community-dwelling elderly patients has not been well described.

Objective: The aim of this study was to assess the prevalence of anticholinergic symptoms, corresponding symptom burden, and anticholinergic-related ADEs in a sample of community-dwelling elderly veterans.

Prevalence of prostate specific antigen testing for prostate cancer in elderly men.

Purpose: We investigated the prevalence and outcome of PSA testing for prostate cancer screening or diagnosis in elderly men 75 years or older at our academic medical center.

Materials And Methods: A cross-sectional study design was used to identify all men 75 years or older who underwent a PSA test through the family medicine or internal medicine service at our institution between January 1, 1998 and June 30, 2004. All patients with a suspected (PSA less than 0.

Comparison of prevalence of atherosclerotic vascular disease in postmenopausal women with osteoporosis or osteopenia versus without osteoporosis or osteopenia.

Atherosclerotic vascular disease (AVD) and osteoporosis or osteopenia are common conditions among postmenopausal women and appear to be linked in a manner that is not fully understood. In a retrospective study that was conducted among 1,000 postmenopausal women who were seen in a general medicine clinic, AVD was more commonly seen among women with osteoporosis (92 of 154, 60%) than among those with osteopenia (63 of 179, 35%, p <0.001) or no osteoporosis or osteopenia (148 of 667, 22%, p <0.

Prevalence and causes of persistent use of hormone replacement therapy among postmenopausal women: a follow-up study.

In a previous study analyzing data from September 2002 to February 2003, we showed that, despite the Women's Health Initiative trial results, many women still remained on hormone replacement therapy (HRT) in an internal medicine practice. However, it is not known whether such use has persisted over time. We performed a retrospective chart analysis of 1000 postmenopausal women seen at the same internal medicine practice from January 2004 to May 2004 to establish whether the prevalence of HRT use had declined, remained stable, or increased when compared with our previous data and to determine the reasons for continued HRT use.

Cerebrovascular diseases as primary hospital discharge diagnoses: national trend (1970-2000) among older adults.

Background: Cerebrovascular diseases are a common cause of mortality, morbidity, and hospitalization among older adults. However, the long-term national trends in cerebrovascular disease-related hospitalizations in this age group are not well known.

Methods: We used the National Center for Health Statistics trend data from the National Hospital Discharge Surveys (1970-2000) to determine incidence of cerebrovascular disease-related hospitalizations among persons 65 years and older in the United States.

Use of complementary medicine in older Americans: results from the Health and Retirement Study.

Purpose: The correlates of complementary and alternative medicine (CAM) utilization among elders have not been fully investigated. This study was designed to identify such correlates in a large sample of older adults, thus generating new data relevant to consumer education, medical training, and health practice and policy.

Design And Methods: A subsample from the 2000 Wave of the Health and Retirement Study (n = 1,099) aged 52 or older were surveyed regarding use of CAM (chiropractic, alternative practitioners, dietary and herbal supplements, and personal practices).

Menopausal symptoms after cessation of hormone replacement therapy.

Objectives: To determine the prevalence of recurrent menopausal symptoms among post-menopausal women who discontinued hormone replacement therapy (HRT) after the publication of the women's health initiative (WHI) study and to describe the therapeutic strategies employed to address these symptoms.

Methods: Retrospective analysis of 1000 post-menopausal women seen consecutively at an internal medicine practice from January 2004 to May 2004.

Results: Among 1000 post-menopausal women, 205 (21%) had discontinued HRT due to the WHI results.

Use of hormone replacement therapy by postmenopausal women after publication of the Women's Health Initiative Trial.

Background: After publication of the Women's Health Initiative (WHI) trial in July 2002, many physicians discontinued hormone replacement therapy (HRT) in most of their postmenopausal patients. However, little is known about the women who remain on HRT.

Methods: We performed a retrospective chart analysis of 1000 postmenopausal women seen at an internal medicine practice to establish the prevalence of continued HRT use after publication of the WHI trial, determine the reasons for its use, and establish the prevalence of conditions adversely affected by HRT.

Prevalence of symptomatic peripheral arterial disease, modifiable risk factors, and appropriate use of drugs in the treatment of peripheral arterial disease in older persons seen in a university general medicine clinic.

Background: Persons with peripheral arterial disease (PAD) have a high incidence of cardiovascular morbidity and mortality.

Methods: We investigated the prevalence of symptomatic PAD, modifiable risk factors, and use of drugs in persons 60 years and older seen in a university general medicine clinic. Symptomatic PAD was documented if the person had a documented history of surgery for PAD, if the person had intermittent claudication or other lower extremity symptoms associated with absent or weak arterial pulses or an ankle-brachial index of <0.

Underutilization of calcium and vitamin D by older adults in a large general internal medicine practice.

The underutilization of calcium and vitamin D supplements in the prevention and treatment of osteoporosis is common among high-risk elders. Less is known about the prevalence and adequacy of calcium and vitamin D use by the general population of older adults. We performed a retrospective chart analysis of 617 women and 383 men over the age of 60 (mean age 73 +/- 9 years) seen at an internal medicine practice to establish the prevalence and evaluate the adequacy of calcium and vitamin D supplementation.

Demographics and payment characteristics of nursing home residents in the United States: a 23-year trend.

Background: With the aging of our population, an increased number of older Americans are expected to reside in nursing homes. Our objective is to determine the national trend in nursing home residence for older Americans.

Methods: Using the Beyond 20/20 software, we analyzed publicly available data from National Nursing Home Surveys 1977-1999 to determine the trend in the demographics, marital status, and source of payments for older Americans residing in nursing homes.