Background: Several pain management guidelines and explicit medication-use criteria identify propoxyphene as an inappropriate medication for use in older adults.
Objective: This study was conducted to estimate trends in propoxyphene use among community-dwelling elderly (age > or = 65 years) Medicare beneficiaries from 1993 through 1999 and to determine whether beneficiaries' drug coverage and specific characteristics of their physicians were associated with receipt of propoxyphene in 1999.
Methods: Data from the Medicare Current Beneficiary Survey (MCBS) were used to examine the prevalence of propoxyphene use in cross-sections of nationally representative samples of community-dwelling elderly Medicare beneficiaries from 1993 through 1999. The 1999 MCBS was linked with the 1999 Area Resource File to examine patient and physician factors associated with propoxyphene use in the community-dwelling elderly at the county level.
Results: Rates of propoxyphene use were generally stable over the 7-year period, from an annual prevalence of 6.8% in 1993 to the slightly decreased prevalence of 6.6% in 1999. No protective effects against propoxyphene use were observed based on beneficiaries' drug coverage or type of drug coverage. Rather, Medicaid beneficiaries were more likely to receive propoxyphene than those without drug coverage (odds ratio [OR] = 1.40; 95% CI, 1.02-1.92). Among physician characteristics, male sex (OR = 1.34; 95% CI, 1.02-1.75) and medical specialty (OR = 0.81; 95% CI, 0.65-1.00) were strongly correlated with prescribing of propoxyphene.
Conclusion: This study found a continuing high prevalence of propoxyphene use in the community-dwelling elderly Medicare population from 1993 through 1999, with > 2 million beneficiaries receiving the drug in 1999.
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http://dx.doi.org/10.1016/s1543-5946(05)80025-x | DOI Listing |
J Prim Health Care
September 2013
School of Pharmacy, The University of Auckland, Auckland, New Zealand.
Introduction: The ageing population means prescribing for chronic illnesses in older people is expected to rise. Comorbidities and compromised organ function may complicate prescribing and increase medication-related risks. Comorbid depression in older people is highly prevalent and complicates medication prescribing decisions.
View Article and Find Full Text PDFAm J Geriatr Pharmacother
September 2005
Department of Pharmaceutical Health Services Research, University of Maryland, Baltimore, Maryland, USA.
Background: Several pain management guidelines and explicit medication-use criteria identify propoxyphene as an inappropriate medication for use in older adults.
Objective: This study was conducted to estimate trends in propoxyphene use among community-dwelling elderly (age > or = 65 years) Medicare beneficiaries from 1993 through 1999 and to determine whether beneficiaries' drug coverage and specific characteristics of their physicians were associated with receipt of propoxyphene in 1999.
Methods: Data from the Medicare Current Beneficiary Survey (MCBS) were used to examine the prevalence of propoxyphene use in cross-sections of nationally representative samples of community-dwelling elderly Medicare beneficiaries from 1993 through 1999.
Drugs Aging
March 2005
Kunin-Lunenfeld Applied Research Unit, Department of Medicine, University of Toronto, Baycrest Centre for Geriatric Care, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Objective: To explore the prescribing of potentially inappropriate drug therapy in Ontario, Canada where there is a restrictive drug formulary relative to the US where there is no single drug formulary.
Methods: A retrospective, cohort study using an administrative database (Ontario, Canada) compared with published survey results (US). All 1,088,680 community-dwelling adults >or=66 years of age in Ontario, Canada compared with published survey results from 2455 community-dwelling older adults in the US in 1996.
J Am Geriatr Soc
August 2003
University of Maryland Baltimore, School of Pharmacy, Maryland 21201, USA.
Objectives: To provide the first comparable national prevalence estimates on use of propoxyphene, a potentially inappropriate drug, by elderly Medicare beneficiaries living in the community and institutions and to determine whether institutionalized beneficiaries are at a greater risk for receiving propoxyphene than community-dwelling beneficiaries.
Design: Cross-sectional study.
Setting: U.
J Am Pharm Assoc (Wash)
January 2003
Division of Pharmaceutical Policy and Evaluative Sciences, School of Pharmacy, University of North Carolina-Chapel Hill, 27599-7360, USA.
Objectives: To provide an updated review of the literature on the extent of and risk factors for inappropriate prescribing in the elderly.
Methods: A comprehensive review of the most recent publications in English assessing inappropriate prescriptions for elderly patients in the United States using the 1997 version of the Beers explicit criteria. The reviewed articles were obtained via an electronic search of the MEDLINE database for articles published between 1997 and 2001 and a manual search through major journals for articles referenced in those located through MEDLINE.
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