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Patterns of medication use among old...
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Fisher, Judith Ellen.
Patterns of medication use among older adults with osteoarthritis.
Record Type:
Electronic resources : Monograph/item
Title/Author:
Patterns of medication use among older adults with osteoarthritis./
Author:
Fisher, Judith Ellen.
Description:
200 p.
Notes:
Source: Dissertation Abstracts International, Volume: 70-10, Section: B, page: 6136.
Contained By:
Dissertation Abstracts International70-10B.
Subject:
Gerontology. -
Online resource:
http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=NR52602
ISBN:
9780494526026
Patterns of medication use among older adults with osteoarthritis.
Fisher, Judith Ellen.
Patterns of medication use among older adults with osteoarthritis.
- 200 p.
Source: Dissertation Abstracts International, Volume: 70-10, Section: B, page: 6136.
Thesis (Ph.D.)--University of Toronto (Canada), 2009.
Background. Osteoarthritis results in substantial long-term morbidity among older persons. Medication use is a central component of symptom management. Decisions regarding medication use involve balancing the competing desires of managing symptoms to facilitate function and minimizing treatment-related harm.
ISBN: 9780494526026Subjects--Topical Terms:
168436
Gerontology.
Patterns of medication use among older adults with osteoarthritis.
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Fisher, Judith Ellen.
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Patterns of medication use among older adults with osteoarthritis.
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200 p.
500
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Source: Dissertation Abstracts International, Volume: 70-10, Section: B, page: 6136.
502
$a
Thesis (Ph.D.)--University of Toronto (Canada), 2009.
520
$a
Background. Osteoarthritis results in substantial long-term morbidity among older persons. Medication use is a central component of symptom management. Decisions regarding medication use involve balancing the competing desires of managing symptoms to facilitate function and minimizing treatment-related harm.
520
$a
Objective. To illustrate and quantify the dynamic, negotiated decision-making process in a cohort of community-dwelling adults.
520
$a
Methods. Data is derived from an established prospective population cohort of 2,411 persons 55+ years with OA followed annually. Prevalence of acetaminophen, opioid and NSAID use was calculated at each year (2000--2003). Multivariate predictive models examined the impact of age and gender on use of each drug, adjusting for: arthritis severity; concurrent diseases; physician contact; and socioeconomic status. Multilevel models examined change trajectories in NSAID use, adjusting for baseline age, sex, arthritis severity, presence of heart disease, and acetaminophen and opioid use.
520
$a
Results. Arthritis severity and medical complexity increased on average over the study period. Acetaminophen use decreased, but remained the most commonly reported medicine; likelihood of use was positively associated with pain and with sex in the context of age. Opioid use increased, but remained low overall (less than 25%). NSAID use decreased over time; likelihood of use was negatively associated with concurrent medical conditions, specifically heart disease, and with age, and positively associated with pain. The positive relationship between NSAID use and pain weakened over time; the negative relationship with heart disease strengthened. The negative relationship between NSAID use and age was consistent over time, and after adjusting for all covariates, including comorbidity.
520
$a
Conclusions. Findings illustrate the complexity of issues concerning medication use in this population and demonstrate that factors other than arthritis severity determine use-patterns over time. In particular, the results are interpreted as confirmation of the substantive constraining effect of 'old age', beyond concerns regarding medical comorbidity, on decisions regarding NSAID use that reflects both clinical evidence and presumption of increasing frailty among the elderly. The prominence of acetaminophen in the context of progressive symptoms, low opioid use and decreasing NSAID use highlights the potential for unmet needs. Further research is warranted to examine factors associated with the observed drug-use patterns.
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School code: 0779.
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University of Toronto (Canada).
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Dissertation Abstracts International
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70-10B.
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Ph.D.
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2009
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http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=NR52602
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