Académique Documents
Professionnel Documents
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Support for this work: NIMH Center Grants P30 MH49693 and MH45131, and by the Department of Veterans Affairs
Prescription Drugs are consuming more health costs (Reinhardt et al., 2004)
Age and gender effect number of Meds taken (Linjakurapu et al., 2002)
Past decade has seen increased use of virtually all classes of meds (Linjakurapu et al., 2002)
Age Group
>65 Years 30-44 Years
DAWN (2003)
Estimated Number (in thousands) of U.S. Residents (Age 12 and Older) Reporting Lifetime Non-Medical Use of Prescription Pain Relievers, 2003
Any Prescription Pain Reliever Darvocet, Darvon, or Tylenol with Codeine Vicodin , Lortab or Lorcet , Percocet, Percodan, or Tylox Codeine Hydrocodone Demerol Oxycontin Morphine Ultram Dilaudid 0 6,985 5,716 2,986 2,832 2,060 1,105 914
Estimated Number of Users (in Thousands)
*Prior to 2002, the NSDUH was known as the National Household Survey on Drug Abuse. Due to changes in the survey, estimates from the 2002 and 2003 NSDUHs should not be compared with estimates from the 2001 and earlier NHSDAs to assess changes over time. SOURCE: Adapted by CESAR from Substance Abuse and Mental Health Services Administration (SAMHSA), Overview of Findings from the 2003 National Survey on Drug Use and Health, 2004.
Comorbidities
Prescription + alcohol Psychiatric diagnoses
Criteria: Report of adverse consequences (e.g., poor work performance, suspension from school etc.)
fails to consider lifespan changes
Structural Problems
Research not consider aged Dosage one size fits all
Antipsychotic Adherence
Standardized Estimates of Annual Cost in Dollars Antipsychotic Adherence* Nonadherent (.01 - .49) Partially Adherent (.5 -.8) Adherent (.8 1.1) Excess Filler ( > 1.1) Hospital 3,413 (368) 2,689 (412) 1,025 (95) 2,472 (272) Outpatient 3,464 (175) 3,693 (208) 3,776 (151) 5,741 (312) Pharmacy 1,542 (107) 3,142 (110) 4,463 (161) 5,635 (188) Total 8,168 (433) 9,403 (542) 9,505 (289) 14,044 (561)
Gilmer, et al 2004
Inappropriate use of 1197.pdf drugs effected by ethnic/cultural factors (Raji et al. 2003)
Healthcare System
ADVERSE EVENT
Provider(s) Patient
EVENT TRAJECTORY
Healthcare System
ADVERSE EVENT
Provider(s) Older Patient
EVENT TRAJECTORY
Summary
Scope of use
30% of prescription consumed by 12% of population >65 years $15 billion/year in elderly (4xs younger individuals)
Abuse and misuse is a problem Estimates of scope of problem hindered by a number of factors Access to prescription drugs is easier than ever before