Cartwright A
Institute for Social Studies in Medical Care, London, UK.
Br Med Bull. 1990 Jan;46(1):63-76. doi: 10.1093/oxfordjournals.bmb.a072395.
Older people consult their doctors less than younger people in relation to both their reported morbidity and their prescribed medication. Some of the large iceberg of symptoms among the elderly might respond to a modification of their current drug regimens. Assessments of medicine taking patterns among the elderly revealed various inadequacies in supervision and a substantial proportion of questionable prescribing. General practitioners were often unaware that elderly patients lived alone, or that they drank alcohol or drove--even when they were taking prescribed medicines for which drinking or driving were contraindicated. Just over a third of elderly people were taking prescribed medicines of which their general practitioners were apparently unaware. The way doctors prescribe for their elderly patients and supervise this prescribing is suggested as a suitable field for audit. The completeness of their records in relation to prescriptions, drinking, driving, and living alone is another possible area for study. So too is the home visiting of the very elderly, particularly those living alone.
与年轻人相比,老年人无论是在报告发病率还是在处方药使用方面,咨询医生的次数都更少。老年人中一些未被发现的大量症状可能可以通过调整他们目前的药物治疗方案得到缓解。对老年人用药模式的评估显示,在监管方面存在各种不足,且有很大比例的处方存在问题。全科医生常常不知道老年患者独居,或者不知道他们饮酒或开车——即使他们正在服用禁止饮酒或开车时服用的处方药。超过三分之一的老年人正在服用全科医生显然不知情的处方药。医生为老年患者开处方以及监督这种处方的方式被认为是一个合适的审计领域。他们在处方、饮酒、开车和独居方面记录的完整性是另一个可能的研究领域。对高龄老人,尤其是独居老人的家访也是如此。