Programme no. 145-OP
GPs experiences and attitudes with prescribing potentially addictive medication to elderly patients, and the effects of an educational intervention program. (Based on the Rx-PAD-study)
Anne Cathrine Sundseth*1
1Department of General Practice ,University of Oslo, Institute of Health and Society,Oslo,Norway
* = Presenting author
Objectives: Objectives To assess Norwegian GPs experiences and attitudes with their own prescription practice of PAMs to elderly patients, and to consider the effects of a conducted individual educational intervention on prescribing to elderly (The Prescription Peer Academic Detailing study, the Rx-PAD study).
Background: Background Elderly people’s risk of harmful side effects from use of potentially addictive medication (PAM) is well known. Still, use of z-hypnotics, benzodiazepines and opioids continue to increase among elderly. The majority of the prescriptions are issued by general practitioners (GPs).
Results: Results Four focus group interviews, with a total of 23 GPs, were conducted through 2010/2011. The interviews were digitally recorded, transcribed and analyzed through qualitative methods. GPs considered their overview of listed elderly patients receiving potentially addictive medication as good and hypnotic prescritions as the most challenging area of PAM prescribing. Tending an educational intervention program had increased the GPs awareness to improve the quality of their own PAM prescribing practice to elderly patients.
Material/Methods: Material and Methods Based on literature studies and material from part I of th Rx-PAD-study, an interview guide was prepared. Clinical relevant questions were emphasized to assess GPs prescription patterns, attitudes and possible effects of eductional intervention on PAM prescribing to elderly patients. Established GP education groups who had participated in the Rx-PAD-study were invited.
Conclusion: Conclusion GPs consider prescribing potentially addictive medication to elderly patients as manageable, but also challanging due to complex and individual conditions related to both prescriber and patients.
Points for discussion: Points for discussion
1) In Norway, over 60% of all potentially addictive medication prescriptions to patients 70 years and older, are issued without face-to-face contact between patient and doctor. Do GPs tend to have less restrictive practices on prescribing potentially addictive medication to elderly than to other patient groups?
2) Is potentially addictive medication given as pre-packed daily medicine dosis adding to the problem of increasing use among elderly?