Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-10T11:59:46.045Z Has data issue: false hasContentIssue false
  • English
  • Français

Prescription Drug Use and Seniors

Published online by Cambridge University Press:  29 November 2010

Robyn Tamblyn  and
Robert Perreault
Robyn Tamblyn
Affiliation:
McGill University
Robert Perreault
Affiliation:
Régie Régionale-Montréal Centre
Get access Rights & Permissions [Opens in a new window]

Abstract

Increasing expenditures for prescription drugs have placed seniors in the spotlight of health reforms because they are the main users of prescription drugs. Substantial improvements could be made in the utilization of prescription drugs that would enhance the benefits of therapy, and minimize adverse effects, particularly for seniors. A variety of problems have been documented, including the over- and under-use of drug therapy, prescribing errors, treatment compliance, and cost-ineffective prescribing. Health care system policies, selected physician and hospital-based pharmacist interventions, and decision-aids and compliance aids have been shown to be effective for components of the problem. Integration of key policies and interventions into a comprehensive solution for optimal drug use is needed. This will include: (1) revision of policies guiding the relationship between the drug industry and health sector, (2) regulations requiring adequate drug testing in seniors for drug approval, (3) a Consumer Health Institute to provide a central objective resource for patient information and decision support systems, (4) integrated clinical information systems to support prescribing, dispensing and drug and disease management systems for pharmacists and primary care physicians, and (5) reforms in medical training and licensure.

Résumé

L'augmentation des dépenses de médicaments a placé les aîné(e)s sous les feux de la réforme de santé puisqu'ils en sont les plus grands consommateurs. On pourrait apporter des modifications substantielles à la consommation de médicaments presents, ce qui rehausserait les bienfaits des traitements et en minimiserait les effets négatifs, surtout chez les aîné(e)s. On documente ici un bon nombre de problèmes, notamment la surconsommation et la sous-consommation des médicaments, les erreurs d'ordonnances, la conformité au traitement et les médicaments inutilement coûteux. On a démontré l'efficacité de certaines éléments à l'égard de certains aspects du problème; qu'on cite simplement les politiques reliées au système de soins de santé, les interventions de certains médecins et de pharmaciens d'hôpitaux, les aides à la prise de dècisions et à la conformité aux traitements. Il faut mettre en place l'intégration des principales politiques et des interventions en une solution globale visant une meilleure utilisation des médicaments. Elle pourrait se composer des éléments suivants: (1) la révision des politiques de relations entre l'industrie pharmacologique et le secteur de la santé; (2) l'établissement de règlements d'expérimentation des médicaments chez les aînés avant leur approbation; (3) un institut du consommateur servant de ressource centrale objective aux demandes de renseignements des patients et de système d'appui aux décisions; (4) des systèmes intégrés d'information clinique à l'appui des systèmes de gestion des ordonnances et de la fourniture des médicaments et de la gestion des médicaments et des maladies à l'intention des pharmaciens et des médecins de premier recours; (5) une réforme de la formation médicale et de l'octroi des permis.

Keywords

SeniorsPrescription DrugsHealth PolicyHealth ServicesAîné(e)smédicaments presentspolitique en matière de santéservices de la santé
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 19 , Issue S1 , Summer/Été 2000 , pp. 143 - 175
Copyright
Copyright © Canadian Association on Gerontology 2000

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Anonymous. National Health Expenditures in Canada – 1985. Ottawa: Health and Welfare Canada, 1985.Google Scholar
2. Anonymous. Enoxacin-A new fluoroquinolone. The Medical Letter 1992;34(883): 103–5.Google Scholar
3. Anonymous Drug Facts and Comparisons. St-Louis, Missouri: Facts and Comparisons, Inc., 1993a.Google Scholar
4. Anonymous. Statistics Med-Echo 1980–81 to 1984–85. Ministry of Health and Social Services 1993b.Google Scholar
5.Alexander, N, Goodwin, JS, Currie, C.Comparison of admission and discharge medications in two geriatric populations. J Am Geriatr Soc 1985;33:827–32.CrossRefGoogle ScholarPubMed
6.Amarasangham, LR.Social and cultural perspectives on medication refusal. American Journal of Psychiatry 1980;137:353–8.Google Scholar
7.Anderson, GM, Kerluke, KJ, Pulcins, IR, Hertzman, C, Barer, ML.Trends and Determinants of Prescription Drug Expenditures in the Elderly: Data from the British Columbia Pharmacare Program. Inquiry 1993;30:199–207.Google ScholarPubMed
8.Angus Reid Group Inc. Medication Use in Canadians Aged 55 and Older: Opinions and Attitudes. a report to the Canadian Coalition on Medication Use and the Elderly 1991.Google Scholar
9.Angus, D, Karpetz, H.Pharmaceutical Policies in Canada: Issues and Challenges. Pharmacoeconomics 1998;14:81–96.CrossRefGoogle ScholarPubMed
10.Ascione, FJ, Shimp, LA.The effectiveness of four education strategies in the elderly. Geriatrics and Gerontology 1984;18:926–31.Google ScholarPubMed
11.Ashton, H.Psychotropic-Drug Prescribing for Women. Brit.J.Psychiat. 1991; 158(suppl.10):30–5.CrossRefGoogle Scholar
12.Association Canadienne de l'Industrie du Médicament.ISBN 2-550-28496-8. L'Utilisation des Médicaments chez les Personnes Agées. Québec: Ministère de la Santé et des Services Sociaux, 1993.Google Scholar
13.Avorn, J, Soumerai, SB.Improving drug-therapy decisions through educational outreach: A randomized controlled trial of academically based “detailing”. N Engl J Med 1983;308:1457–63.CrossRefGoogle ScholarPubMed
14.Avorn, J, Soumerai, SB, Taylor, W, Wessels, MR, Janousek, J, Weiner, M.Reduction of incorrect antibiotic dosing through a structured educational order form. Arch.Intern.Med. 1988;148:1720–4.CrossRefGoogle ScholarPubMed
15.Bacovsky, RA.Federal, Provincial and Territorial Government-Sponsored Drug Plans and Drug Databases.Health Canada 1997; Background information Prepared for the Conference on National Approaches to Pharmacareon January 18–20, 1998.Google Scholar
16.Barnett, GO, Winickoff, R, Dorsey, JL, Morgan, MM, Lurie, RS.Quality assurance through automated monitoring and concurrent feedback using a computer-based medical information system. Med Care 1978;16:962–70.CrossRefGoogle ScholarPubMed
17.Barnett, GO, Winickoff, RN, Morgan, MM, Zielstorff, RD.A computer-based monitoring system for follow-up of elevated blood pressure. Med Care 1983; 21(4):400–9.Google Scholar
18.Baxendale, C, Gourlay, M, Gibson, IIJM.A self-medication retraining programme. Br.Med.J. 1978;2:1278–9.CrossRefGoogle ScholarPubMed
19.Becker, MH, Drachman, RH, Kirscht, JP.Predicting mother's compliance with pediatric medical regimes. Journal of Pediatrics 1972;81(4):843–54.CrossRefGoogle Scholar
20.Becker, MH, Green, LW.A family approach to compliance with medical treatment: A selective review of the literature. Int J Health Educ 1975;18:173.Google Scholar
21.Becker, MH, Maiman, LA.Sociobehavioral determinants of compliance with health and medical care recommendations. Med Care 1975;12:10.CrossRefGoogle Scholar
22.Beers, MH, Dang, J, Hasegawa, J, Tamai, IY.Influence of hospitalization on drug therapy in the elderly. J Am Geriatr Soc 1989;37:679–83.CrossRefGoogle ScholarPubMed
23.Beers, MH, Fingold, SF, Ouslander, JG, Reuben, DB, Morgenstern, H, Beck, J.Characteristics and quality of prescribing by doctors practising in nursing homes. J Am Geriatr Soc 1993;41:802–7.CrossRefGoogle Scholar
24.Beers, MH, Ouslander, JG, Fingold, SF, Morgenstern, H, Reuben, DB, Rogers, W, et al. Inappropriate medication prescribing in skilled-nursing facilities. Ann.Intern.Med. 1992;117:684–9.CrossRefGoogle ScholarPubMed
25.Beers, MH, Storrie, M, Lee, G.Potential adverse drug interactions in the emergency room. Ann.Intern.Med. 1990;112:61–4.CrossRefGoogle ScholarPubMed
26.Bellamy, N, Brooks, PM, Emmerson, BT, Gilbert, JR, Campell, J, McCredie, M.A Survey of current prescribing practices of anti-inflammatory and urate-lowering drugs in gouty arthritis in New South Wales and Queensland. Med.J.Aust. 1989;151:531–7.CrossRefGoogle ScholarPubMed
27.Bergman, U, Wiholm, BE.Drug-related problems causing admission to a medical clinic. Eur.J Clin.Pharmacol. 1981;20:193–200.Google Scholar
28.Bingle, GJ, O'Connor, TP, Evans, WO, Detamore, S.The effect of ‘detailing’ on physicians' prescribing behavior for postsurgical narcotic analgesia. Pain 1991;45:171–3.CrossRefGoogle ScholarPubMed
29.Bjornson, DC, Rector, TS, Daniels, CE, Wertheimer, AI, Snowdon, DA, Litman, TJ.Impact of a drug-use review program intervention on prescribing after publication of a randomized clinical trial. Am.J.Hosp.Pharm. 1990;47:1541–6.Google ScholarPubMed
30.Bliss, MR.Prescribing for the elderly. Br.Med.J. 1981;283:203–6.CrossRefGoogle ScholarPubMed
31.Bloom, BS.Direct medical costs of disease and gastrointestinal side effects during treatment of arthritis. Am.J.Med. 1988;84:20–4.Google Scholar
32.Bloom, BS.Cross-national changes in the effects of peptic ulcer disease. American College of Physicians 1991;114:558–62.Google ScholarPubMed
33.Bloom, JA, Frank, JW, Shafir, MS, Martiquet, P.Potentially undesirable prescribing and drug use among the elderly: Measurable and remediable. Can.Fam.Physician 1993;39:2337–45.Google ScholarPubMed
34.Bottiger, LE, Westerholm, B.Drug-induced blood dyscrasias in Sweden. Br.Med.J. 1973;3:339–43.Google Scholar
35.British Pharmacopea. Oxford Press, 1910.Google Scholar
36.Brook, RH, Kamberg, CJ, Mayer-Oakes, A, Beers, MH, Raube, K, Steiner, A.Appropriateness of Acute Medical Care for the Elderly. Santa Monica, Ca.: RAND Corporation, 1989.Google Scholar
37.Burgess, MM.Ethical and economic aspects of noncompliance and overtreatment. Can.Med.Assoc.J. 1989;141:777–80.Google ScholarPubMed
38.Cafferata, GL, Kasper, J, Bernstein, A.Family roles, structure, and stressors in relation to sex differences in obtaining psychotropic drugs. J Health Soc Behav 1983;24(June): 132–43.CrossRefGoogle ScholarPubMed
39.Cafferata, GL, Meyers, SM.Pathways to psychotropic drugs: Understanding the basis of gender differences. Med Care 1990;28:285–300.CrossRefGoogle ScholarPubMed
40.Campbell, AJ, Borrie, MJ, Spears, GF. Risk factors for falls in a community-based prospective study of people 70 years and older. Journal of Gerontology 1989;44:112–7.Google Scholar
42.Carruthers, G, Goldberg, T, Segal, H, Sellers, E.Drug Utilization A Comprehensive Literature Review. Department of Health Administration.University of Toronto, 1987.Google Scholar
41.Campbell, AJ, Spears, GF, Borrie, MJ.Examination by logistic regression modeling of the variables which increase the relative risk of elderly women Falling compared to elderly men. J Clin Epidemiol 1990;43(12):1415–20.CrossRefGoogle ScholarPubMed
43.Chapman, S.Drug formularies – good or evil? A view using prescribing analyses and cost trends data. Cardiology 1994;85 (suppl.1):46–53.Google Scholar
44.Cheung, A, Kayne, R.An application of clinical pharmacy services in extended care facilities. California Pharmacy 1975;23:22–43.Google Scholar
45.Chren, M, Landefeld, S.Physicians' behavior and their interactions with drug companies: A controlled study of physicians who requested additions to a hospital drug formulary. J Am Med Assn 1994;271:684–9.CrossRefGoogle ScholarPubMed
46.Chrymko, MM, Conrad, W.Effect of removing clinical pharmacy input. Am.J.Hosp.Pharm. 1982;39:641.Google ScholarPubMed
47.CIHI. National Health Expenditure Trends, 1975–1998. National Health, 1998.Google Scholar
48.Clary, C, Mandos, LA, Schweizer, E.Results of a brief survey on the prescribing practices for monoamine oxidase inhibitor antidepressants. J.Clin.Psychiatry 1990;51:226–31.Google ScholarPubMed
49.Coambs, RB, Jepson, M, Hao Her, M, Ferguson, BS, Jarry, JL, Wong, JSW, et al. Review of the Scientific Literature on the Prevalence, Consequences, and Health Costs of Noncompliance & Inappropriate Use of Prescription Medication in Canada. Ottawa, ON: Pharmaceutical Manufacturers Association of Canada, 1995.Google Scholar
50.Coe, RM, Prendergast, CG, Psathas, G.Strategies for obtaining compliance with medical regimens. J Am Geriatr Soc 1984;32:589–94.Google Scholar
51.Col, N, Fanale, JE, Kronholm, P.The role of medication noncompliance and adverse drug reactions in hospitalizations of the elderly. Arch.Intern.Med. 1990; 150:841–5.CrossRefGoogle ScholarPubMed
52.Committee on Safety of Medicines. Non-steroidal anti-inflammatory drugs and serious gastrointestinal adverse reactions 2. Br.Med.J. 1986;292:1190–1.CrossRefGoogle Scholar
53.Cooper, JK, Love, DW, Raffoul, PR.Intentional prescription nonadherence (noncompliance) by the elderly. J Am Geriatr Soc 1982;30(5):329–33.CrossRefGoogle ScholarPubMed
54.Cooper, JW.Effect of initiation, termination, and reinitiation of consultant clinical pharmacist services in a geriatric long-term care facility. Med Care 1985;23(1):84–9.CrossRefGoogle Scholar
55.Cooper, JW, Bagwell, G.Contribution of the consultant pharmacist to rational drug usage in the long-term care facility. J Am Geriat Soc 1978;26(11):513–20.CrossRefGoogle Scholar
56.Cooper, JW, Francisco, GE. Psychotropic usage in long-term care facility geriatric patients. Hosp Formul 1981;April:407–19.Google Scholar
57.Cooperstock, R.Sex differences in psychotropic drug use. Soc.Sci.Med. 1978; 12:179–86.Google ScholarPubMed
58.Copperstock, R.Sex differences in the use of mood-modifying drugs: An explanatory model. J Health Soc Behav 1971;12:238–44.Google Scholar
59.Cowan, PF.Patient satisfaction with an office visit for the common cold. J.Fam.Pract. 1987;24(4):412–3.Google Scholar
60.Crain, EF, Kercsmar, C, Weiss, KB, Mitchell, H, Lynn, H.Reported difficulties in access to quality care for children with asthma in the inner city. Arch Pediatr Adolesc Med 1998; 152:333–9.Google Scholar
61.Cumming, RG, Klineberg, RJ.Psychotropics, thiazide diuretics and hip fractures in the elderly. Med.J.Aust. 1993;158:414–7.Google Scholar
62.Cusson, J, Pepler, C, Tousignant, P, Williams, J, McKim, W, Tonks, R, et al. Proceedings of an Invitational Consensus Conference on Research Priorities: Drug utilization related problems in elderly Canadians.Canadian Coalition on Medication Use and the Elderly 1990;1–87.Google Scholar
63.Cutson, TM, Gray, SL, Hughes, MA, Carson, SW, Hanlon, JT.Effect of a single dose of diazepam on balance measures in older people. J Am Geriatr Soc 1997; 45:435–40.Google Scholar
64.Davidson, W, Malloy, W, Bédard, M.Physician characteristics and prescribing for elderly people in New Brunswick: Relation to patient outcomes. Can.Med.Assoc.J. 1995;152:1227–34.Google ScholarPubMed
65.Davidson, W, Malloy, W, Somers, G, Bédard, M.Relation between physician characteristics and prescribing for elderly people in New Brunswick. Can.Med.Assoc.J. 1994a;150(6):917–21.Google ScholarPubMed
66.Davidson, W, Malloy, W, Somers, G, Bédard, M.Relationships between physician practice characteristics and prescribing behaviour for the elderly in New Brunswick. Can.Med.Assoc.J. 1994b;150:917.Google Scholar
67.DeSantis, G, Harvey, KJ, Howard, D, Mashford, ML, Moulds, RFW.Improving the quality of antibiotic prescription patterns in general practice. Med.J.Aust. 1994;160:502–5.Google Scholar
68.deSmedt, M.Drug formularies – good or evil? A viw from the EEC. Cardiology 1994;85(suppl.1):41–5.Google Scholar
69.Dickinson, JC, Warshaw, GA, Gehlbach, SH, Bobula, JA, Muhlbaier, LH, Parkerson, GR.Improving hypertension control: Impact of computer feedback and physician education. Med Care 1981;19(8):843–54.CrossRefGoogle ScholarPubMed
70.Duke, T, Kellermann, A, Ellis, R, Self, T.Asthma in the emergency department:Impact of a protocol on optimizing therapy. Am.J.Emerg.Med. 1991;9:432–5.CrossRefGoogle ScholarPubMed
71.Dumas, J, Matte, J.Characteristics of pharmaceutical opinions written in a Quebec community pharmacy. The Annals of Pharmacotherapy 1992;26:835–9.CrossRefGoogle Scholar
72.Ekedahl, A, Lidbeck, J, Lithman, T, Noreen, D, Melander, A.Benzodiazepine prescribing patterns in a high-prescribing Scandinavian community. Eur.J Clin.Pharmacol. 1993;444:141–6.CrossRefGoogle Scholar
73.Elzarian, EJ, Shirachi, DY, Jonest, JK.Educational approaches promoting optimal laxative use in long-term-care patients. J Chron Dis 1980;33:613–26.Google Scholar
74.Engel, W, Freund, DA, Stein, JS, Fletcher, RH.The treatment of patients with asthma by specialists and generalists. Med Care 1989;27(3):306–14.CrossRefGoogle ScholarPubMed
75.Eraker, SA, Kirscht, JP, Becker, MH.Understanding and improving patient compliance. Ann.Intern.Med. 1984;100:258–68.CrossRefGoogle ScholarPubMed
76.Esposito, L.The effects of medication education on adherence to medication regimens in an elderly population. J.Adv.Nurs. 1995;21:935–43.CrossRefGoogle Scholar
77.Evans, CE, Haynes, RB, Birkett, NJ, Gilber, JR, Taylor, DW, Sackett, DL, et al. Does a mailed continuing education program improve physician performance? Results of a randomized trial in antihypertensive care. J Am Med Assn 1986;255(4):501–4.CrossRefGoogle ScholarPubMed
78.Fattore, G., Jommi, C.The new pharmaceutical policy in Italy. Health Policy 1998;46:21–41.CrossRefGoogle ScholarPubMed
79.Ferguson, JA.Patient age as a factor in drug prescribing practices. Canadian Journal on Aging 1990;9(3):278–95.Google Scholar
80.Ferguson, RI, Maling, TJB.The Nelson general practice prescribing project. Part I: a pilot audit of the regional prescribing profile. N.Z.Med.J. 1990;103:558–60.Google ScholarPubMed
81.Ferry, ME, Lamy, PP, Becker, LA.Physicians' knowledge of prescribing for the elderly. J.Am.Geriatr.Soc. 1985;33:616–25.CrossRefGoogle ScholarPubMed
82.Fincham, JE.Patient compliance in the ambulatory elderly: A review of the literature. J of Geriatr Drug Ther 1988;2:31.Google Scholar
83.Fiorio, R, Bellantuono, C, Arreghini, E, Leoncini, M, Micciolo, R.Psychotropic drug prescription in general practice in Italy: a two-week prevalence study. International Clinical Psychopharmacology 1989;4:7–17.Google Scholar
84.Foo, Lin I, Spida, R, Fortsch, W.Insight and adherence to medication chronic schizophrenics. J.Clin.Psychiatry 1979;40:430.Google Scholar
85.Francis, V, Dorsch, BM, Morris, MJ.Gaps in doctor patient communication:Patients' response to medical advice. N Engl J Med 1969;280:535.CrossRefGoogle ScholarPubMed
86.Freer, CB. Study of Medicine Prescribing for Elderly Patients. Br.Med.J. 1985; 290:1113–6.CrossRefGoogle ScholarPubMed
87.Friday, GA, Khine, H, Lin, MS, Caliguiri, LA.Profile of children requiring emergency treatment for asthma. Ann Allergy Asthma Immunol 1997;78:221–4.CrossRefGoogle ScholarPubMed
88.Fudge, KA, Moore, KA, Schneider, DN, Sherrin, TP, Wellman, GS.Change in prescribing patterns of intravenous histamine2-receptor antagonists results in significant cost savings without adversely affecting patient care. The Annals of Pharmacotherapy 1993;27:232–7.CrossRefGoogle ScholarPubMed
89.Gabriel, SE, Jaakkimainen, L, Bombardier, C.Risk for serious gastrointestinal complications related to use of nonsteroidal anti-inflammatory drugs. Ann.Intern.Med. 1991,115:787–96.CrossRefGoogle ScholarPubMed
90. Garcia Rodriguez, LA, Walker, AM, Perez, Gutthann S.Nonsteroidal anti-inflammatory drugs and gastrointestinal hospitalizations in Saskatchewan: A cohort study. Epidemiology 1992;3:337–42.CrossRefGoogle Scholar
91.Garrard, J, Makris, L, Dunham, T, Heston, LL, Cooper, S, Ratner, ER, et al. Evaluation of neuroleptic drug use by nursing home elderly under proposed medicare and medicaid regulations. J Am Med Assn 1991;265(4):463–7.CrossRefGoogle ScholarPubMed
92.Gehlbach, SH, Wilkinson, WE, Hammond, WE, Clapp, NE, Finn, AL, Taylor, WJ, et al. Improving drug prescribing in a primary care practice. Med Care 1984; 22(3): 193–201.CrossRefGoogle Scholar
93.Gordon, M.Principles in prescribing for the older patient. Drug Protocol 1987;2:15–24.Google Scholar
94.Gottlieb, DJ, Beiser, AS, O'Connor, GT.Poverty, race, and medication use are correlates of asthma hospitalization rates: A small area analysis in Boston. Chest 1995;108:28–35.Google Scholar
95.Graf, JM, Schulenburg, VD.The German health care system at the crossroads. Health Economics 1994;3:301–3.CrossRefGoogle Scholar
96.Granek, B, Baker, SP, Abbey, H, Robinson, B, Myers, AH, Samkoff, JS, et al. Medications and diagnoses in relation to falls in a long-term care facility. J Am Geriatr Soc 1987;35(6):503–11.CrossRefGoogle ScholarPubMed
97.Grasela, TH Jr., Green, JA.A nationwide survey of prescribing patterns for thrombolytic drugs in acute myocardial infarction. Pharmacotherapy 1990;10:35–41.CrossRefGoogle ScholarPubMed
98.Graveley, EA, Oseasohn, CS.Multiple drug regimens: Medication compliance among veterans 65 Years and older. Research in Nursing & Health 1991;14:51–8.Google Scholar
99.Graves, EJ.Utilization of short-stay hospitals. National Centre for Health Statistics 1985;13(91).Google Scholar
100.Greene, JM, Winickoff, RN.Cost-conscious prescribing of nonsteroidal anti-inflammatory drugs for adults with arthritis. Arch.Intern.Med. 1992a;152:1995–2002.CrossRefGoogle ScholarPubMed
101.Greene, JM, Winickoff, RN. Cost-conscious prescribing of NSAIDs abstract & commentary. Internal Medicine Alert 1992b; 179–80.Google Scholar
102.Griffin, MR, Piper, JM, Daugherty, JR, Snowden, M, Ray, WA.Nonsteroidal anti-inflammatory drug use and increased risk for peptic ulcer disease in elderly persons. Ann.Intern.Med. 1991;114:257–63.CrossRefGoogle ScholarPubMed
103.Griffiths, C, Naish, J, Sturdy, P, Pereira, F.Prescribing and hospital admissions for asthma in east London. Br.Med. J. 1996;312:481–2.CrossRefGoogle ScholarPubMed
104.Grymonpre, RE, Mitenko, PA, Sitar, DS, Aoki, FY, Montgomery, PR.Drug-associated hospital admissions in older medical patients. J Am Geriatr Soc 1988;36:1092–8.CrossRefGoogle ScholarPubMed
105.Guess, HA, West, R, Strand, LM, Helston, D, Lydick, EG, Bergman, U, et al. Fatal upper gastrointestinal hemmorrage or perforation among users and nonusers of nonsteroidal anti-inflammatory drugs in Saskatchewan. J.Clin.Epidemiol. 1988;41(1):35–45.Google Scholar
106.Gurwitz, J, Col, NF, Avorn, J.The exclusion of the elderly and women from clinical trials in acute myocardial infarction. J Am Med Assn 1992;268(11):1417–22.Google Scholar
107.Gurwitz, JH, Avorn, J.The ambiguous relation between aging and adverse drug reactions. Ann.Intern.Med. 1991;114:956–66.CrossRefGoogle ScholarPubMed
108.Hadsall, RS, Freeman, RA, Norwood, GJ.Factors related to the prescribing of selected psychotropic drugs by primary care physicians. Soc.Sci.Med. 1982;16:1747–56.CrossRefGoogle Scholar
109.Hallas, J, Gram, LF, Grodum, E, Damsbo, N, Brosen, K, Haghfelt, T, et al. Drug related admissions to medical wards: A population based survey. Br.J.Clin.Pharmacol. 1992;33:61–8.CrossRefGoogle ScholarPubMed
110.Hammarlund, ER, Ostrom, JR, Kethley, AJ.The effects of drug counseling and other educational strategies on drug utilization of the elderly. Med Care 1983;23(2): 165–70.CrossRefGoogle Scholar
111.Hammarlund, ER, Ostrom, JR, Kethley, AJ.The effects of drug counseling and other educational strategies on drug utilization of the elderly. Med Care 1985;23(2): 165–70.CrossRefGoogle ScholarPubMed
112.Hartert, TV, Windom, HH, Peebles, RS Jr, Freidhoff, LR, Togias, A.Inadequate outpatient medical therapy for patients with asthma admitted to two urban hospitals. Am. J.Med. 1996;100(4):386–94.CrossRefGoogle ScholarPubMed
113.Hartzema, AG, Christensen, DB.Nonmedical factors associated with the prescribing volume among family practioners in an HMO. Med Care 1983;21:990–1000.CrossRefGoogle Scholar
114.Haskitt, RL.Patient compliance: tapping into a billion-dollar drug market. Pharmaceutical Executive 1989;9:46, 48, 52.Google Scholar
115.Haynes, RB, Davis, D, McKibbon, A, Tugwell, P.A critical appraisal of the efficacy of continuing medical education. J Am Med Assn. 1984;251:61–4.CrossRefGoogle ScholarPubMed
116.Health and Welfare Canada. Canada Health Survey.author No.82–538E 1981.Google Scholar
117.Health Canada. National Pharmaceutical Strategy Discussion Document. The National Pharmaceutical Strategy Office, 1993.Google Scholar
118.Hemenway, D, Fallon, D.Testing for physician-induced demand with hypothetical cases. Med Care 1985;23(4):344–9.CrossRefGoogle ScholarPubMed
119.Henry, D, Garcia, Rodriguez LA, Perez, Gutthann S, Carson, JL, Savage, R, Logan, R, et al. Variability in risk of gastrointestinal complications with individual non-steriodal anti-inflammatory drugs: results of a collaborative meta-analysis. Br.Med.J. 1996;312:1563–6.Google Scholar
120.Henry, DA, Johnston, A, Dobson, AJ, Duggan, JM.Fatal peptic ulcer complications and the use of non-steroidal anti-inflammatory drugs, aspirin and corticosteroids. Br.Med.J. 1987;295:1227–9.CrossRefGoogle ScholarPubMed
121. Herings RMC, Stricker, BH, de Boer, A, Bakker, A, Sturmans, F.Benzodiazepines and the risk of falling leading to femur fractures. Arch.Intern.Med. 1995;155:1801–7.Google Scholar
122.Hershey, CO, Porter, DK, Breslau, D, Cohen, DI.Influence of simple computerized feedback on prescription charges in an ambulatory clinic. Med Care 1986;24(6):472–81.CrossRefGoogle Scholar
123.Hine, LK, Gross, TP, Kennedy, DL.Outpatient antiarrhythmic drug use. Arch.Intern.Med. 1989;149:1524–7.CrossRefGoogle ScholarPubMed
124.Hochberg, MC.Association of nonsteroidal anti-inflammatory drugs with upper gastrointestinal disease: Epidemiologic and economic considerations. The Journal of Rheumatology 1992;19:63–7.Google Scholar
125.Hogan, DB, Campbell, NRC, Crutcher, R, Jennett, P, MacLeod, N.Prescription of nonsteroidal anti-inflammatory drugs for elderly people in Alberta. Can.Med.Assoc.J. 1994;151(3):315–22.Google Scholar
126.Hogan, DB, Ebly, EM.Regional variations in use of potentially inappropriate medications by Canadian seniors participating in the Canadian Study of Health and Aging. Can J Clin Pharmacol 1995;2(4): 167–74.Google Scholar
127.Hohmann, AA.Gender bias in psychotropic drug prescribing in primary care. Med.Care. 1989;27:478–90.CrossRefGoogle ScholarPubMed
128.Holmes-Rovner, M, Kroll, J, Rothert, ML, Schmitt, N, Rovner, DR, Breer, L, et al. Patients satisfaction with health care decision. Med.Decis.Making 1996;in press.CrossRefGoogle Scholar
129.Holmes, JK.Patterns of prescribing in Irish general practitioners. Br.Med.J. 1992;85(4):154–6.Google Scholar
130.Holt, WS, Mazzuca, SA.Prescribing behaviors of family physicians in the treatment of osteoarthritis. Fam.Med. 1992;24(7):524–7.Google ScholarPubMed
131.Homer, CJ, Szilagyi, P, Rodewald, L, Bloom, SR, Greenspan, P, Yazdgerdi, S, et al. Does quality of care affect rates of hospitalization for childhood asthma? Pediatrics 1996;98(1):18–23.Google Scholar
132.Hood, JC, Lemberger, M, Stewart, RB.Promoting appropriate therapy in a long-term care facility. Journal of the American Pharmaceutical Association 1975;15(1):32–7.Google ScholarPubMed
133.Horn, CR, Cochrane, GM.Management of asthma in general practice. Respiratory Medicine 1989;83:67–70.CrossRefGoogle ScholarPubMed
134.Hulka, BS, Cassel, JC, Kupper, L.Disparities between medications prescribed and consumed among chronic disease patients. Mt. Kosco, New York:Futura: Patient compliance, 1976.Google Scholar
135.Hurwitz, N.Predisposing factors in adverse reactions to drugs. Br.Med.J. 1969;1:536–9.CrossRefGoogle ScholarPubMed
136.Inman, W, Pearce, G.Prescriber profile and post-marketing surveillance. Lancet 1993:342:658–61.CrossRefGoogle ScholarPubMed
137.Inman, WHW, Adelstein, AM.Rise and fall of asthma mortality in England and Wales in relation to use of pressurised aerosols. Lancet 1969;2:279–85.CrossRefGoogle ScholarPubMed
138.Inui, TS, Yourtee, EL, Williamson, JW.Improved outcomes in hypertension after physician tutorials: A controlled trial. Ann.Intern.Med. 1976;84:646–51.CrossRefGoogle ScholarPubMed
139.Isaac, LM, Tamblyn, RM, and the McGill Calgary Drug Research Team. Compliance and cognitive function: A methodological approach to measuring unintentional errors in medication compliance in the elderly. The Gerontologist 1993;33(6):772–81.CrossRefGoogle ScholarPubMed
140.Ives, TJ, Bentz, EJ, Gwyther, RE.Drug-related admissions to a family medicine inpatient service. Arch.Intern.Med. 1987; 147:1117–20.CrossRefGoogle ScholarPubMed
141.Jacobs, J, Goldstein, AG, Kelly, ME.NSAID dosing schedule and compliance. Drug Intell Clin Pharm 1988;22:727.Google ScholarPubMed
142.Jensen, J, Nielsen, LH.Drugs and femoral neck fracture: a case-control study. Journal of Internal Medicine 1991;229:29–33.Google Scholar
143.Johnson, JA.Pharmacoeconomic analysis in formulary decisions: an international perspective. Am.J.Hosp.Pharm. 1994;51(20):2593–8.Google ScholarPubMed
144.Katz, PR, Beam, TR Jr., Brand, F, Boyce, K.Antibiotic use in the nursing home: physician practice patterns. Arch.Intern.Med. 1990;150:1465–8.CrossRefGoogle ScholarPubMed
145.Kaufman, A, Brickner, PW, Varner, R, Mashburn, W.Tranquilizer Control. J Am Med Assn 1972;221:1504–6.Google Scholar
146.Kendrick, R, Bayne, JRD.Compliance with prescribed medication by elderly patients. Can.Med.Assoc.J. 1982; 127:961–2.Google ScholarPubMed
147.Kesten, S, Rebuck, AS, Chapman, KR.Clinical aspects of allergic disease: Trends in asthma and chronic obstructive pulmonary disease therapy in Canada, 1985 to 1990. The Journal of Allergy and Clinical Immunology 1993;92:499–506.Google Scholar
148.Keys, J, Beardon, PHG, Lau, C, Lang, CC, McDevitt, DG.General practitioners' use of non-steroidal anti-inflammatory drugs in Tayside and Fife regions. Journal of the Royal Society of Medicine 1992;85:442–5.CrossRefGoogle ScholarPubMed
149.Klapper, JA.Toward a standard drug formulary for the treatment of headache. Headache 1995;35(4):225–7.CrossRefGoogle Scholar
Klein, LE, German, PS, Levine, DM.Adverse drug reactions among the elderly: A reassessment. J Am Geriatr Soc 1981;29:525–30.CrossRefGoogle ScholarPubMed
151.Koepsell, TD, Gurtel, AL, Diehr, PH, Temkin, NR, Helf, KH, Gleser, MA, et al. The Seattle evaluation of computerized drug profiles: Effects on prescribing practices and resource use. Am.J.Public Health 1983;73(8):850–4.CrossRefGoogle ScholarPubMed
152.Kroenke, K, Pinholt, EM.Reducing polypharmacy in the elderly: A controlled trial of physician feedback. J Am Geriatr Soc 1990;38:31–6.Google Scholar
153.Krstenansky, PM.Ketorolac injection use in a university hospital. Am.J.Hosp.Pharm. 1993;50:99–102.Google ScholarPubMed
154.Kurfees, JF, Dotson, RL.Drug interactions in the elderly. J.Fam.Pract. 1987, 25:477–88.Google Scholar
155.Lane, MF, Barbarite, RV, Bergner, L, Harris, D.Child-resistant medicine containers: experience in the home. American Journal of Publish Health 1971;61:1861–8.Google Scholar
156. Langman MJS, Well, J, Wainwright, P, Lawson, DH, Rawlins, MD, Logan, RFA, et al. Risks of bleeding peptic ulcer associated with individual non-steroidal anti-inflammatory drugs. Lancet 1994;343:1075–8.Google Scholar
157.Laporte, JR, Carne, X, Vidal, X, Moreno, V, Juan, J.Upper gastrointestinal bleeding in relation to previous use of analgesics and non-steroidal anti-inflammatory drugs. Lancet 1991;337:85–9.Google Scholar
158.Lazarou, J, Pomeranz, BH, Corey, PN.Incidence of adverse drug reactions in hospitalized patients: A meta-analysis of prospective studies. J Am Med Assn. 1998;279:1200–5.CrossRefGoogle ScholarPubMed
159.Legorreta, AP, Christian-Herman, J, O'Connor, RD, Hasan, MM, Evans, R, Leung, K-M.Compliance with national asthma management guidelines and specialty care: A health maintenance organization experience. Arch Intern Med 1998;158:457–64.CrossRefGoogle Scholar
160.Leibowitz, A, Manning, WG, Newhouse, JP.The demand for prescription drugs as a Function of cost-sharing. Soc.Sci.Med. 1985;21:1063–9.CrossRefGoogle ScholarPubMed
161.Lesar, TS, Bricestand, LL, Delcoure, K, Parmalee, JC, Masta-Garnic, V, Pohl, H.Medication prescribing errors in a teaching hospital. J Am Med Assn. 1990;263(17):2328–34.CrossRefGoogle ScholarPubMed
162.Levy, AR, Tamblyn, R, Abrahamowicz, M, McLeod, PJ, Fitchett, D.Effectiveness of β-blocker therapy for secondary prevention of ischemic coronary events and death after myocardial infarction in the elderly. Montreal, QC: McGill University, 1998.Google Scholar
163.Lexchin, J.Interactions between physicians and the pharmaceutical industry: What does the literature say? Can.Med.Assoc.J. 1993;149(10):1401–7.Google Scholar
164.Lexchin, J.After compulsory licensing: Coming issues in Canadian pharmaceutical policy and politics. Health Policy 1997;40:69–80.CrossRefGoogle ScholarPubMed
165.Ley, P.Satisfaction, compliance and communication. British Journal of Clinical Psychology 1982;21:241–54.CrossRefGoogle ScholarPubMed
166.Lipton, HL, Bird, JA.Drug utilization review in ambulatory settings: State of the science and directions for outcomes research. Med.Care. 1993;12:1069–82.CrossRefGoogle Scholar
167.Lowe, CJ, Raynor, DK, Courtney, EA, Purvis, J, Teale, C.Effects of self medication programme on knowledge of drugs and compliance with treatment in elderly patients. Br.Med.J. 1995;310:1229–31.CrossRefGoogle ScholarPubMed
168.Lowenthal, DT.Drug therapy in the elderly: Special considerations. Geriatrics 1987;42(11):77.Google ScholarPubMed
169.Lurie, N, Rich, EC, Simpson, DE.Pharmaceutical representatives in academic medical centers: interaction with faculty and housestaff. J.Gen.Intern.Med. 1990;5:240–3.CrossRefGoogle ScholarPubMed
170.Manning, PR, Lee, PV, Clintworth, WA, Denson, TA, Oppenheimer, PR, Gilman, NJ.Changing prescribing practices through individual continuing education. J Am Med Assn 1986:256:230–2.CrossRefGoogle ScholarPubMed
171.Manning, WG, Leibowitz, A, Goldberg, GA, Rogers, WH, Newhouse, JP.A controlled trial of the effect of a prepaid group practice on use of service. N Engl J Med 1984:310:1505–10.Google Scholar
172.Maronde, RF, Lee, PV, McCarron, MM, Seibert, S.A study of prescribing patterns. Med Care 1971:9:383–95.Google Scholar
173.Martin, DC, Mean, K.Reducing medication errors in a geriatric population. J Am Geriatr Soc 1982;30(4):258–60.CrossRefGoogle Scholar
174.May, FE, Stewart, RB, Cluff, LE.Drug interactions and multiple drug administration. Clin.Pharmocol.Therap. 1977;22:322.CrossRefGoogle ScholarPubMed
175.Mazzuca, SA, Brandt, KD, Anderson, SL, Musick, BS, Katz, BP.The therapeutic approaches of community based primary care practitioners to osteoarthritis of the hip in an elderly patient. J.Rheumatol. 1991;18(10):1593–600.Google Scholar
176.Mazzullo, J.Methods of improving patient compliance. Mt. Kisco, N.Y.:Futura, 1976.Google Scholar
177.McConnell, TS, Cushing, AH, Bankhurst, AD, healy, JL, Mcllvenna, PA, Skipper, BJ.Physician behavior modification using claims data: Tetracycline for upper respiratory infection. West J Med 1982;137(5):448–50.Google ScholarPubMed
178.McKenney, JM, Munroe, WP, Wright, JT.Impact of an electronic medication compliance aid on long-term blood pressure control. Hypertension 1992;32:277–83.Google ScholarPubMed
179.McLane, CG, Zyzanski, SJ, Flocke, SA.Factors associated with medication noncompliance in rural elderly hypertensive patients. AJH 1995;8:206–9.Google Scholar
180.McLaughlin, TJ, Soumerai, SB, Willison, DJ, Gurwitz, JH, Borbas, C, Guadagnoli, E, et al. Adherence to national guidelines for drug treatment of suspected acute myocardial infarction: evidence for undertreatment in women and the elderly. Archives.of.Internal.Medicine 1996;156:799–805.CrossRefGoogle ScholarPubMed
181.Melander, A, Henricson, K, Stenberg, P, Lowenhielm, P, Malmvik, J, Sternebring, B, et al. Anxiolytic-hypnotic drugs: Relationships between prescribing, abuse and suicide. Eur.J Clin.Pharmacol. 1991;41:525–9.CrossRefGoogle ScholarPubMed
182.Mendelson, WB.The use of sedative/hypnotic medication and its correlation with falling down in the hospital. Sleep 1996;19(9):698–701.Google Scholar
183.Metge, C, Black, C, Peterson, S, Kozyrskyj, A.The population's use of Pharmaceuticals. Med Care 1999;37:JS42–59.CrossRefGoogle Scholar
184.Meyer, TJ, Van Kooten, D, Marsh, S, Prochazka, AV.Reduction of polypharmacy by feedback to clinicians. J.Gen.Intern.Med. 1991;6:133–6.CrossRefGoogle ScholarPubMed
185.Miles, DL.Multiple prescriptions and drug appropriateness. Health Serv.Res. 1977;12:3–10.Google ScholarPubMed
186.Minister of Public Works and Government Services. Canadian Health Action: Building on the Legacy -Synthesis Reports and Issues Papers. Cat. No. H21–126/5–2–1997E. Ottawa, ON: National Forum on Health, 1997.Google Scholar
187.Mokkink, H, Smits, A, Grol, R, Meyboom, W, van Son, J, University of Nijmegen. Practice Performance and Quality of Care: Practice-Styles of Family Physician. Ottawa, ON: Can-Heal Publications Inc, Book Number 0–921495–01–4, 1990.Google Scholar
188.Molstad, S, Hovelius, B, Kroon, L, Melander, A.prescription of antibiotics to out-patients in hospital clinics, community health centres and private practice. Eur.J Clin.Pharmacol. 1990;39:9–12.Google Scholar
189.Monette, J, Tamblyn, RM, McLeod, P, Gayton, D, Abrahamowicz, M, Berkson, L, et al. Profile of long-acting benzodiazepine drug prescribers. Journal of Clinical Investigative Medicine 1993;16(suppl.4):B59.Google Scholar
190.Montague, T, Taylor, L, Martin, S, Barnes, M, Ackman, M, Tsuyuki, R, et al. Can practice patterns and outcomes be successfully altered? Examples from cardiovascular medicine. Can J Cardiol 1995; 11(6):487–92.Google Scholar
191.Morabia, A, Fabre, J, Dunand, J-P.The influence of patient and physician gender on prescription of psychotropic drugs. J.Clin.Epidem. 1992;45(2):111–6.CrossRefGoogle ScholarPubMed
192.Morgan, TO, Nowson, C, Murphy, J, Snowdon, R.Compliance and the elderly hypertensive. Drugs 1986;31(suppl.4):174–83.CrossRefGoogle ScholarPubMed
193.Morrow, D, Leirer, V, Sheikh, J.Adherence and medication instructions: Review and recommendations. J Am Geriatr Soc 1988;36:1147–60.Google Scholar
194.Murdoch, JC.The epidemiology of prescribing in an urban general practice. Journal of the Royal College of General Practitioners 1980;30:593–602.Google Scholar
195.Murray, MD, Birt, JA, Manatunga, AK, Darnell, JC.Medication compliance in elderly outpatients using twice-daily dosing and unit-of-use packaging. Geriatrics and Gerontology 1993;27:616–21.Google ScholarPubMed
196.Nelson, AA, Quick, MR.Copayment for pharmaceutical services in a medicaid program. Contemporary Pharmacy Practice 1980;3(1):37–42.Google Scholar
197.Nelson, AA, Reeder, CE, Dickson, M.The effect of a medicaid drug copayment program on the utilization and cost of prescription services. Med Care 1984;22(5):724–36.CrossRefGoogle ScholarPubMed
198.Neutel, CI, Hirdes, JP, Maxwell, CJ, Paten, SB.New evidence on benzodiazepine use and falls: The time factor. Age and Aging 1996;25:277.CrossRefGoogle ScholarPubMed
199.Newhouse, JP, Manning, WG, Norris, C, et al. Some interim results from a controlled trial of cost-sharing in health insurance. N Engl J Med 1981;305:1501.Google Scholar
200.Nolan, L, O'Malley, K.Prescribing for the elderly Parti: Sensitivity of the elderly to adverse drug reactions. J Am Geriatr Soc 1988a;36:142–9.CrossRefGoogle Scholar
201.Nolan, L, O'Malley, K.Prescribing for the elderly: Part II prescribing patterns: Differences due to age. J Am Geriatr Soc 1988b;36:245–54.CrossRefGoogle ScholarPubMed
202.O'Brien, B.The effect of patient charges on the utilization of prescription medicines. Journal of Health Economics 1989;8:109–32.CrossRefGoogle ScholarPubMed
203.Palmer, RH, Reilly, MC.Individual and institutional variables which may serve as indicators of quality of medical care. Med Care 1979;17(7):693–736.CrossRefGoogle ScholarPubMed
204.Pashos, CL, Normand, SL, Garfinkle, JB, Newhouse, JP, Epstein, AM, McNeil, BJ.Trends in the use of drug therapies in patients with acute myocardial infarction: 1988 to 1992. Journal of the American College of Cardiology 1994;23:1023–30.Google Scholar
205.Peay, MY, Peay, ER.Patterns of preference for information sources in the adoption of new drugs by specialists. Soc.Sci.Med. 1990;31:467–76.CrossRefGoogle ScholarPubMed
206. Pharmaceutical Inquiry of Ontario. Prescriptions for Health. Toronto, 1990.Google Scholar
207.Pineault, R.The effect of prepaid group practice on physicians' utilization behavior. Med Care 1986;14:121.Google Scholar
208.Pitts, J, Vincent, S.What influences doctors' prescribing? Sore throats revisited. Journal of the Royal College of General Practitioners 1989;39:65–6.Google Scholar
209.Portenoy, RK, Kanner, RM.Patterns of analgesic prescription and consumption in a university-affiliated community hospital. Arch.Intern.Med. 1985;145:439–41.CrossRefGoogle Scholar
210.Porter, MW.Drug defaulting in a general practice. Br.Med.J. 1969;1:218–22.Google Scholar
211.Power, B, Downey, W, Schnell, BR.Utilization of psychotropic drugs in Saskatchewan: 1977–1980. Can.J.Psychiatry 1983;28:547–51.Google Scholar
212.Proos, M, Reiley, P, Eagan, J, Stengrevics, S, Castile, J, Arian, D.A study of the effects of self-medication on patients' knowledge of and compliance with their medication regimen. Journal of Nursing Care Quality 1992; Special Report: 18–26.CrossRefGoogle ScholarPubMed
213.Prudham, D, Evans, JG.Factors associated with falls in the elderly: A community study. Age and Aging 1981;10:141–6.CrossRefGoogle ScholarPubMed
214.Pullar, T, Murphy, B, Taggart, A, Wright, V.Patterns of out-patients non-steroidal anti-inflammatory drug prescribing in two teaching hospital rheumatology units-implications for post-marketing surveillance. Journal of Clinical Pharmacy and Therapeutics 1990;15:267–72.CrossRefGoogle ScholarPubMed
215.Quinn, K, Baker, MJ, Evans, B.A population-wide profile of prescription drug use in Saskatchewan. Can.Med.Assoc.J. 1992;146:2177–86.Google ScholarPubMed
216.Radecki, SE, Kane, RL, Solomon, DH, Mendenhall, RC, Beck, JC.Do physicians spend less time with older patients? J Am Geriatr Soc 1988,36:713–8.CrossRefGoogle ScholarPubMed
217.Rawson, NSB, D'Arcy, C.Sedative hypnotic drug use in Canada. Health Reports 1991;3(1):33–57.Google ScholarPubMed
218.Ray, MA, Griffin, MR, Downey, W.Benzodiazepines of long and short elimination half-life and the risk of hip fracture. J Am Med Assn 1989;262:3303–7.CrossRefGoogle ScholarPubMed
219.Ray, WA, Blazer, DG II, Schaffner, W, Federspiel, CF, Fink, R.Reducing long-term diazepam prescribing in office practice: A controlled trial of educational visits. J Am Med Assn 1986;256:2536–9.CrossRefGoogle Scholar
220.Ray, WA, Fought, RL, Decker, MD.Psychoactive drugs and the risk of injurious motor vehicle crashes in elderly drivers. Am.J.Epidemiol. 1992;136(7):873–83.CrossRefGoogle ScholarPubMed
221.Ray, WA, Griffin, MR, Schaffner, W, Baugh, DK, Melton, LJ.Psychotropic drug use and the risk of hip fracture. N Engl J Med 1987;316:363–9.CrossRefGoogle ScholarPubMed
222.Ray, WA, Schaffner, W, Federspiel, CF.Persistence of improvement in antibiotic prescribing in office practice. J Am Med Assn 1985;253(12):1774–6.CrossRefGoogle ScholarPubMed
223.Raynes, NV.Factors affecting the prescribing of psychotropic drugs in general practice consultations. Psychological Medicine 1979;9:671–9.CrossRefGoogle ScholarPubMed
224.Raynor, DK, Booth, TG, Blenkinsopp, A.Effects of computer generated reminder charts on patients' compliance with drug regimens. Br.Med.J. 1993;306:1158–61.CrossRefGoogle ScholarPubMed
225.Redelmeier, DA, Tan, SH, Booth, GL.The treatment of unrelated disorders in patients with chronic medical diseases [see comments]. N Engl J Med 1998;338(21): 1516–20.CrossRefGoogle ScholarPubMed
226.Reeder, CE, Nelson, AA.The differential impact of copayment on drug use in a medicaid population. Inquiry 1985;22:396–403.Google Scholar
227.Renaud, M, Beuchemin, J, Lalonde, C, Poirier, H, Berthiaume, S.Practice settings and prescribing profiles: The simulation of tension headaches to general practioners working in different practice settings in the Montreal area. Am.J.Public Health 1980;70:1068–73.CrossRefGoogle Scholar
228. Review Committee. Report to the Saskatchewan Minister of Health. Study into the Growth in Use of Health Services. Saskatchewan, 1989.Google Scholar
229.Rigter, H.Recent public policies in the Netherlands to control pharmaceutical pricing and reimbursement. Pharmacoeconomics 1994;6(suppl. 1):15–21.Google Scholar
230.Robinson, A.After years of steady growth, winds of restraint blowing on prescription-drug industry. Can.Med.Assoc.J. 1995;153(1):85–8.Google ScholarPubMed
231.Roth, SH.Nonsteroidal anti-inflammatory drugs: Gastropathy, deaths, and medical practice. Ann.Intern.Med. 1988; 109 (5):353–4.CrossRefGoogle ScholarPubMed
232.Ryan, M, Yule, B, Bond, C, Taylor, RJ.Scottish general practioners' attitudes and knowledge in respect of prescribing costs. Br.Med.J. 1990; 300:1318–20.CrossRefGoogle Scholar
233.Safavi, KT, Rodney, A, Hayward, MD.Choosing between apples and apples: Physicians' choices of prescription drugs that have similar side effects and efficacies. J.Gen.Intern. Med. 1992;7:32–7.CrossRefGoogle ScholarPubMed
234.Sanz, EJ, Bergman, U, Dahlstrom, M.Paediatric drug prescribing. A comparison of Tenerife (Canary Islands, Spain) and Sweden. Eur.J Clin.Pharmacol. 1989;37:65–8.Google ScholarPubMed
235.Saunders, CE.Patient compliance in filling prescriptions after discharge from the emergency department. Am.J.Emerg.Med. 1987;5(4):283–6.CrossRefGoogle ScholarPubMed
236.Schaffner, W, Ray, WA, Federspiel, CF, Miller, WO.Improving antibiotic prescribing in office practice: A controlled trial of three educational methods. J Am Med Assn 1983;250:1728–32.CrossRefGoogle Scholar
237.Schnarch, B, Tamblyn, RM, McLeod, P, Abrahamowicz, M, Berkson, L, Dauphinee, D, et al. Psychotropic Drug Prescribing in the Elderly: Exploration of the Patient Gender-Physician Gender Relationship. Toronto: The Canadian Pharmacoepidemiology Forum Abstract, 1993.Google Scholar
238.Schwartz, MA.The role of the pharmacist in the patient-health team relationship. New York: Patient Compliance. Mount Krisco New York: Futura Publishing Co, 1976.Google Scholar
239.Sclar, DA, Skaer, TL, Chin, A, Okamoto, MP, Nakahiro, RK, Gill, MA.Effectiveness of the C Cap in promoting prescription refill compliance among patients with Glaucoma. Clinical Therapeutic 1991;13(3):396–400.Google Scholar
240.Seidl, LG, Thornton, GF, Smith, JW, Cluff, LE.Studies on the epidemiology of adverse drug reactions III. Reactions in patients on a general medical service. Bull.John.Hopkins. Hosp. 1966;19:299–315.Google Scholar
241. Service de l'évaluation des programmes et des statistique de la Régie. Annuelle 1992. 22e éd. Québec: Régie de l'assurance-maladie de Québec, 1992; ISSN 0226–5346:1–303.Google Scholar
242.Shelley, M, Croft, P, Chapman, S, Pantin, C.Is the ratio of inhaled corticosteroid to bronchodilator a good indicator of the quality of asthma prescribing? Cross sectional study linking prescribing data to data on admissions. Br.Med.J. 1996;313:1124–6.CrossRefGoogle ScholarPubMed
243.Shorr, RI, Bauwens, SF, Landefeld, CS.Failure to limit quantities of benzodiazepine hypnotic drugs for outpatients: Placing the elderly at risk. Am.J.Med. 1990;89:725–32.CrossRefGoogle ScholarPubMed
244.Skegg, DCG, Doll, R, Perry, J.Use of medicines in general practice. Br.Med.J. 1977;1:1561. 3.CrossRefGoogle ScholarPubMed
245.Smalley, WE, Ray, WA, Daugherty, JR, Griffin, MR.Nonsteroidal anti-inflammatory drugs and the incidence of hospitalizations for peptic ulcer disease in elderly persons. Am.J.Epidemiol. 1995;141:539–45.CrossRefGoogle ScholarPubMed
246.Sobel, KG, McCart, GM.Drug use and accidental falls in an intermediate care facility. Geriatrics and Gerontology 1983;17:539–45.Google Scholar
247.Sorock, GS, Shimkin, EE.Benzodiazepine sedatives and the risk of falling in a community- dwelling elderly cohort. Arch.Intern.Med. 1988; 148:2441–4.CrossRefGoogle Scholar
248.Soucy, G. Directeur d'evaluation, Régie de l'assurance-maladie du Québec. Personal Communication, 1993.Google Scholar
249.Soumerai, SB, Avorn, J.Economic and policy analysis of university-based drug “detailing”. Med Care 1986;24(4):313–31.CrossRefGoogle ScholarPubMed
250.Soumerai, SB, Avorn, J.Predictors of physician prescribing change in an educational experiment to improve medication use. Med Care 1987;25:210–21.Google Scholar
251.Soumerai, SB, Avorn, J, Gortmaker, S, Hawley, S.Effect of government and commercial warnings on reducing prescription misuse: the case of propoxyphene. Am.J.Public Health 1987;77:1518–23.CrossRefGoogle ScholarPubMed
252.Soumerai, SB, Avorn, J, Ross-Degnan, D, Gortmaker, S.Payment restrictions for prescription drugs under medicaid: Effects on therapy, cost, and equity. N.Engl.J.Med. 1987;317:550–6.CrossRefGoogle Scholar
253.Soumerai, SB, McLaughlin, TJ, Spiegelman, D, Hertzmark, E, Thibault, G, Goldman, L.Adverse outcomes of underuse of beta-blockers in elderly survivors of acute myocardial infarction. J Am Med Assn 1997;277:115–21.CrossRefGoogle ScholarPubMed
254.Soumerai, SB, Ross-Degnan, D.Experience of state pharmaceutical benefit programs in improving medication utilization. Health Affairs 1990;9:36–54.CrossRefGoogle Scholar
255.Soumerai, SB, Ross-Degnan, D.Inadequate prescription-drug coverage for medicare enrollees - A call to action. N Engl J Med 1999;340:722–8.CrossRefGoogle ScholarPubMed
256.Soumerai, SB, Ross-Degnan, D, Avorn, J, McLaughlin, TJ, Choodnovskkiy, I.Effects of medicaid drug-payment limits on admission to hospitals and nursing homes. N Engl J Med 1991:325:1072–77.Google Scholar
257.Sova, G. 1989 Corpus Almanac and Canadian Sourcebook. Vol. 1: Don Mills, ON: Corpus Information Services, 1989.Google Scholar
258.Steele, MA, Bess, DT, Franse, VL, Graber, SE.Cost effectiveness of two interventions for reducing outpatient prescribing costs. DICP, The Annals of Pharmacotherapy 1989;23:497–500.Google Scholar
259.Stewart, RB, Caranasos, GJ.Medication compliance in the elderly. Med Clin of NA 1989;73(6):1551–63.Google ScholarPubMed
260.Stolley, PD, Lasagna, L.Prescribing patterns of physicians. J.Chron.Dis. 1969;22:395–405.CrossRefGoogle ScholarPubMed
261.Strandberg, LR, Dawson, GW, Mathleson, D, Rawlings, J, Clark, BG.Effect of comprehensive pharmaceutical services on drug use in long-term care facilities. Am.J.Hosp.Pharm. 1980:37:92–94.Google ScholarPubMed
262.Stross, JK, Bole, GG.Evaluation of a continuing education program in rheumatoid arthritis. Arthritis and Rheumatism 1980;23(7):846–9.CrossRefGoogle ScholarPubMed
263.Svarstad, BL, Mount, JK.Nursing home resources and tranquilizer use among the institutionalized elderly. J Am Geriat Soc 1991;39:869–75.Google Scholar
264.Taggart, HM.Do drugs affect the risk of hip fractures in elderly women? J Am Geriatr Soc 1988:36:1006–10.Google Scholar
265.Tamblyn, R, Abrahamowicz, M, Brailovsky, C, Grand'Maison, P, Lescop, J, Norcini, J, et al. Association between licensing examination scores and resource use and quality of care in primary care practice. J Am Med Assn 1998;280(11): 989–96.Google Scholar
266.Tamblyn, R, Berkson, L, Dauphinee, WD, Gayton, D, Grad, R, Huang, A, et al. Unnecessary prescribing of NSAIDs and the management of NSAID-related gastropathy in medical practice [see comments]. Ann.Intern.Med. 1997;127:429–38.CrossRefGoogle ScholarPubMed
267.Tamblyn, R, Laprise, R, Schnarch, B, Monette, J, McLeod, P.Caractéristiques des médecins prescrivant des psychotropes à une plus grande proportion de femmes que d'hommes dans leur pratique. Santé Mentale au Québec 1997;22(1):239–62.CrossRefGoogle Scholar
268.Tamblyn, R, Laprise, R, Mayo, N, Mallet, L, Grad, R, McLeod, P, et al. Évaluation de l'impact du régime général d'assurance médicament. Ministère de la Santé et des Services Sociaux du Québec 1999; Study Report, July 1998.Google Scholar
269.Tamblyn, R, Perreault, R.Methods to encourage the sensible use of prescription medication in the elderly. In: Anonymous, Determinants of Health ADULTS AND SENIORS. Volume 2. Éditions MultiMondes, 1997:217–85.Google Scholar
270.Tamblyn, RM, Battista, RN.Changing clinical practice: Which interventions work? J.Contin.Educ.Health Prof. 1993;13(4):273–88.Google Scholar
271.Tamblyn, RM, Benaroya, S, Snell, L, McLeod, P, Schnarch, B, Abrahamowicz, M.The feasibility and value of using patient satisfaction ratings to evaluate internal medicine residents. J.Gen.Intern.Med. 1994;9:146–52.CrossRefGoogle ScholarPubMed
272.Tamblyn, RM, McLeod, P, Abrahamowicz, M, Monette, J, Gayton, D, Berkson, L, et al. Questionable prescribing for elderly patients in Quebec. Can.Med.Assoc.J. 1994;150(11):1801–9.Google ScholarPubMed
273.Tamblyn, RM, McLeod, PJ, Abrahamowicz, M, Laprise, R.Do too many cooks spoil the broth? Multiple physician involvement in medical management and inappropriate prescribing in the elderly. Can.Med.Assoc.J. 1996;154:1177–84.Google Scholar
274.Tamblyn, RM, McLeod, PJ, Abrahamowicz, M, Monette, J, Gayton, DC, Berkson, L, et al. Questionable prescribing for elderly patients in Quebec. Can.Med.Assoc.J. 1994;150 (11):1801–9Google Scholar
275.The Medical Letter. Pravastatin, simvastatin, and lovastatin for lowering serum cholesterol concentrations. The Medical Letter 1992;34(872):57–8.Google Scholar
276.Tierney, WM, Hui, SL, McDonald, CJ.Delayed feedback of physician performance versus immediate reminders to perform preventive care: Effects on physician compliance. Med Care 1986;24(8):659–66.CrossRefGoogle ScholarPubMed
277.Tinetti, ME, Speechley, M.Prevention of falls among the elderly. Medical Intelligence 1989;320:1055–9.Google ScholarPubMed
278.Tinetti, ME, Speechley, M, Ginter, SF.Risk factors for falls among elderly persons living in the community. N Engl J Med 1988;319:1701–7.Google Scholar
279.Tinetti, ME, Williams, TF, Mayewski, R.Fall risk index for elderly patients based on number of chronic disabilities. The American Journal of Medicine 1986;80:429–34.Google Scholar
280.Vail, S.Focus on drugs. The Canadian Nurse 1996;92:60, 59.Google ScholarPubMed
281.Van Nostrand, JF, Furner, SE, Suzman, R.Health data on older Americans: United States, 1992. National Center for Health Statistics.Vital Health Stat 1993;3:9–21.Google Scholar
282.Verbrugge, LM.How physicians treat mentally distressed men and women. Soc.Sci.Med. 1984;18:1–9.CrossRefGoogle ScholarPubMed
283.Wade, OL, Hood, H.Prescribing of drugs reported to cause adverse reactions. Br.J.Prev.Soc.Med. 1972;26:205–11.Google Scholar
284.Wandless, I, Davie, JW.Can drug compliance in the elderly be improved? Br.Med.J. 1977; 1:359–61.CrossRefGoogle ScholarPubMed
285.Ware, GJ, Harris, RG.Unit dose calendar packaging and elderly patient compliance. NZ.Med.J. 1991;104:495–7.Google ScholarPubMed
286.Wareham, NJ, Harrison, BD, Jenkins, PF, Nicholls, J, Stableforth, DE.A district confidential enquiry into deaths due to asthma. Thorax 1993;48:1117–20.CrossRefGoogle ScholarPubMed
287.Webster, G.American Board of Internal Medicine Final Report on the Patient Satisfaction Questionnaire Project. Philadelphia: ABIM, 1989.Google Scholar
288.Wennberg, JE.On patient need, supplier-induced demand, and the need to assess the outcome of common medical problems. Med Care 1985;23(5):512–20.CrossRefGoogle Scholar
289.Wessling, A, Boethius, G, Sjoqvist, F.Prescription monitoring of drug dosages in the county of Jamtland and Sweden as a whole in 1976,1982,1985. Eur.J Clin.Pharmacol. 1990;38:329–34.Google Scholar
290.West, RL.Prospective memory and aging. New York: Practical Aspects of Memory: Current Research and Issues, 1989.Google Scholar
291.Westerling, R.Diagnoses associated with the prescription of psychotropic drugs at a Swedish Health Centre. Scand J Prim Health Care 1988;6:93–8.CrossRefGoogle Scholar
292.Weyerer, S, Dilling, H.Psychiatric and physical illness, sociodemographic characteristics, and the use of psychotropic drugs in the community: Results from the Upper Bavarian Study. J.Clin.Epidem. 1991;44:303–11.CrossRefGoogle Scholar
293.Wilcher, DE, Cooper, JW.The consultant pharmacist and analgesic/anti-inflammatory drug usage in a geriatric long-term facility. J Am Geriat Soc 1981;29(9):429–32.CrossRefGoogle Scholar
294.Wilcox, SM, Himmelstein, DU, Woolhandler, S.Inappropriate drug prescribing for the community-dwelling elderly. J Am Med Assn 1994;272:292–6.CrossRefGoogle Scholar
295.Williams, AP, Cockerill, R.Report of the 1989 Survey of the Prescribing Experiences and Attitudes Toward Prescription Drugs of Ontario Physicians. Ontario Ministry of Health, 1990.Google Scholar
296.Williams, P, Rush, DR.Geriatric polypharmacy. Hospital Practice 1986;21:109–20.CrossRefGoogle ScholarPubMed
297.Williamson, DH, Cooper, JW, Kotzan, JA, Gelbart, AO.Consultant pharmacist impact on antihypertensive therapy in a geriatric long-term care facility. Hosp Formul 1984;19:123–8.Google Scholar
298.Wong, BSM, Normal, DC.Evaluation of a novel medication aid, the calendar blister-pack, and its effect on drug compliance in a geriatric outpatient clinic. J Am Geriatr Soc 1987;35:21–6.Google Scholar
299.Woodhouse, KW.Drug formularies – good or evil? The clinical perspective. Cardiology 1994;85(suppl.1):36–40.CrossRefGoogle ScholarPubMed
300.Wysowski, DK, Kennedy, DL, Gross, TP.Prescribed use of cholesterol-lowering drugs in the United States, 1978 through 1988. J Am Med Assn 1990;263:2185–8.Google Scholar
301.Young, FE.Questions about your medicine? Go ahead-ask. FDA Consumer 198;21:2.Google Scholar
302.Young, LY, Leach, BD, Anderson, DA, Rice, RT.Decreased medication costs in a skilled nursing facility by clinical pharmacy services. Contemporary Pharmacy Practice 1981;4(4):233–7.Google Scholar
303.Zammit-Lucia, J, Dasgupta, R. Reference Pricing The European Experience Health Policy Review Paper No. 10. St. Mary's Hospital Medical School London England, 1995.Google Scholar
304.Zieve, FJ, Ciesco, E. Computer-Focused Modification of Physician Prescribing Behavior. Annual Symposium on Computer Applications in Medical Care 1992; Richmond, VA:617–20.Google Scholar