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BPJ 11 February 2008

Best Practice Journal

Dilemmas: Why is it difficult

Prescribing for elderly people is difficult because the risks of polypharmacy, adverse drug effects and drug interactions are all greater. In addition, the results of drug trials are often difficult to apply to elderly people. View Article

Dilemmas: Principles of prescribing for elderly people

Several key principles should be considered when prescribing for elderly people. Quality of life is the most relevant outcome. GPs should manage the whole of their patient's treatment regimen, treating the disease process rather than the symptoms, being cautious before adding a new medication and closely monitoring for adverse effects. View Article

Dilemmas: Recognition and treatment of pain in elderly people

Chronic pain is common in elderly people, however it is often unrecognised, treated sub-optimally or not treated at all. Regular analgesia such as paracetamol and opioids can be very effective in managing pain. View Article

Dilemmas: Depression in elderly people

Depression in elderly people can be a significant cause of disability and is under-recognised and often complex to treat. A SSRI such as citalopram can be used initially for most depressed older people, in addition to psychological and other therapies. View Article

Dilemmas: Managing cardiovascular risk in elderly people

Older people have a higher cardiovascular risk and therefore appear to have the most potential to benefit from risk reduction, however they are often also at risk of adverse drug events and drug interactions. The decision to treat must be made on a case by case basis, taking into account the likely benefits and risks, quality of life and what the patient wants. View Article

Dilemmas: Alternative remedies and lifestyle measures for longevity

The development and marketing of anti-ageing products is a multi-million dollar industry. There is no shortage of remedies and lifestyle measures, claimed to slow, stop or reverse the process of ageing. View Article

Dilemmas: Exploring the everyday experiences of older Māori and their medication

When prescribing for older Māori people, it is important to take their views and beliefs into consideration and provide information about their medicines in a way that they can relate to. Bevan Clayton-Smith shares his experiences. View Article

Upfront: Impacts of an ageing population on New Zealand society

A Māori perspective on impacts on New Zealand society of an ageing population. View Article