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Why do family doctors prescribe potentially inappropriate medication to elderly patients?

Overview of attention for article published in BMC Family Practice, July 2016
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  • Above-average Attention Score compared to outputs of the same age (56th percentile)
  • Average Attention Score compared to outputs of the same age and source

Mentioned by

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4 tweeters

Citations

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31 Dimensions

Readers on

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90 Mendeley
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Title
Why do family doctors prescribe potentially inappropriate medication to elderly patients?
Published in
BMC Family Practice, July 2016
DOI 10.1186/s12875-016-0482-3
Pubmed ID
Authors

Karen Voigt, Mandy Gottschall, Juliane Köberlein-Neu, Jeannine Schübel, Nadine Quint, Antje Bergmann

Abstract

Based on changes in pharmacokinetics and -dynamics in elderly patients, there are potentially inappropriate medications (PIM) that should be avoided in patients aged ≥ 65 years. Current studies showed prescription rates of PIM between 22.5 and 28.4 % in the primary care setting. The evidence concerning reasons for PIM prescription by FPs is limited. This mixed method study consisted of three research parts: 1) semi-standardized content analysis of patients' records, 2) qualitative interviews with FPs using a) open questions and b) selected patient-specific case vignettes and 3) qualitative interviews with FPs' medical assistants. The integration of qualitative interviews was used to explain the quantitative results (triangulation design). PIM were identified according to the German PRISCUS list. Descriptive and multivariate statistical analysis was done using SPSS 22.0. Qualitative content analysis of interviews was used to classify the content of the interviews for indicating pertinent categories. All data were pseudonymously recorded and analyzed. Content analysis of 1846 patients' records and interviews with 7 related FPs were conducted. Elderly patients [n = 1241, mean age: 76, females: 56.6 %] were characterized in average by 8.3 documented chronic diagnosis. 23.9 % of elderly patients received at least one PIM prescription. Sedatives/hypnotics were the most frequent prescribed PIM-drugs (13.7 %). Mental disorders, gender and number of long-term medication were detected as predictors for the probability of a PIM prescription. Common reported reasons for PIM prescription by FPs concerned limited knowledge regarding PIM, limited applicability of PIM lists in daily practice, lack of time, having no alternatives in medication, stronger patient-related factors than age that influence prescription, own bad experiences regarding changes of medication or refusal of following prescriptions of sedative/hypnotics. It is essential to see FPs in a complex decision making situation with several influencing factors on their prescribing, including: patient-oriented prioritization, FPs' experiences in daily practice, FPs' knowledge regarding existing recommendations and their trust in it and organizational characteristics of FPs' daily medical practice. These pros and cons of PIM prescription in elderly patients should be considered in FPs' advanced training.

Twitter Demographics

The data shown below were collected from the profiles of 4 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 90 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Spain 1 1%
Ecuador 1 1%
Unknown 88 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 20 22%
Researcher 18 20%
Student > Bachelor 11 12%
Student > Ph. D. Student 10 11%
Student > Postgraduate 8 9%
Other 12 13%
Unknown 11 12%
Readers by discipline Count As %
Medicine and Dentistry 29 32%
Nursing and Health Professions 12 13%
Pharmacology, Toxicology and Pharmaceutical Science 12 13%
Social Sciences 5 6%
Psychology 4 4%
Other 11 12%
Unknown 17 19%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 July 2016.
All research outputs
#3,639,774
of 8,165,722 outputs
Outputs from BMC Family Practice
#572
of 995 outputs
Outputs of similar age
#109,112
of 258,024 outputs
Outputs of similar age from BMC Family Practice
#27
of 41 outputs
Altmetric has tracked 8,165,722 research outputs across all sources so far. This one has received more attention than most of these and is in the 54th percentile.
So far Altmetric has tracked 995 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.9. This one is in the 41st percentile – i.e., 41% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 258,024 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 56% of its contemporaries.
We're also able to compare this research output to 41 others from the same source and published within six weeks on either side of this one. This one is in the 31st percentile – i.e., 31% of its contemporaries scored the same or lower than it.