“I can’t sleep”: Managing Insomnia in the older adult.

Morgan Hrynyk Messenger, Optimized Prescribing with Seniors

Jane, a 75-year-old woman presents to your office for routine follow-up after being recently discharged from the hospital. She reports poor sleep since discharge and wants a renewal of Zopiclone, a sedative-hypnotic. Her past medical history indicates mild cognitive impairment, hypertension, type 2 diabetes mellitus and osteoarthritis. Issue Sedative-hypnotics are commonly prescribed for insomnia despite a lack of evidence for …

Using Medication Reconciliation (MedRec) to optimize medications for seniors in the family physician’s clinic

Collette D. Messenger, Optimized Prescribing with Seniors Leave a Comment

Jasneet Parmar, MBBS, Dip.COE (Jasneet.Parmar@covenanthealth.ca) Cynthia, who is 80-years-old, visits you, her family physician for follow-up after discharge from hospital. She is accompanied by her daughter. Cynthia was recently discharged after a four-week stay in hospital for complications from coronary artery disease and congestive heart failure. She also suffers from diabetes, hypertension and osteoporosis. Her discharge diagnosis includes mild cognitive …

The association between medications and fall risk

Collette D. Optimized Prescribing with Seniors Leave a Comment

  Francis is an 84-year-old female who fell going to the bathroom one night and sustained a right hip fracture. She had a period of confusion in the hospital that has now resolved. She has returned home after a prolonged hospitalization on her usual medications of ramipril, hydrochlorothiazide, ASA, alendronate, Vitamin D, calcium, and l-thyroxine. In addition, she is also …

Polypharmacy: Appropriate and Problematic.

Collette D. Optimized Prescribing with Seniors Leave a Comment

Polypharmacy: Appropriate and Problematic. The term polypharmacy dates back at least to the mid-19th century and has had many definitions. Usually it refers to more than four or five medications used concurrently. Issue: Recent adoption of the terms “appropriate polypharmacy” and “problematic polypharmacy” reflect both the realities of treating multi-morbidity in the population and the potential harm associated with prescribing …