Medicare Part D and Potentially Inappropriate Medication Use in the Elderly

Sep 18, 2012 | Posted by: roboblogger | Full story: The American Journal of Managed Care

Julie M. Donohue, PhD; Zachary A. Marcum, PharmD, MS; Walid F. Gellad, MD, MPH; Judith R. Lave, PhD; Aiju Men, MS; and Joseph T. Hanlon, PharmD, MS We found that Medicare Part D was associated with small increases in the use of high-risk medications but no change in drug-disease interactions among the elderly transitioning from no coverage to the ... (more)

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rehabthebill

Bryn Mawr, PA

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#1
Sep 22, 2012
 
Key words: medicare and elderly. Key word=MEDICARE=covered patient=money. Does the senior citizen really need or want that care? To top it off geriatric medicine is a failure in the US for lack of serious study, data and opened minded physicians.

Forget about success rate, studies etc. How about the simple things like what works for younger adults like working out, vitamins, rest, activity etc. Problem is you can prescribe a drug for that so they have to prescibe a drug at the very least if not a procedure.

But does the patient really need it? If a person makes well into their senior years like the 80s wouldn't traditional thinking fall below them. Is it worth trying to get an 80 something patient up to spec. If they made it 80 years with high bp, high chlestoral etc does chemical medicine really explain that except they are not up to "their" numerical standards.

Especially now with the uninsured increasing. A hospital gets ahold of a senior with medicare/insurance guess what. Not only what ever procedure the patient wants but the procedures they recommend as well. Easy money.
widow2

Golconda, IL

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Sep 22, 2012
 
rehabthebill wrote:
Key words: medicare and elderly. Key word=MEDICARE=covered patient=money. Does the senior citizen really need or want that care? To top it off geriatric medicine is a failure in the US for lack of serious study, data and opened minded physicians.

Forget about success rate, studies etc. How about the simple things like what works for younger adults like working out, vitamins, rest, activity etc. Problem is you can prescribe a drug for that so they have to prescibe a drug at the very least if not a procedure.

But does the patient really need it? If a person makes well into their senior years like the 80s wouldn't traditional thinking fall below them. Is it worth trying to get an 80 something patient up to spec. If they made it 80 years with high bp, high chlestoral etc does chemical medicine really explain that except they are not up to "their" numerical standards.

Especially now with the uninsured increasing. A hospital gets ahold of a senior with medicare/insurance guess what. Not only what ever procedure the patient wants but the procedures they recommend as well. Easy money.
At 80 I should still have the right to decide what care I do and do not want. All this is leading to is rationed care for the elderly. Already the board is rationing care. Should I not be treated for cancer or must I accept life in a wheel chair at 70 ? They are already turning seniors aged 70 down for knee replacement ,cataract surgery and cancer treatment. People are healthier then ever at 80. Medicare pays so little no Dr or hospital wants to care for you. The time it takes alone to justify the need on paper more then eats up the cost of the visit. Drs need to be educated about best practices and need to involve the elderly in their decision making as it is their care.
rehabthebill

Bryn Mawr, PA

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#3
Sep 23, 2012
 
widow2 wrote:
<quoted text>
At 80 I should still have the right to decide what care I do and do not want. All this is leading to is rationed care for the elderly. Already the board is rationing care. Should I not be treated for cancer or must I accept life in a wheel chair at 70 ? They are already turning seniors aged 70 down for knee replacement ,cataract surgery and cancer treatment. People are healthier then ever at 80. Medicare pays so little no Dr or hospital wants to care for you. The time it takes alone to justify the need on paper more then eats up the cost of the visit. Drs need to be educated about best practices and need to involve the elderly in their decision making as it is their care.
At 80 you should have the right to decide but geriatric medicine is so narrow minded and behind the times they really even can't offer an 80 year old choiceS. And irreguardless of the choices involved some doctors/practices have learned how to word their diagnosis, prognosis and need for THEIR procedure thus resulting in the overly aggressive procedure and/or medicine prescribing. I don't think you would've seen things this aggressive years ago(setting aside the scam called geriatric medicine) But the avarage senior citizen being covered under medicare is better than no or declining business from non seniors without insurance.

Between sports medicine orthepedic & fitness knowledge and nutrition seniors can lead a much healthier life into their 80s & 90s. Heck if a young kid lead the sanctioned lifestyle the current so called medical professionals advocate/tolerate they would be stroke victims by 12. If a young kid didn't exercise their bones would be brittle, their bodies weak and their weight out of control.

I know younger people who had swelling from injury in the feet and ankles and were told just do foot pumps and toe raises: stand on your feet and raise you toes to improve muscle tone and thus circulation to reduce the swelling. And it worked. A senior is given 'massaging socks' and expensive packet of bandages and told stay off your feet. Just like some of the workouts once reserved for athletes are now given to people to loose weight on shows like the Biggest Loser they can use many of these techniques and thinking on seniors to improve their general health and basic conditions. Point being there is frequently more than one way to skin a cat. But geriatric medicine in America just waits for their patients to die.

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