University of Iowa Older Adults Center for Education and Research on Therapeutics (Iowa CERT). Inclusive Dates: 04/14/06 - 03/31/12.

摘要

Between 14 and 23% of the elderly receive a medication they should not have been prescribed. Up to 40% of patients do not take their medications as prescribed. Under-use of certain medications like beta blockers or ACE inhibitors is also of concern. Whereas clinical practice guidelines exist and departures from optimal practice are well-documented for specific diseases, it is not known whether such guidelines generalize to the elderly with multiple co-morbidities. In the limited clinical situations where clinical trial evidence of therapeutic benefit among the elderly is strong, barriers to guideline adherence are more prevalent in the elderly including drug-to-drug interactions, drug-disease contraindications, alterations in decision-making capacities, and compounded adverse event risk due to multiple medications. The University of Iowa Older Adults CERTs (UIOAC) offers the CERTs program research expertise for (1) making policy-relevant estimates of treatment effects and cost-effectiveness among subsets of the elderly defined by important characteristics such as function status, co-morbidity, and age and (2) identifying and designing interventions to address barriers to optimal therapeutics in the elderly in community care settings. The specific aims of the Iowa CERT were to: 1. Improve safety and effectiveness of medication use among older adults through intervention and database research projects. 2. Expand existing collaborations to new partnerships with private and public entitities; and 3. Educate healthcare providers, patients, and policy makers about therapeutic decision-making in the elderly.