The research program will systematically examine medication use in the elderly using a single drug category, antihypertensive agents, as a model. The program will include two components: (10 a population-based utilization study of antihypertensive therapy, using information from a large claims database to study medication compliance and secular trends of antihypertensive prescribing in geriatric practice, and (2) a clinical trial of the outcomes of antihypertensive medication reduction to measure the hemodynamic, functional, and metabolic effects of tapering antihypertensive therapy in symptomatic older patients with well-controlled blood pressure and potentially drug-related side effects. Dr. Monane will focus on issues in medication compliance and hypertension treatment, two areas critical to the management of the elderly patient. In addition, he will prepare patient education materials on these topics in an effort to optimize medication use in the outpatient setting. The substantial research, training, and clinical resources of the Harvard Division on Aging will be committed to assure accomplishment of the goals set out in this application.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Clinical Investigator Award (CIA) (K08)
Project #
1K08AG000642-01
Application #
2048470
Study Section
Biological and Clinical Aging Review Committee (BCA)
Project Start
1994-01-01
Project End
1998-12-31
Budget Start
1994-01-01
Budget End
1994-12-31
Support Year
1
Fiscal Year
1994
Total Cost
Indirect Cost
Name
Brigham and Women's Hospital
Department
Type
DUNS #
071723621
City
Boston
State
MA
Country
United States
Zip Code
02115
Glynn, R J; Monane, M; Gurwitz, J H et al. (1999) Aging, comorbidity, and reduced rates of drug treatment for diabetes mellitus. J Clin Epidemiol 52:781-90
Glynn, R J; Monane, M; Gurwitz, J H et al. (1999) Agreement between drug treatment data and a discharge diagnosis of diabetes mellitus in the elderly. Am J Epidemiol 149:541-9
Gurwitz, J H; Kalish, S C; Bohn, R L et al. (1997) Thiazide diuretics and the initiation of anti-gout therapy. J Clin Epidemiol 50:953-9
Monane, M; Bohn, R L; Gurwitz, J H et al. (1997) The effects of initial drug choice and comorbidity on antihypertensive therapy compliance: results from a population-based study in the elderly. Am J Hypertens 10:697-704
Monane, M; Gurwitz, J H; Bohn, R L et al. (1997) The impact of thiazide diuretics on the initiation of lipid-reducing agents in older people: a population-based analysis. J Am Geriatr Soc 45:71-5
Gurwitz, J H; Everitt, D E; Monane, M et al. (1996) The impact of ibuprofen on the efficacy of antihypertensive treatment with hydrochlorothiazide in elderly persons. J Gerontol A Biol Sci Med Sci 51:M74-9
Monane, M; Glynn, R J; Avorn, J (1996) The impact of sedative-hypnotic use on sleep symptoms in elderly nursing home residents. Clin Pharmacol Ther 59:83-92
Monane, M; Bohn, R L; Gurwitz, J H et al. (1996) Compliance with antihypertensive therapy among elderly Medicaid enrollees: the roles of age, gender, and race. Am J Public Health 86:1805-8
Monane, M; Avorn, J (1996) Medications and falls. Causation, correlation, and prevention. Clin Geriatr Med 12:847-58
Monane, M; Kanter, D S; Glynn, R J et al. (1996) Variability in length of hospitalization for stroke. The role of managed care in an elderly population. Arch Neurol 53:875-80

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