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BACKGROUND Optimizing polypharmacy is often difficult, and critical appraisal of medication use often leads to one or more changes. We developed the Prescribing Optimization Method (POM) to assist physicians, especially general practitioners (GPs), in their attempts to optimize polypharmacy in elderly patients. The POM is based on six questions: (i) is(More)
OBJECTIVES To investigate the association between antipsychotic drug use and risk of pneumonia in elderly people. DESIGN A nested case-control analysis. SETTING Data were used from the PHARMO database, which collates information from community pharmacies and hospital discharge records. PARTICIPANTS A cohort of 22,944 elderly people with at least one(More)
Hyponatraemia is known to occur as a rare but clinically important adverse reaction to treatment with different psychotropic drugs, including selective serotonin reuptake inhibitors and antiepileptic drugs. In past decades, reports have been published that describe the development of hyponatraemia in association with antipsychotic drug treatment. Our(More)
The aim of this study was to assess whether use of selective serotonin reuptake inhibitors (SSRIs) is associated with extrapyramidal syndromes (EPS). We analysed the spontaneous reports of adverse drug reactions (ADRs) collected by The Netherlands Pharmacovigilance Foundation Lareb in the period 1985-99 (n = 24,263). The study population comprised all(More)
INTRODUCTION In geriatric patients, atypical presentation and limitations in diagnostic scope may lead to underdiagnosis. The aim of this study was to establish the frequency, nature and causes of clinical diagnostic errors in a geriatric population. DESIGN A retrospective study. METHODS We assessed the accuracy of clinical diagnosis using autopsy(More)
BACKGROUND Antipsychotic drugs (APD) are widely prescribed for people with dementia residing in long term care facilities (LTCFs). Concern has been expressed that such prescribing is largely inappropriate. The objective of this study is to examine if differences in facility-level prevalence of APD use in a sample of LTCFs for patients with dementia can be(More)
In the geriatric department of a Dutch psychiatric hospital the charts of 51 patients treated with lithium in addition to cyclic antidepressants were reviewed. A response was seen in 33 patients (65%). For patients with recurrent depressive episodes, a statistical trend was found towards more responders with more complete responses, compared to patients(More)
BACKGROUND Hyponatraemia due to antipsychotic use is a potentially serious problem; however, it is not known whether it is an adverse drug reaction (ADR) to antipsychotic use or is due to the underlying psychiatric disease. OBJECTIVE To estimate the strength of the association between antipsychotics and hyponatraemia or syndrome of inappropriate(More)
PURPOSE We determined the prevalence and incidence of Parkinson's disease among persons aged 55 years and older in pharmacy records. METHODS Data came from the PHARMO database which includes information on drug dispensing for all residents of six Dutch cities. We selected all persons aged 55 years and older who had used antiparkinsonian drugs, and(More)