ALCOHOL/RX INTERACTIONS--HEALTH OUTCOMES IN THE ELDERLY

申请人摘要：伴随的问题可能会导致重大问题， 处方药与酒精混合使用。 酒精与药物的相互作用 对于老年饮酒者--即使是适度饮酒者--也很重要，因为 多种药物治疗的可能性，药物动力学的衰老相关变化， 药效学和与年龄相关的健康变化。 没有研究 已知的，已经检查，前瞻性地，健康结果的共同 同时使用酒精和酒精相互作用药物的模式 老人 特别需要的是前瞻性研究， 联合使用酒精和处方药，这是常用的 老人 我们建议利用现有的数据库， 关于酒精使用和酒精相互作用药物使用的广泛信息， 老人 已知使用处方药的老年人样本， 酒精相互作用的处方药是从 宾夕法尼亚州老年人药物援助合同（PACE）。 PACE索赔数据用于开发9个用户的随机样本， 不同的药理治疗类药物。 横截面 关于饮酒和健康及功能状况的电话和邮件调查 从超过10，000名PACE老年处方药使用者中获得， 1990年和1991年。 我们建议进行一项历史前瞻性研究，涵盖 1989-1995年，涉及计算机设备行动伙伴关系索赔数据、死亡率数据、酒精 相关调查数据和基于医疗保险索赔的医疗保健利用数据。 拟议研究的具体目的是评估使用 酒精、处方药和酒精-药物相互作用对死亡率的影响， 选定的临床结果，并对卫生保健支出的衡量， Medicare和PACE基于索赔的医疗服务。

APPLICANT'S ABSTRACT: Significant problems can result from the concomitant use of prescription drugs with alcohol. Alcohol-drug interactions are important for elderly drinkers - even moderate drinkers - because of the likelihood of polypharmacy, aging-related changes in pharmacoknetics and pharmacodynamics, and aged-linked changes in health. There are no studies known that have examined, prospectively, the health outcomes of common patterns of concomitant use of alcohol and alcohol-interactive drugs by the elderly. Especially needed are prospective studies that examine the impact of joint use of alcohol and prescription drugs that are commonly used by the elderly. We propose to take advantage of an existing data base that provides extensive information on alcohol use and alcohol-interactive drug use by the elderly. Samples of elderly with known use of prescription drugs and alcohol-interactive prescription drugs were obtained from members of the Pennsylvania Pharmaceutical Assistance Contract for the Elderly (PACE). PACE claims data were used to develop random samples of users of nine different pharmacologic-therapeutic classes of drugs. Cross-sectional telephone and mail surveys on alcohol use and health and functional status were obtained from over 10,000 PACE elderly users of prescription drugs in 1990 and 1991. We propose to conduct a historical prospective study covering the period 1989-1995, involving linkage of PACE claims data, mortality data, alcohol related survey data, and Medicare claims-based health care utilization data. The specific aims of the proposed study are to assess the impact of use of alcohol, prescription drugs, and alcohol-drug interaction on mortality, selected clinical outcomes, and on health-care expenditures as measured by Medicare and PACE claims-based health services.