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April 14, 1989

Drugs in the Institutionalized Elderly

Author Affiliations

Harborview Medical Center Seattle, Wash

Harborview Medical Center Seattle, Wash

JAMA. 1989;261(14):2066-2067. doi:10.1001/jama.1989.03420140068024

To the Editor. —  I would like to underscore a point made in the editorial1 on the article by Beers et al2 and to draw a conclusion that has not been remarked on.Beers et al have made an important contribution to the growing literature on prescribing practices in long-term care facilities. They discovered that among 850 residents of such facilities, 53% took psychoactive medications, 28% using sedatives/hypnotics; 26%, antipsychotics; and 14%, antidepressant agents. The implication that emerges from these tabulations, together with the authors' demonstration of poor correlations between psychiatric diagnoses and prescribed medications and their observations that the actual agents prescribed were not the optimal ones for this population, is that there is a reprehensible degree of polypharmaceutical mismanagement occurring. The editorial1 appears to endorse this conclusion with the comment that "the study... inspires little confidence in prescribing practices in the long-term care setting."The