The Elderly and Drug Policy: Coming of Age

Publisher Website
Google Scholar
Abstract
Prologue: When the subjects of prescription drugs and the elderly population intersect, an array of issues emerges spanning the worlds of science, politics, and economics. It is a complicated subject that does not easily generate public policies to balance the often conflicting issues that present themselves. The overview of this thematic issue on prescription drugs and the elderly underscores this complexity by focusing on the geriatric dimension of drug development and regulation, the participation of the elderly in clinical research trials, pharmaceutical pricing, drug utilization, medication use in long-term care, the study of drug effects in aging, and the role of federal agencies in shaping policy on drugs and the elderly—a role briefly in the spotlight during congressional consideration of a Medicare benefit to cover the costs of catastrophic acute illnesses. The author, Jerry Avorn, holds a medical degree from Harvard University and is one of very few academically affiliated physicians specializing in the complex relationship between prescription drugs and the elderly. An internist and a geriatrician, Avorn is an associate professor at Harvard Medical School and is a member of the Gerontology Division of one of Harvard's teaching hospitals, Beth Israel, where he directs the Program for the Analysis of Clinical Strategies. The program devotes its energies to the study of medication use, particularly among the elderly, from the disparate perspectives of pharmacology, epidemiology, clinical decision making, and health services research. In the 1980s, Avorn and colleagues pioneered studies improving physicians' choice of medications through the use of educational outreach (“ academic detailing ”) to better inform prescribers about issues of efficacy, risk, and cost. His current research focuses on the study of adverse drug effects in the elderly through epidemiological analysis of large population-based data sets and clinical trials. Avorn's work has been published in the Journal of the American Medical Association and The New England Journal of Medicine.