Drug Treatment in the Elderly. Mac Donald ET, MacDonald JB. New York, John Wiley and Sons, 1982, 239 pages, $35.95.
This book is the first volume of the Wiley series entitled Disease Management in the Elderly, and it is written, according to the series preface, primarily for geriatric medicine students. Given that focus, the content presupposes a certain level of reader knowledge of pharmacology, pharmacodynamics, physiology, and pathophysiology. While the text may be of some value for nurses who are case managers or primary caregivers, it would not be particularly useful for those giving patient care.
An extensive chapter-by-chapter bibliography serves to identify areas of research concerning drug pharmacokinetics, much of which is related to the aging process. The authors are cautious about drawing conclusions or inferences from limited research. However, references from these sources, combined with the writing style, prohibit the even flow of content. Areas of emphasis are highlighted by tables and lists.
The major portion of the book is divided into chapters dealing with drug therapy for specific diseases or relative to certain body systems. Disease processes most commonly seen in the elderly population are the focus of most of the material, although the drugs acting on the central nervous system are divided into categories with pathology content secondary. Throughout these chapters the authors are consistent in their emphasis on the need for thorough patient evaluation before prescribing, that short duration drug therapy is preferable to long, and the hazards of polypharmacy.
The last four chapters address patient compliance with drug regimens. Topics covered include the background, measurement, and incidence of compliance, problems of prescriptions and packaging, and methods to improve compliance. Emphasis is placed on the responsibility of members of the healthcare team to communicate with and educate clients. Although the authors place importance on this subject, it does not lend itself to lengthy discussion, and therefore, the content is often repetitive.