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Professor of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA
Published Online, January 15, 2008. www.theannals.com, DOI 10.1345/aph.1K331
Audience: The text is designed to be a clinical resource for medical professionals, including pharmacists, physicians/clinicians, nurse practitioners and students, who care for older adults.
Purpose: As stated in the preface, "For the majority of drugs, exact dosing guidelines for geriatric patients have not been established and most references do not specifically address the use of medications in older adults." The objective of this handbook, then, is to fill this gap and to address specific considerations when dealing with medications for older adults by providing compiled information from the literature and clinical experience to supplement manufacturers' information.
Content: This book is divided into 4 sections: introductory information, an alphabetical listing of 868 drug monographs by generic name cross-listed by trade names, an extensive appendix, and a pharmacological category index. The drug monographs include up to 37 fields of information typically found in handbooks, with the unique addition of specific dosing information for older adults and special geriatric considerations. The appendix includes over 140 pages of information covering a variety of topics, including assessment of renal function, 16 comparative drug charts, disease management (eg, asthma, hyperlipidemia, osteoporosis, Parkinson's disease, and constipation), 4 medication/therapy guidelines, and additional information. Tables and figures are used extensively in the appendix to summarize key issues.
Usability: This handbook is very user-friendly, as the drug monographs follow a dictionary-like format and are cross-referenced to related appendix material. The appendix includes a quick guide to medication classes and therapy guidelines relevant to the care of older adults.
Highlights: Geriatric Dosage Handbook is an easy-to-use reference. The inclusion of special geriatric considerations in each drug monograph offers unique information that is typically not found in other handbooks.
Limitations: In order to serve its purpose as an easy-to-use guide, this handbook is not intended to be an exhaustive guide to medication management in older adults. With this noted, the appendix does not include disease management or therapy guidelines for some important and prevalent conditions in older adults, such as hypertension and diabetes. The coverage of unique aspects of disease management for older adults is also inconsistent within the appendix. In the medical management of geriatric patients, especially those who are frail or over 80 years of age, a clinician often encounters many controversies regarding medication use (eg, stringency of treatment goals, length of therapy to observe benefit for newly initiated preventive therapies). Highlighting some of these controversies would have added depth to this handbook.
Comparison with Previous Edition or Version: This edition includes an additional 22 new drug monographs, many updates to the appendix (eg, updated recommendations for prevention of infective endocarditis) and a new appendix section outlining the CMS Guidelines for Gradual Dose Reduction of Psychopharmacological Agents in Nursing Facility Residents.
Comparison with Other Related Books or Products: This annually updated handbook is unique in its focus on older adults.
Reviewer's Summary: Overall, the authors have accomplished their goal of providing a concise, practical, and easy-to-use handbook that can provide dosing information quickly in the clinical setting. This handbook will be invaluable to all health professionals who prescribe and monitor medications in a practice with a significant geriatric population.
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