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P OSTER
A BSTRACTS
thus, 90% were considered non-adherent with at least one medication.
The mean number of medications that individuals were non-adherent
to was 3.4. None of the cognitive or physical function measures
appeared to be associated with medication non-adherence in this
study.
Medication non-adherence is a very prevalent problem among
elders who self-neglect. Physicians who find high rates of medication
non-adherence should consider the possibility of elder self-neglect in
their patents. Future efforts should focus on studying the underlying
reasons for medication non-adherence in larger samples of elder selfneglecters.
This would facilitate the development of interventions to
reduce medication non-adherence in this population.
B76
Nocturia and overnight polysomnography outcomes among adults
with Parkinson disease.
C. P. Vaughan, 1,2 J. L. Juncos, 3 L. M. Trotti, 3 T. M. Johnson, II, 1,2
D. L. Bliwise. 3 1. Birmingham/Atlanta VA GRECC, Decatur, GA; 2.
Geriatric Medicine & Gerontology, Emory University, Atlanta, GA; 3.
Neurology, Emory University, Atlanta, GA.
Supported By: Supported by NINDS RO1 NS-050595 and PHS
Grant UL1 RR025008 and KL2 RR025009 (Dr. Trotti) from the
Clinical and Translational Science Award program, National
Institutes of Health, National Center for Research Resources. Dr.
Vaughan is supported by a VA Rehabilitation R&D career development
award.
Background: Epidemiologic studies have shown nocturia to be a
frequent and bothersome complaint for patients with Parkinson disease
(PD). Detailed clinical and sleep data have not been available
for this population and may provide insight into the pathophysiology
and bother related to nocturia in the setting of PD.
Methods: PD patients were recruited from university-based
movement disorders clinics for two consecutive nights of in-laboratory
polysomnography regardless of any sleep or voiding complaints.
Nocturia frequency and overall satisfaction related to urinary symptoms
were assessed using the American Urological Association
Symptom Index. Measured sleep characteristics included total sleep
time (minutes) and sleep efficiency (percent). Differences between
those with at least two episodes of nocturia and those with fewer
were determined using chi-square, t-tests, or Wilcoxon signed rank
tests. Linear and logistic regression techniques were used to assess
factors associated with nocturia frequency.
Results: Sixty-three adults (65% male, mean age 63, (range 32-
83)) with PD completed the study. Fifty-nine (93%) participants had
1 or more and 37 (61%) reported 2 or more nocturia episodes nightly.
Unified Parkinson Disease Rating Scale motor score was a predictor
of nocturia occurring at least twice nightly (p=0.02). This association
persisted when controlling for age and gender (p=0.03). MMSE score
did not predict nocturia frequency. Compared to participants with 2-3
episodes of nocturia who were mostly satisfied with their urinary
symptoms (n=13), participants with 2-3 episodes who reported being
dissatisfied with their urinary symptoms (n=12) demonstrated significantly
less total sleep time (372.5 ± 58.7 min vs. 280.5 ± 116.1 min,
p=0.03) and worse sleep efficiency (75.9% ± 11.2 min vs. 59.2% ±
22.7, p=0.04).
Conclusions: Nocturia at least twice per night in adults with PD
is predicted by motor symptom severity, but not cognitive impairment.
PD patients with 2-3 episodes of nocturia and dissatisfaction
related to urinary symptoms have significantly worse sleep compared
to those reporting 2-3 episodes and no dissatisfaction with urinary
symptoms. Improving sleep as part of a multicomponent treatment
strategy for nocturia in PD patients might be an independent target
for therapy.
B77
Consumer-Targeted Drug Information to Reduce Inappropriate
Prescriptions: Feedback from Older Adults and Preliminary
Effectiveness.
C. Tannenbaum, 1 R. Tamblyn, 2 S. Ahmed. 2 1. Université de Montreal,
Montreal, QC, Canada; 2. McGill University, Montreal, QC, Canada.
Supported By: This research was supported by a grant from the
Canadian Institutes of Health Research. There are no financial disclosures
to report in relation to this work.
Previous interventions have targeted physicians and pharmacists
to reduce inappropriate prescriptions. We sought to ascertain
older adults’ response to directly receiving a knowledge transfer intervention
aimed at empowering them to discuss benzodiazepine discontinuation
with their pharmacist and/or physician.
Methods: A written knowledge transfer tool was validated by a
panel of geriatric pharmacists and pilot tested with focus groups of
adults aged 60+. The tool includes a self-assessment component, presentation
of evidence-based risks associated with benzodiazepine use,
knowledge statements designed to create cognitive dissonance about
the safety of benzodiazepine use, education about drug interactions,
peer-champion stories intended to augment self-efficacy, suggestions
for equally or more effective therapeutic substitutes for insomnia and
anxiety, and simple tapering recommendations. The tool was distributed
to eligible participants recruited and randomized to the intervention
group of an open-label cluster randomized controlled trial on
inappropriate prescribing being conducted in Quebec, Canada. Participants
consuming any benzodiazepine > 3 months were contacted
one week after receiving the intervention to ascertain their initial reaction,
change in knowledge with respect to the risks associated with
benzodiazepines and their anticipated course of action.
Results: 50 participants (75% female, mean age 75 + 7 years,
mean duration of benzodiazepine use 11 + 9 years) were contacted
for their feedback. Prior to receipt of the tool, less than 27% correctly
answered questions about the long-term safety of benzodiazepine
use. After receipt of the tool, the proportion increased to 66%
(p