Journal of Postgraduate Medicine
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  Table of Contents     
LETTER
Year : 2015  |  Volume : 61  |  Issue : 1  |  Page : 58-59

Authors' reply


1 Department of Surgery, Division of Trauma, Critical Care and Burn, College of Medicine, The Ohio State University, Columbus, Ohio, USA
2 Department of Anesthesiology, College of Medicine, The Ohio State University, Columbus, Ohio, USA
3 Center for Biostatistics, College of Medicine, The Ohio State University, Columbus, Ohio, USA
4 Department of Pharmacy, College of Medicine, The Ohio State University, Columbus, Ohio, USA
5 Department of Research and Innovation, St Luke's University Health Network, Bethlehem, Pennsylvania, USA

Date of Web Publication15-Dec-2014

Correspondence Address:
Dr. S P Stawicki
Department of Research and Innovation, St Luke's University Health Network, Bethlehem, Pennsylvania
USA
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Wisler J R, Springer A N, Hateley K, Mo X M, Evans D C, Cook C H, Gerlach A T, Murphy C V, Eiferman D S, Steinberg S M, Bergese S D, Papadimos T J, Stawicki S P. Authors' reply. J Postgrad Med 2015;61:58-9

How to cite this URL:
Wisler J R, Springer A N, Hateley K, Mo X M, Evans D C, Cook C H, Gerlach A T, Murphy C V, Eiferman D S, Steinberg S M, Bergese S D, Papadimos T J, Stawicki S P. Authors' reply. J Postgrad Med [serial online] 2015 [cited 2019 Dec 11];61:58-9. Available from: http://www.jpgmonline.com/text.asp?2015/61/1/58/147062


Sir,

We appreciate the insights from Bhad and Hazari. [1] The issue of polypharmacy in the elderly population is of increasing importance due to the rapidly aging population - A phenomenon of truly global proportions. [2],[3] While the present study identifies several combinations of pre-injury cardiac and neuropsychiatric medications that may be associated with increased mortality following trauma, it is important to note that this paper is purely descriptive in nature and that no causative effect is claimed by the study team. [4] The authors would like to emphasize that they fully recognize limitations of the present study and have cautioned readers in the discussion about the generalizability of the findings. These data are reported purely as preliminary findings in a clinical area with little to no previous investigation along the current line of scientific inquiry. [4] We echo Bhad and Hazari's sentiment that the overarching issue at hand is not necessarily isolated to the use of neuro-psychiatric or cardiac medications but rather to the emerging phenomenon of polypharmacy and the secondary effects of multi-medication regimens that we are just now beginning to more fully appreciate. [5],[6] We also agree that many of the patients taking neuro-psychiatric medications may not have been previously able to participate in activities that many others in the society take for granted, and have thus tremendously benefited from both the availability improving efficacy of these pharmaceutical agents. [7],[8],[9] Having said that, it is important to emphasize that the associations noted in the current study [4] are unlikely to be present purely by chance and that further investigation within this specific area is certainly warranted.

 
 :: References Top

1.
Bhad R, Hazari N. Combining pharmacological treatments in geriatric population: Weighing the balance. J Postgrad Med 2014;61:57-8.  Back to cited text no. 1
    
2.
Evans DC, Cook CH, Christy JM, Murphy CV, Gerlach AT, Eiferman D, et al. Comorbidity-polypharmacy scoring facilitates outcome prediction in older trauma patients. J Am Geriatr Soc 2012;60:1465-70.  Back to cited text no. 2
    
3.
Lutz W, Sanderson W, Scherbov S. The coming acceleration of global population ageing. Nature 2008;451:716-9.  Back to cited text no. 3
    
4.
Wisler JR, Springer AN, Hateley K, Mo XM, Evans DC, Cook CH, et al. Pre-injury neuro-psychiatric medication use, alone or in combination with cardiac medications, may affect outcomes in trauma patients. J Postgrad Med 2014;60:366-71.  Back to cited text no. 4
[PUBMED]  Medknow Journal  
5.
Evans DC, Gerlach AT, Christy JM, Jarvis AM, Lindsey DE, Whitmill ML, et al. Pre-injury polypharmacy as a predictor of outcomes in trauma patients. Int J Crit Illn Inj Sci 2011;1:104-9.  Back to cited text no. 5
[PUBMED]  Medknow Journal  
6.
Stawicki SP, Gerlach AT. Polypharmacy and medication errors: Stop, listen, look, and analyze... OPUS 12 Scientist 2009;3:6-10.  Back to cited text no. 6
    
7.
Razzano LA, Cook JA, Burke-Miller JK, Mueser KT, Pickett-Schenk SA, Grey DD, et al. Clinical factors associated with employment among people with severe mental illness: Findings from the employment intervention demonstration program. J Nerv Ment Dis 2005;193:705-13.  Back to cited text no. 7
    
8.
Soumerai SB, McLaughlin TJ, Ross-Degnan D, Casteris CS, Bollini P. Effects of limiting Medicaid drug-reimbursement benefits on the use of psychotropic agents and acute mental health services by patients with schizophrenia. N Engl J Med 1994;331:650-5.  Back to cited text no. 8
    
9.
Wang PS, Schneeweiss S, Avorn J. Recent developments in psychopharmacoepidemiology. Curr Opin Psychiatry 2003;16:719-24.  Back to cited text no. 9
    




 

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2004 - Journal of Postgraduate Medicine
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