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(Article, p 689; Editorial, p. 756)
(Guideline, p. 738; Evidence Paper, p. 740)
Three-quarters of women over age 70 in a telephone survey reported having a had recent mammography, Pap test, or both, according to a new study (Article, p. 661) Although it is known that older women whose life expectancy is less than five years are unlikely to benefit from screening mammography or Pap tests, in this study, women who reported worse health were as likely to get the tests as those in better health. An editorial writer says that keeping healthy and mobile are the primary goals for many elderly, not merely extending life (Editorial, p. 754). "Screening can have, at best, only a limited effect on mortality" among the elderly, he says.
A study examined management of pharmacologic care of 372 vulnerable elderly patients in two managed care organizations against explicit quality indicators. Researchers found failures in educating patients on proper use of medications, monitoring medications appropriately, documenting necessary information, educating patients about their medications and coordinating with the patients' other physicians (Article, p. 714). Researchers also found underuse of potentially beneficial medications but did not find problems with prescriptions for inappropriate medications.