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Optimized Prescribing with Seniors

Optimized Prescribing with Seniors is a joint communication of the Alberta Medical Association and the College of Physicians & Surgeons of Alberta, these articles are written by physicians for physicians prescribing in the care of older patients.

OPS is for you: Send us your questions and suggestions

  • Is there a particular issue you would like to see addressed?
  • Do you see a scenario frequently and want to know an ideal, yet practical, approach to management?
  • Uncertain about the role of the "latest and greatest" new drug?

Ask us! Email your questions and suggestions to webmaster@albertadoctors.org. 

OPS Physician Coordinator

Dr. Lesley Charles, MBChB, CCFP, is a geriatric physician at the Grey Nuns Community Hospital. Her areas of clinical interest include dementia, delirium and treatment of osteoporosis. She obtained her medical education at the University of Edinburgh then completed her family medicine residence at the University of Alberta.

Dr. Charles is an associate professor with the Department of Family Medicine (Division of Care of the Elderly) at the University of Alberta. Her research interests include the Care of the Elderly Program; Decision-Making Capacity Assessment and Implementation and Sustainability Framework; Care of the Elderly Graduates Research; Developing and the Effects of Introducing Core Competencies; and Caregivers

Past Issues

Alcohol use disorder in seniors

Medical management of behavioural and psychological symptoms of dementia

Evaluating the likelihood of emerging acute or decompensated heart failure – Part 2

Evaluating the likelihood of emerging acute or decompensated heart failure – Part 1

Nocturia

Constipation in the elderly

Focus on Parkinson’s disease – Part 2 (advanced disease and psychosis)

Optimization prescribing orthostatic hypotension

Focus on Parkinson’s disease: Part 1

Deprescribing ChEI Residents Dementia

Reducing anticholinergic burden

Vertigo Management Older Adults

Vitamin B12 deficiency and metformin

End of life care

Managing Delirium

Tackling polypharmacy by deprescribing

When Medication is Not the Answer

Managing urinary incontinence

Managing atrial fibrillation with recurrent falls

Evaluating decision-making capacity

Involving the Family Caregiver in Optimized Prescribing

Optimal management of dementia

Factoring in Frailty

Antipsychotics in Dementia

Practical approach stopping medications

Therapeutic failure or forgetting pills

Medical cannabis and the older adult

BP management and dementia prevention

Promoting Diagnostic Stewardship

Managing dizziness

Managing apathy in Alzheimer’s type dementia

Management of osteoporosis

Subclinical hypothyroidism

Treatment targets for hypertension

New diagnosis or adverse effect?

Treat pain to resolve aggression dementia

Deprescribing PPIs

Use and misuse of benzodiazepines

Managing osteoporosis LTC

Antipsychotic use in dementia

Tackling therapeutic competition

Asymptomatic bacteriuria or UTI

Management of chronic non-cancer pain

Pharmacological treatment of urinary incontinence

Statins: Risk assessment and treatment decisions

Antidepressant use in later life depression

Hypertension in the elderly

The DOACs

Managing Insomnia

MedRec to optimize medication

Association between medications and fall risk

Polypharmacy: Appropriate and Problematic

Flu vaccine: efficacy outweighs risks

Pharmacological factors and falls

Recognizing anticholinergic effects

Tackling GERD

HgA1c targets and use of agents for diabetes

Medication reviews in LTC and supportive living

Sedative hypnotics and risk for adverse events

When to stop medications

Risks and benefits atypical antipsychotics dementia

Introducing Optimized Prescribing with Seniors

Managing falls in the older adult

Treating chemotherapy-induced peripheral neuropathy