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"These findings come as no surprise for geriatricians and health care professionals who face on a daily basis the challenges of recognizing and managing the complexity of caring for older adults," said Dr. Gisele Wolf-Klein, who reviewed the new findings. She directs geriatric education at Northwell Health in Great Neck, N.Y.
She noted that elderly patients face many challenges, such as "multiple medical conditions, which often include depression and forgetfulness."
That can make it tough for them to initiate and stick with a quit-smoking regimen such as medications, lozenges or patches, Wolf-Klein said.
The new study was led by Dr. Neha Pagidipati of Duke University Medical Center in Durham, N.C. It was scheduled for presentation Sunday at the annual meeting of the American Heart Association, in New Orleans.
The study included nearly 2,400 heart attack survivors older than 65 who were either current or recent smokers and were treated at 377 U.S. hospitals. During their hospital stay, the patients were advised by health staff to quit smoking.
Nearly all of them received prescriptions for smoking-cessation medications before being discharged from the hospital.
But, the study found that only about one in 10 actually filled a prescription for the smoking-cessation medications bupropion (Wellbutrin) or varenicline (Chantix) within 90 days of leaving the hospital.
That rate barely budged over time: Only 13 percent filled a prescription within one year after leaving the hospital, the study found.
The older the patient, the less likely they were to fill the prescription, the researchers noted. And, men and minorities were less apt to try the anti-smoking aids than women or white patients.
The findings show that much more needs to be done during their hospital stay to help heart attack patients quit smoking, the researchers said.
Wolf-Klein agreed, but said there are reasons patients fail to take advantage of smoking-cessation aids.
"Older adults are particularly concerned with taking too many medications, both because of the increasing and often unsurmountable monthly costs of their prescribed drug regimen, and because of the difficulty of remembering when to take them," she pointed out.
Too often, patients are simply handed the medications without much explanation, she added. "Before 'buying into' the new market of smoking-cessation medication, older adults will need strong scientific data to persuade them -- and their caregivers -- of the longevity and quality of life benefits of giving up one of their last pleasurable habits," she said.
Dr. Satjit Bhusri is a cardiologist at Lenox Hill Hospital in New York City. He agreed that "we clearly have a long way to go in continued long-term counseling" for elderly heart patients who smoke.
"We need to enhance our smoking-cessation counseling outside of the hospital by providing additional assistance and education to our patients," Bhusri said. "The importance of not smoking after a heart attack is crucial to recovery and prevention of future heart attacks."
Experts note that studies presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.
-- Robert Preidt
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