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Drugs & Aging

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https://www.readbyqxmd.com/read/28258537/use-of-an-e-learning-educational-module-to-better-equip-doctors-to-prescribe-for-older-patients-a-randomised-controlled-trial
#1
Shane Cullinan, Denis O'Mahony, Stephen Byrne
BACKGROUND: The older patient population is significantly different from the younger adult population with regards to dose selection for a wide variety of drugs. Recent investigation of prescribing attitudes indicates that doctors feel there is insufficient distinction made between the two cohorts during their undergraduate education, and that doctors do not receive enough training in geriatric pharmacotherapy. OBJECTIVES: The aim of this study was to determine if an online module, focused on geriatric pharmacotherapy, improves doctors' prescribing knowledge, as well as prescribing confidence, as applied to older patients...
March 4, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28258536/move-it-or-lose-it-is-it-reasonable-for-older-adults-with-osteoarthritis-to-continue-to-use-paracetamol-in-order-to-maintain-physical-activity
#2
REVIEW
Kayla Lee, Julie Cooke, Gabrielle Cooper, Alison Shield
Osteoarthritis is a common progressive disease in older adults, and those affected often have impaired physical function, co-existing disease states, and reduced quality of life. In patients with osteoarthritis, pain is reported as a primary cause of mobility limitation, and guidelines recommend a mix of pharmacologic and non-pharmacologic strategies for pain management. The benefits of exercise in the management of osteoarthritis are well established; however, pain appears to be the biggest barrier to patients engaging in, and adhering to, physical activity programs...
March 4, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28258535/routine-use-of-budesonide-formoterol-fixed-dose-combination-in-elderly-asthmatic-patients-practical-considerations
#3
Nicola Scichilone, Fulvio Braido, Federico Lavorini, Mark L Levy, Omar S Usmani
Asthma has been demonstrated to be as common in the elderly as in younger age groups. Although no specific recommendations exist to manage the disease differently in older individuals, functional features and clinical presentations may be affected by age per se, and by age-related conditions, such as comorbidities and polypharmacy. In this review article, we aimed to explore the efficacy and safety in elderly asthmatic patients of one of the most currently used inhaled treatments for asthma, that is, the fixed-dose combination of budesonide/formoterol...
March 4, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28247317/adverse-health-events-related-to-self-medication-practices-among-elderly-a-systematic-review
#4
REVIEW
Médéa Locquet, Germain Honvo, Véronique Rabenda, Thierry Van Hees, Jean Petermans, Jean-Yves Reginster, Olivier Bruyère
BACKGROUND: Older adults often resort to self-medication to relieve symptoms of their current illnesses; however, the risks of this practice are multiplied in old age. In particular, this age group is more vulnerable to adverse drug events because of the physiological changes that occur due to senescence. OBJECTIVE: The aim of the study was to obtain an overview of the adverse health events related to self-medication among subjects aged 60 years and over through a systematic review of the literature...
February 28, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28299634/prevalence-and-determinants-of-the-use-of-lipid-lowering-agents-in-a-population-of-older-hospitalized-patients-the-findings-from-the-reposi-registro-politerapie-societ%C3%A3-italiana-di-medicina-interna-study
#5
Marco Bertolotti, Carlotta Franchi, Marco B L Rocchi, Andrea Miceli, M Vittoria Libbra, Alessandro Nobili, Giulia Lancellotti, Lucia Carulli, Chiara Mussi
BACKGROUND: Older patients are prone to multimorbidity and polypharmacy, with an inherent risk of adverse events and drug interactions. To the best of our knowledge, available information on the appropriateness of lipid-lowering treatment is extremely limited. AIM: The aim of the present study was to quantify and characterize lipid-lowering drug use in a population of complex in-hospital older patients. METHODS: We analyzed data from 87 units of internal medicine or geriatric medicine in the REPOSI (Registro Politerapie della Società Italiana di Medicina Interna) study, with reference to the 2010 and 2012 patient cohorts...
April 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28258538/trends-in-the-prescription-and-long-term-utilization-of-antidementia-drugs-among-patients-with-alzheimer-s-disease-in-spain-a-cohort-study-using-the-registry-of-dementias-of-girona
#6
Laia Calvó-Perxas, Oriol Turró-Garriga, Joan Vilalta-Franch, Manuela Lozano-Gallego, Rosa de Eugenio, Fabián Márquez, Olga Carmona, Jordi Gich, Anna Manzano, Marta Viñas, Anna Mª Roig, Josep Garre-Olmo
BACKGROUND: Acetylcholinesterase inhibitors (AChEIs) and the N-methyl D-aspartate-antagonist memantine are indicated for the symptomatic treatment of Alzheimer's disease (AD). OBJECTIVES: Our aims were to describe the baseline characteristics of patients with AD according to prescription of these treatments after the diagnostic work-up to describe long-term trends in the use of these medications and to identify baseline characteristics associated with the frequency of use of each treatment...
April 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28247316/selecting-potential-pharmacological-interventions-in-sarcopenia
#7
Amanda J Kilsby, Avan A Sayer, Miles D Witham
Sarcopenia of age is prevalent and costly and proven pharmacological interventions are currently lacking. The pathophysiology of sarcopenia is incompletely understood but appears to involve multiple pathways, including inflammation, hormonal dysregulation, impaired regeneration, mitochondrial dysfunction and denervation. There are several ways in which we might select potential pharmacological interventions for testing in clinical trials. These include a 'bottom-up' approach using basic science to elucidate the molecular processes involved and identify potential targets from this knowledge-a strategy that has led to the development of myostatin inhibitors...
April 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28224284/complementary-and-alternative-medicine-use-in-rheumatoid-arthritis-considerations-for-the-pharmacological-management-of-elderly-patients
#8
REVIEW
Sizheng Zhao, Fred Otieno, Asan Akpan, Robert J Moots
Complementary and alternative medicines (CAMs) are widely used by patients with rheumatoid arthritis (RA); however, a significant proportion of these patients do not inform their physicians. This has many potential implications in a group of predominantly elderly patients with altered pharmacokinetics, comorbidities and polypharmacy of potentially toxic drugs. CAM usage may affect compliance and pharmacokinetics of conventional therapy for RA and comorbidities; therefore, physicians should engage patients in dialogues regarding CAM usage...
April 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28224283/health-service-use-costs-and-adverse-events-associated-with-potentially-inappropriate-medication-in-old-age-in-germany-retrospective-matched-cohort-study
#9
Dirk Heider, Herbert Matschinger, Andreas D Meid, Renate Quinzler, Jürgen-Bernhard Adler, Christian Günster, Walter E Haefeli, Hans-Helmut König
BACKGROUND: Drug-related problems are an important healthcare safety concern in the growing population of older people. Prescription of potentially inappropriate medication (PIM) is one aspect of this concern that is considered to increase the risk of adverse health outcomes. OBJECTIVE: The aim of the Health Economics of Potentially Inappropriate Medication (HEPIME) study was to analyze the association between the prescription of PIMs according to the German PRISCUS list and healthcare utilization, healthcare costs, and the occurrence of adverse events in old age...
April 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28220381/pharmacological-management-of-people-living-with-end-stage-chronic-obstructive-pulmonary-disease
#10
Victoria Dalgliesh, Hilary Pinnock
Supportive care and pharmacological treatment can improve the quality of life of people with end-stage chronic obstructive pulmonary disease (COPD) who cope on a daily basis with substantial physical, psychological, social and spiritual morbidity. Smoking cessation is the only intervention that reduces the rate of progression of COPD, but evidence-based drug treatments and non-pharmacological strategies can relieve symptoms and reduce the impact of exacerbations. People with severe COPD live with increasingly troublesome breathlessness and other symptoms such as fatigue, pain, sputum production and weight loss...
April 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28220380/effectiveness-of-interventions-to-deprescribe-inappropriate-proton-pump-inhibitors-in-older-adults
#11
REVIEW
Tom D Wilsdon, Ivanka Hendrix, Tilenka R J Thynne, Arduino A Mangoni
BACKGROUND: The use of proton pump inhibitors (PPIs) in older adults is high, often inappropriate, and may cause harm. Deprescribing is defined as the reduction, withdrawal, or discontinuation of inappropriate medication. OBJECTIVE: We conducted a systematic review to determine the effectiveness of interventions to deprescribe inappropriate PPIs in older adults. METHODS: We searched MEDLINE, PubMed, Embase, the Cochrane Library, ProQuest Dissertations and Theses Global, and Google from inception to January 2017 for randomized and non-randomized studies describing the outcomes of interventions to deprescribe inappropriate PPIs in older adults (mean or median age of ≥65 years)...
April 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28214970/optimal-bowel-cleansing-for-colonoscopy-in-the-elderly-patient
#12
Samuel B Ho, Rita Hovsepians, Samir Gupta
Colonoscopy is an important diagnostic and screening tool for colorectal cancer detection and prevention, and adequate bowel preparation is critical for successful colonoscopy. Complications related to colonoscopy, either directly or indirectly related to the procedure, are increased in elderly patients, and the risks and benefits of colonoscopy procedures need to be carefully considered in these patients. Recent studies have shown that 4 L polyethylene glycol with a split preparation is safe and effective for elderly patients, and is the preferred preparation for patients with medical comorbidities...
March 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28197947/targeted-therapies-in-elderly-patients-with-metastatic-colorectal-cancer-a-review-of-the-evidence
#13
REVIEW
Gonzalo Tapia Rico, Amanda R Townsend, Vy Broadbridge, Timothy J Price
Metastatic colorectal cancer (mCRC) is the third leading cause of cancer deaths worldwide. As the population of the western world ages, the incidence of colorectal tumours among elderly patients is increasing and consequently so is the demand for treatments for elderly patients. Unfortunately, elderly patients (≥65 years) often go untreated and they are also under-represented in clinical trials. Yet there is some evidence suggesting that 'fit' elderly patients have similar outcomes and tolerance to chemotherapy treatment to their younger counterparts (although the definition of fitness in the elderly population is still a matter of debate)...
March 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28164255/late-onset-asthma-a-diagnostic-and-management-challenge
#14
Charlotte Suppli Ulrik
Late-onset asthma is common, associated with poor outcome, underdiagnosed and undertreated, possibly due to the modifying effect of ageing on disease expression. Although the diagnostic work-up in elderly individuals suspected of having asthma follows the same steps as in younger individuals (case history and spirometry), it is important to acknowledge that elderly individuals are likely to have diminished bronchodilator reversibility and some degree of fixed airflow obstruction. Elderly individuals, therefore, often require further objective tests, including bronchial challenge testing, to objectively confirm asthma...
March 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28138912/tolerability-of-cholinesterase-inhibitors-a-population-based-study-of-persistence-adherence-and-switching
#15
Anat Fisher, Greg Carney, Ken Bassett, Colin R Dormuth
BACKGROUND: Cholinesterase inhibitors (ChEIs) are prescribed to dementia patients despite their poor tolerance. Low tolerability potentially reduces persistence and adherence, while inducing switching between medications. Comparisons of these utilization measures contribute to knowledge of the relative tolerability of these medications. AIM: The aim was to compare persistence, adherence, and switching between donepezil, galantamine, oral rivastigmine, and rivastigmine patch...
March 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28138911/new-onset-diabetes-after-statin-exposure-in-elderly-women-the-australian-longitudinal-study-on-women-s-health
#16
Mark Jones, Susan Tett, Geeske M E E Peeters, Gita D Mishra, Annette Dobson
INTRODUCTION: Extensive clinical research has consistently shown statins lower the risk of cardiovascular events and mortality. Some studies also suggest statins increase the risk of new-onset diabetes. Research to date has rarely included elderly women, hence little is known about the risk of diabetes after statin exposure in this population. OBJECTIVES: Our objectives were to evaluate and estimate the risk of new-onset diabetes associated with statin exposure in a cohort of elderly Australian women...
March 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28124262/atypical-antipsychotics-and-the-risks-of-acute-kidney-injury-and-related-outcomes-among-older-adults-a-replication-analysis-and-an-evaluation-of-adapted-confounding-control-strategies
#17
Patrick B Ryan, Martijn J Schuemie, Darmendra Ramcharran, Paul E Stang
OBJECTIVE: A recently published analysis of population-based claims data from Ontario, Canada reported higher risks of acute kidney injury (AKI) and related outcomes among older adults who were new users of atypical antipsychotics (AAPs) compared with unexposed patients. In light of these findings, the objective of the current study was to further investigate the risks of AKI and related outcomes among older adults receiving AAPs. METHODS: A replication of the previously published analysis was performed using the US Truven MarketScan Medicare Supplemental database (MDCR) among patients aged 65 years and older...
March 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28074410/improving-medication-adherence-and-health-outcomes-in-older-adults-an-evidence-based-review-of-randomized-controlled-trials
#18
REVIEW
Zachary A Marcum, Joseph T Hanlon, Michael D Murray
BACKGROUND: Poor medication adherence is a major public health problem in older adults often resulting in negative health outcomes. OBJECTIVE: The objective of this review was to provide an updated summary of evidence from randomized controlled studies to determine whether interventions aimed at improving medication adherence also improve the health outcomes of older adults residing in community-based settings. METHODS: Articles that assessed medication adherence interventions and related health outcomes in elderly individuals were identified through searches of MEDLINE (1970-June 2016), the Cochrane Database of Systematic Reviews (through to June 2016), and Google Scholar...
March 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28120326/thrombolytic-treatment-for-ischaemic-stroke-could-the-crisis-of-confidence-have-been-avoided-by-better-analysis-of-trial-data
#19
REVIEW
David Barer, Eivind Berge
In many countries, thrombolysis with intravenous alteplase has become a central part of acute stroke care in recent years, requiring radical restructuring of services. However, a significant minority of emergency and stroke physicians have always had serious doubts about the safety and efficacy of thrombolytic treatment, and in 2015 these prompted a major review of the licensing status of alteplase by the UK regulatory authorities. Subsequent dramatic headlines and media stories have called into question the integrity of researchers and clinicians and undermined public faith in medical research...
February 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28097633/meropenem-dosing-based-on-a-population-pharmacokinetic-pharmacodynamic-model-in-elderly-patients-with-infection-of-the-lower-respiratory-tract
#20
Qing-Tao Zhou, Bei He, Ning Shen, Ying Liang, Li-Na Sun
BACKGROUND: Meropenem is used for the treatment of severe lower respiratory tract infections (LRTIs) caused by multidrug-resistant Gram-negative bacilli. OBJECTIVE: We evaluated the clinical benefits of a strategy of meropenem dosing based on a population pharmacokinetics/pharmacodynamics (PK/PD) model in elderly patients with an LRTI. METHODS: In this prospective single-center open-label randomized controlled trial, 79 elderly patients with an LRTI caused by Gram-negative bacilli were randomized to a study group (SG) or a control group (CG)...
February 2017: Drugs & Aging
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