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Drugs & Aging

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https://www.readbyqxmd.com/read/29350336/brain-over-bladder-a-systematic-review-of-dual-cholinesterase-inhibitor-and-urinary-anticholinergic-use
#1
REVIEW
Laura K Triantafylidis, Jenna S Clemons, Emily P Peron, John Roefaro, Kristin M Zimmerman
BACKGROUND: Case reports have demonstrated that dual use of cholinesterase inhibitors (ChIs) and urinary anticholinergics (UAChs) in older adults may be associated with delusions, aggression, changes in cognition, and anxiety, which typically resolve on drug discontinuation. Despite opposing mechanisms of action, these drugs continue to be co-prescribed. OBJECTIVE: This systematic review evaluates cognitive and functional outcomes of dual use of ChIs and UAChs and describes its prevalence...
January 19, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29350335/tools-for-assessment-of-the-appropriateness-of-prescribing-and-association-with-patient-related-outcomes-a-systematic-review
#2
REVIEW
Nashwa Masnoon, Sepehr Shakib, Lisa Kalisch-Ellett, Gillian E Caughey
BACKGROUND: There are tools and criteria in the literature aimed at distinguishing between appropriate and inappropriate medicines use. However, many have not been externally validated with regard to patient-related outcomes, potentially limiting their use in clinical practice. OBJECTIVES: The aim of the study was to conduct a systematic review to summarise (1) available prescribing appropriateness assessment tools and criteria, and (2) their associations with patient-related outcomes (external validity)...
January 19, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29335932/the-euro-forta-fit-for-the-aged-list-international-consensus-validation-of-a-clinical-tool-for-improved-drug-treatment-in-older-people
#3
Farhad Pazan, Christel Weiss, Martin Wehling
BACKGROUND: Drug treatment of older people is still potentially inappropriate in many cases as multimorbidity and related polypharmacy are highly prevalent. To increase the quality of drug treatment in older people, the FORTA (Fit fOR The Aged) List (first version 2012) was developed in a Delphi consensus procedure and updated (FORTA2015) by 21 experts from Germany and Austria. It has been validated in a randomized, controlled, prospective trial demonstrating significant improvement in the quality of drug treatment and clinical endpoints (VALFORTA)...
January 15, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29322470/associations-between-the-drug-burden-index-potentially-inappropriate-medications-and-quality-of-life-in-residential-aged-care
#4
Stephanie L Harrison, Lisa Kouladjian O'Donnell, Clare E Bradley, Rachel Milte, Suzanne M Dyer, Emmanuel S Gnanamanickam, Enwu Liu, Sarah N Hilmer, Maria Crotty
BACKGROUND: Inappropriate polypharmacy may negatively impact the quality of life of residents in aged care facilities, but it remains unclear which medications may influence this reduced quality of life. OBJECTIVE: The objective of this study was to examine whether the Drug Burden Index and potentially inappropriate medications were associated with quality of life in older adults living in residential care with a high prevalence of cognitive impairment and dementia...
January 11, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29256044/treatment-of-older-patients-with-acute-lymphoblastic-leukaemia
#5
REVIEW
Nicola Gökbuget
The outcome of adult acute lymphoblastic leukaemia (ALL) has improved significantly during the past decade, mainly due to intensive paediatric-based chemotherapy. Less improvement has been observed in older patients. A significantly lower rate of complete remissions, higher early mortality, higher relapse rate and poorer survival is observed in older compared with younger ALL patients. Most importantly, intensive chemotherapy with or without stem-cell transplantation is less well tolerated in older patients...
December 18, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29243033/incontinence-associated-dermatitis-pathogenesis-contributing-factors-prevention-and-management-options
#6
Hilde Beele, Steven Smet, Nele Van Damme, Dimitri Beeckman
Incontinence-associated dermatitis (IAD) is a common type of irritant contact dermatitis, seen in patients with urinary or faecal incontinence. Mechanical factors such as traumata and friction may aggravate the lesions. The fragile skin in elderly patients is more prone to developing IAD. The clinical picture of IAD consists of persistent redness on the one hand and skin loss on the other. Both categories may be associated with clinical signs of major colonisation or infection. It is important to distinguish IAD from pressure ulcers and other dermatoses in the genital region...
December 14, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29222667/drug-burden-and-its-association-with-falls-among-older-adults-in-new-zealand-a-national-population-cross-sectional-study
#7
Hamish A Jamieson, Prasad S Nishtala, Richard Scrase, Joanne M Deely, Rebecca Abey-Nesbit, Martin J Connolly, Sarah N Hilmer, Darrell R Abernethy, Philip J Schluter
BACKGROUND: Adverse outcomes associated with advanced diseases are often exacerbated by polypharmacy. OBJECTIVES: The current study investigated an association between exposure to anticholinergic and sedative medicines and falls in community-dwelling older people, after controlling for potential confounders. METHODS: We conducted a retrospective cross-sectional study of a continuously recruited national cohort of community-dwelling New Zealanders aged 65 years and over...
December 8, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29214512/anticholinergic-prescribing-in-medicare-part-d-beneficiaries-residing-in-nursing-homes-results-from-a-retrospective-cross-sectional-analysis-of-medicare-data
#8
Joshua Niznik, Xinhua Zhao, Tao Jiang, Joseph T Hanlon, Sherrie L Aspinall, Joshua Thorpe, Carolyn Thorpe
BACKGROUND: Prescribing of medications with anticholinergic properties in older nursing home residents is relatively common, despite an association with an increased risk for falls, delirium, and other outcomes. Few studies have investigated what factors influence different levels of prescribing of these agents. OBJECTIVES: The primary objective was to identify factors associated with low- and high-level anticholinergic burden in nursing home residents. A secondary objective was to examine in detail the contribution of different medications to low versus high burden to aid in determining which drugs to target in interventions...
December 6, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29214511/managing-gout-flares-in-the-elderly-practical-considerations
#9
Abhishek Abhishek
Gout is common in the elderly, affecting an estimated 4.7 million people aged > 60 years in the USA alone. The incidence and prevalence of gout increases, and male predisposition to gout reduces, with increasing age. The elderly have more comorbidities, and gout manifests differently, with more frequent involvement of knees, ankles, and wrists at disease onset, systemic upset, and tophi. Comorbidities and polypharmacy make the management of gout flares challenging in this population. Intra-articular corticosteroid injection remains the treatment of choice for accessible joints, oral prednisolone is preferred over low-dose colchicine, and non-steroidal anti-inflammatory drugs (NSAIDs) are best avoided...
December 6, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29210011/n-of-1-randomized-trials-of-ultra-micronized-palmitoylethanolamide-in-older-patients-with-chronic-pain
#10
Federico Germini, Anna Coerezza, Luca Andreinetti, Alessandro Nobili, Paolo Dionigi Rossi, Daniela Mari, Gordon Guyatt, Maura Marcucci
BACKGROUND: Ultra-micronized palmitoylethanolamide (um-PEA) represents an attractive option for chronic pain control in complex older patients at higher risk of adverse effects with traditional analgesics. OBJECTIVE: The aim of this study was to determine the effectiveness of um-PEA versus placebo on chronic pain intensity and function in individual geriatric patients. DESIGN: We performed randomized, blinded N-of-1 trials with two 3-week um-PEA versus placebo comparisons, separated by 2-week washout periods...
December 5, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29196903/concurrent-use-of-prescription-drugs-and-herbal-medicinal-products-in-older-adults-a-systematic-review
#11
REVIEW
Taofikat B Agbabiaka, Barbara Wider, Leala K Watson, Claire Goodman
BACKGROUND: The use of herbal medicinal products (HMPs) is common among older adults; however, little is known about concurrent use with prescription drugs, as well as potential interactions associated with such combinations. OBJECTIVE: The aim of this systematic review was to identify and evaluate the literature on concurrent prescription and HMP use among older adults to assess prevalence, patterns, potential interactions and factors associated with this use. METHODS: Systematic searches were conducted in the MEDLINE, PsycINFO, EMBASE, CINAHL, AMED, Web of Science and Cochrane databases from inception to May 2017 for studies reporting concurrent use of prescription medicines with HMPs in adults ≥ 65 years of age...
December 1, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29177885/clopidogrel-therapy-in-patients-with-cardiovascular-disease-undergoing-transurethral-resection-of-the-prostate-a-step-towards-individualization
#12
Petros Tzimas, Maria Tsoumani, Dimitrios Giannakis, Kallirroi Kalantzi, Anastasios Petrou, Vasileios Chantzichristos, Nikolaos Sofikitis, Georgios Papadopoulos, Haralampos Milionis, Alexandros Tselepis
OBJECTIVES: The objective of this study was to test platelet function pre- and peri-operatively in clopidogrel-treated patients undergoing transurethral resection of the prostate. METHODS: This was a pilot study involving 20 male patients treated with clopidogrel (75 mg/day) for the secondary prevention of cardiovascular disease and scheduled for elective transurethral resection of the prostate. Platelet function testing with light transmittance aggregometry in platelet-rich plasma of four samples (T0, T1, T2, and T3 drawn on the same day, 3 and 7 days of clopidogrel cessation and 24-h post-operatively, respectively) was performed and evaluated in each patient...
November 25, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29177770/interventions-to-improve-medicines-management-for-people-with-dementia-a-systematic-review
#13
REVIEW
Mairead McGrattan, Cristín Ryan, Heather E Barry, Carmel M Hughes
BACKGROUND: The importance of optimising medicines management for people with dementia has been emphasised through research and policy. However, evidence is currently lacking regarding how to achieve this in this patient population. OBJECTIVE: The aim was to assess the effectiveness of medicines management interventions for people with dementia living in their own home or a care home, with or without nursing care. METHODS: A systematic literature search was conducted in February 2016 across six electronic databases and three trial registries...
November 24, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29170864/risk-of-malignancy-in-a-nationwide-cohort-of-elderly-inflammatory-bowel-disease-patients
#14
Nabeel Khan, Carlos Vallarino, Trevor Lissoos, Umar Darr, Michelle Luo
BACKGROUND: Management of elderly inflammatory bowel disease (IBD) patients (≥ 65 years of age) is complicated due to many factors, including a higher risk of cancer, which may impact therapeutic decisions. OBJECTIVE: The aim of this study was to determine the risk of cancer among elderly IBD patients compared with younger IBD patients. Additionally, the absolute risk of malignancy and factors contributing to it were evaluated, and therapeutic patterns among the elderly were assessed...
November 23, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29159733/management-of-hemophilia-in-older-patients
#15
REVIEW
Massimo Franchini, Pier Mannuccio Mannucci
In recent decades, several improvements in hemophilia care have resulted in increased quality of life and life expectancy for those affected by this inherited hemorrhagic condition. Nowadays, individuals with hemophilia enjoy a life expectancy at birth close to that of males in the general population. As a consequence of the increasing age of the hemophilia population, a growing number of these patients develop age-related co-morbidities, such as cardiovascular disease and cancer, the management of which represents a new challenge for caregivers at hemophilia treatment centers...
November 20, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29119468/clinical-decision-support-and-optional-point-of-care-testing-of-renal-function-for-safe-use-of-antibiotics-in-elderly-patients-a-retrospective-study-in-community-pharmacy-practice
#16
Mette Heringa, Annemieke Floor-Schreudering, Peter A G M De Smet, Marcel L Bouvy
OBJECTIVE: The aim was to investigate the management of drug therapy alerts on safe use of antibiotics in elderly patients with (potential) renal impairment and the contribution of optional creatinine point of care testing (PoCT) in community pharmacy practice. METHODS: Community pharmacists used a clinical decision support system (CDSS) for seven antibiotics. Alerts were generated during prescription processing in the case of previously registered renal impairment and when no information on renal function was available for patients aged 70 and over...
November 8, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29086350/underuse-of-anticoagulation-in-older-patients-with-atrial-fibrillation-and-chads2-score-%C3%A2-%C3%A2-2-are-we-doing-better-since-the-marketing-of-direct-oral-anticoagulants
#17
Séverine Henrard, Caroline Vandenabeele, Sophie Marien, Benoit Boland, Olivia Dalleur
OBJECTIVE: Our objectives were to (1) describe the evolution of the underuse of anticoagulants in older people with atrial fibrillation (AF) and a CHADS2 score ≥ 2 since direct oral anticoagulants (DOACs) were introduced to the market and (2) describe factors associated with this underuse. METHODS: We conducted a retrospective cross-sectional study including geriatric patients admitted during the pre-DOAC (2008-2011) and post-DOAC (2013-2015) periods in an academic hospital in Belgium...
October 30, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29116600/recent-progress-in-the-pharmacotherapy-of-alzheimer-s-disease
#18
Rita Khoury, Kush Patel, Jake Gold, Stephanie Hinds, George T Grossberg
Alzheimer's disease is the most common major neurocognitive disorder with substantial social and economic impacts. This article is an update on current pharmacotherapy, advancements in biomarker use, and drugs in the pipeline for this disease. To date, no new drug has qualified to be added to the current therapeutic arsenal comprising cholinesterase inhibitors and the NMDA receptor antagonist memantine. Drugs in the pipeline include symptomatic therapies that are neurotransmitter-based, but mostly disease-modifying therapies...
November 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29110264/optimization-of-drug-prescription-and-medication-management-in-older-adults-with-cardiovascular-disease
#19
Nanette K Wenger, Caroline Lloyd Doherty, Jerry H Gurwitz, Glenn A Hirsch, Holly M Holmes, Matthew S Maurer, Michael D Murray
Cardiovascular disease increases incrementally with age and elderly patients concomitantly sustain multimorbidities, with resultant prescription of multiple medications. Despite conforming with disease-specific cardiovascular clinical practice guidelines, this polypharmacy predisposes many elderly individuals with cardiovascular disease to adverse drug events and non-adherence. Patient-centered care requires that the clinician explore with each patient his or her goals of care and that this shared decision-making constitutes the basis for optimization of medication management...
November 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29086349/targeted-therapies-in-the-management-of-ovarian-cancer-a-focus-on-older-patients
#20
REVIEW
Caroline Lum, Christopher B Steer
Ovarian cancer is one of the most common gynaecological malignancies and one of the leading causes of cancer mortality in women. The standard of care for ovarian cancer is maximal de-bulking surgery followed by adjuvant platinum-based chemotherapy. The median age at diagnosis is 63 years, yet older patients are under-represented in clinical trials. Historically, 65 years of age has been used as a definition of elderly; however, such an age cut-off encompasses a highly heterogeneous population with regards to comorbidity, functional status, and cognition...
November 2017: Drugs & Aging
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