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https://www.readbyqxmd.com/read/29016367/updates-in-nutrition-and-polypharmacy
#1
Milta O Little
PURPOSE OF REVIEW: Medications have the potential to affect nutritional status in negative ways, especially as the number of medications increase. The inter-relation between polypharmacy and malnutrition is complex and not fully delineated in previous studies. More research has been done and compiled in the last year, which helps to clarify this relationship. This review brings together the most recent literature with the previous research to help healthcare providers to better assess and manage medication therapy in older adults...
October 7, 2017: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/28951110/n-of-1-trials-for-assessing-the-effects-of-deprescribing-medications-on-short-term-clinical-outcomes-in-older-adults-a-systematic-review
#2
REVIEW
Alexander J Clough, Sarah N Hilmer, Sharon L Naismith, Luke Kardell, Danijela Gnjidic
OBJECTIVE: To determine the feasibility of using the N-of-1 method for deprescribing trials in older adults. STUDY DESIGN AND SETTING: Systematic review identifying any human studies conducted in older adults (≥ 50 years), deprescribing any long-term treatment over less than a year using the N-of-1 trial method. Two authors independently reviewed all articles for eligibility and extracted data. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
September 22, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28945453/de-prescription
#3
Diane Portman
Deprescribing is the removal or reduction of medications to improve patient function and quality of life. Despite potential benefits, patients who have received medications from trusted clinicians may resist deprescription, as they fear return of medical problems, use medications to cope, or view them as instruments to benefit health or prolong life. Deprescribing clinicians often struggle with opposition and patient distress as they seek to enhance patient well-being. (PsycINFO Database Record
September 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28945268/do-residents-need-all-their-medications-a-cross-sectional-survey-of-rns-views-on-deprescribing-and-the-role-of-clinical-pharmacists
#4
Nagham Ailabouni, June Tordoff, Dee Mangin, Prasad S Nishtala
A cross-sectional survey was mailed to 307 RNs of a nationally representative sample of residential aged care facilities to investigate their views and perceptions on medication use and deprescribing in older adults. Questions were grouped according to each stage of the medication use process, and a dedicated section to explore nurses' views on deprescribing was included. Ninety-one questionnaires were received, yielding a 29.6% response rate. Respondents highlighted several challenges including achieving medication reconciliation for new residents, access to physicians to admit patients in a timely fashion, and issues pertaining to lack of clear medical information transcribing when transferring patients between health care settings...
October 1, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/28927372/potentially-inappropriate-medication-use-in-nursing-homes-an-observational-study-using-the-norgep-nh-criteria
#5
Gunhild Nyborg, Mette Brekke, Jørund Straand, Svein Gjelstad, Maria Romøren
BACKGROUND: Frail residents in the nursing home sector call for extra care in prescribing. The Norwegian General Practice Nursing Home (NORGEP-NH) list of 34 explicit criteria for potentially inappropriate medication use in nursing homes was developed explicitly for this population. The aim of this study was to employ the NORGEP-NH Criteria to study the extent of potentially inappropriate medication use among nursing home residents and explore possible associated factors. METHODS: Cross-sectional observational pharmacoepidemiological study from residents in nursing homes in the county of Vestfold, Norway...
September 19, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28913911/older-adults-awareness-of-deprescribing-a-population-based-survey
#6
Justin P Turner, Cara Tannenbaum
OBJECTIVES: To determine older adults' awareness of the concept of medication-induced harm and their familiarity with the term "deprescribing." Secondary objectives were to ascertain determinants of self-initiated deprescribing conversations and to identify how older adults seek information on medication harms. DESIGN: Cross-sectional population-based household telephone survey using random-digit dialling. SETTING: Canada. PARTICIPANTS: Community-dwelling adults aged 65 and older (N = 2,665; n = 898 men, n = 1,767 women, mean age 74...
September 15, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28895169/we-have-had-a-gutful-the-need-for-deprescribing-proton-pump-inhibitors
#7
M Naunton, G M Peterson, L S Deeks, H Young, S Kosari
WHAT IS KNOWN AND OBJECTIVE: Proton pump inhibitor (PPI) prescribing may often be inappropriate and expose patients to a risk of adverse effects, while incurring unnecessary healthcare expenditure. Our objective was to determine PPI usage in Australia since 2002 and review international studies investigating inappropriate PPI prescribing, including those that discussed interventions to address this issue. METHODS: Australian Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) data were analysed...
September 11, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28887346/leveraging-electronic-medical-record-data-for-population-health-management-in-the-veterans-health-administration-successes-and-lessons-learned
#8
Jannet M Carmichael, Joy Meier, Amy Robinson, Janice Taylor, Diana T Higgins, Shardool Patel
PURPOSE: The process and operational elements to establish a population health program using electronic medical record data in a Veterans Health Administration region are described. SUMMARY: Pharmacists are uniquely qualified to assume important roles in population health through the use of their clinical knowledge, assisted by electronic tools that consolidate and report patient-specific data for clinical care. Veterans Integrated Services Network (VISN) 21 has developed 300 dashboards and reports to improve the quality, safety, and value of healthcare to veterans...
September 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28870834/prevalence-of-preventive-cardiovascular-medication-use-in-nursing-home-residents-room-for-deprescribing-the-shelter-study
#9
Alireza Malek Makan, Hein van Hout, Graziano Onder, Harriet Finne-Soveri, Henriëtte van der Roest, Rob van Marum
INTRODUCTION: In nursing home (NH) residents with a very short life expectancy, the benefits of preventive cardiovascular medication maintenance are questionable. OBJECTIVE: To assess the prevalence of 4 classes of preventive cardiovascular medication (PCM) in NH residents, and to explore differences of prevalence across length of stay, mortality risk, cognitive impairment, functional disability, and across countries. METHODS: A 12-month prospective cohort study was conducted in 57 NHs in 8 countries (Czech Republic, England, Finland, France, Germany, Italy, The Netherlands, and Israel)...
September 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28860728/patient-provider-concordance-in-the-perception-of-illness-and-disease-a-cross-sectional-study-among-multimorbid-patients-and-their-general-practitioners-in-switzerland
#10
Stefan Neuner-Jehle, Stefan Zechmann, Daniela Grundmann Maissen, Thomas Rosemann, Oliver Senn
BACKGROUND: Multiple chronic health conditions are leading to multiple treatment procedures and polypharmacy. Prioritizing treatment according to patients' needs and preferences may be helpful for deprescribing. Thus, for improving health care, it is crucial for general practitioners (GPs) to perceive the chief complaints (CCs) of patients. The primary aim of this study was to investigate the patient-provider concordance of CCs and the secondary aim was to investigate the concordance between CCs and diagnosis, in a sample of Swiss multimorbid patients...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28853000/discontinuation-of-preventive-medicines-in-older-people-with-limited-life-expectancy-a-systematic-review
#11
REVIEW
Sujita W Narayan, Prasad S Nishtala
BACKGROUND: In the presence of multimorbidity and limited life expectancy (LLE), the need for continued use of preventive medicines becomes uncertain as they may neither improve health nor confer continued health benefits. OBJECTIVE: Our objective was to systematically review the literature to examine the discontinuation of preventive medicines in older people with LLE. METHODS: A systematic literature search was conducted using the Ovid MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Central Register databases...
August 29, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28804870/effect-of-the-tool-to-reduce-inappropriate-medications-on-medication-communication-and-deprescribing
#12
Terri R Fried, Kristina M Niehoff, Richard L Street, Peter A Charpentier, Nallakkandi Rajeevan, Perry L Miller, Mary K Goldstein, John R O'Leary, Brenda T Fenton
OBJECTIVES: To examine the effect of the Tool to Reduce Inappropriate Medications (TRIM), a web tool linking an electronic health record (EHR) to a clinical decision support system, on medication communication and prescribing. DESIGN: Randomized clinical trial. SETTING: Primary care clinics at a Veterans Affairs Medical Center. PARTICIPANTS: Veterans aged 65 and older prescribed seven or more medications randomized to receipt of TRIM or usual care (N = 128)...
October 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28764753/supporting-prescribing-in-older-people-with-multimorbidity-and-significant-polypharmacy-in-primary-care-sppire-a-cluster-randomised-controlled-trial-protocol-and-pilot
#13
Caroline McCarthy, Barbara Clyne, Derek Corrigan, Fiona Boland, Emma Wallace, Frank Moriarty, Tom Fahey, Carmel Hughes, Paddy Gillespie, Susan M Smith
BACKGROUND: Multimorbidity, defined as the presence of at least two chronic conditions, becomes increasingly common in older people and is associated with poorer health outcomes and significant polypharmacy. The National Institute for Clinical Excellence (NICE) recently published a multimorbidity guideline that advises providing an individualised medication review for all people prescribed 15 or more repeat medicines. This study incorporates this guideline and aims to assess the effectiveness of a complex intervention designed to support general practitioners (GPs) to reduce potentially inappropriate prescribing and consider deprescribing in older people with multimorbidity and significant polypharmacy in Irish primary care...
August 1, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28752589/frailty-and-potentially-inappropriate-medication-use-at-nursing-home-transition
#14
Laura C Maclagan, Colleen J Maxwell, Sima Gandhi, Jun Guan, Chaim M Bell, David B Hogan, Nick Daneman, Sudeep S Gill, Andrew M Morris, Lianne Jeffs, Michael A Campitelli, Dallas P Seitz, Susan E Bronskill
BACKGROUND/OBJECTIVES: To estimate the prevalence of potentially inappropriate medication (PIM) use among older adults with cognitive impairment or dementia prior to and following admission to nursing homes and in relation to frailty. DESIGN: Retrospective cohort study using health administrative databases. SETTING: Ontario, Canada. PARTICIPANTS: 41,351 individuals with cognitive impairment or dementia, aged 66+ years newly admitted to nursing home between 2011 and 2014...
October 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28733142/deprescribing-for-frail-older-people-learning-from-the-case-of-mrs-hansen
#15
Anne Gerd Granas, Marit Stendal Bakken, Sabine Ruths, Katja Taxis
Drug treatment is often an essential part in treatment and prevention of diseases in older people, but there is much concern about inappropriate medication use. This paper aims to describe the complexity of medication safety issues and clinical judgments when optimizing prescribing in older individuals. It uses the case of Mrs. Hansen, an aged nursing home resident, to illustrate the facilitators and barriers of this process. With decreasing life expectancy, medication use should shift from cure to care, focusing on symptomatic treatment to increase the patient's well-being...
July 13, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28720634/physician-factors-associated-with-polypharmacy-and-potentially-inappropriate-medication-use
#16
Kenya Ie, Maria Felton, Sydney Springer, Stephen A Wilson, Steven M Albert
BACKGROUND: Despite accumulating evidence about the harm of polypharmacy in family medicine, few studies have investigated factors related to polypharmacy. The objective of this study was to explore factors related to physicians' prescribing behavior. METHODS: We conducted a survey of physicians at 5 family medicine residency practices and a linked health record review of their patients ≥65 years old. The determinants of physicians' mean number of prescriptions and potentially inappropriate medications (PIMs) were examined using a generalized linear model...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28700758/deprescribing-a-simple-method-for-reducing-polypharmacy
#17
Kathryn McGrath, Emily R Hajjar, Chandrika Kumar, Christopher Hwang, Brooke Salzman
Polypharmacy brings with it increased risks for adverse drug events and reduced functional capacity. This 4-step plan will help you safely deprescribe in older adults.
July 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28694287/is-deprescribing-swimming-against-the-tide
#18
Sarah Burbank
No abstract text is available yet for this article.
July 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28694270/swimming-against-the-tide-primary-care-physicians-views-on-deprescribing-in-everyday-practice
#19
Katharine A Wallis, Abby Andrews, Michelle Henderson
PURPOSE: Avoidable hospitalizations due to adverse drug events and high-risk prescribing are common in older people. Primary care physicians prescribe most on-going medicines. Deprescribing has long been essential to best prescribing practice. We sought to explore the views of primary care physicians on the barriers and facilitators to deprescribing in everyday practice to inform the development of an intervention to support safer prescribing. METHODS: We used a snowball sampling technique to identify potential participants...
July 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28694261/in-this-issue-trends-prescribing-deprescribing
#20
EDITORIAL
Kurt C Stange
No abstract text is available yet for this article.
July 2017: Annals of Family Medicine
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