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https://www.readbyqxmd.com/read/29442099/prescribing-or-deprescribing-in-older-persons-what-are-the-real-life-concerns-in-geriatric-practice
#1
Barbara Bień, Katarzyna Bień-Barkowska
INTRODUCTION Multimorbidity in older adults leads to polypharmacy with all its hazardous outcomes and drug related problems. OBJECTIVES We assess the difference in the number of drugs between admission to and discharge from a geriatric ward and identify the patient-related factors associated with changes in the drug regimen. PATIENTS AND METHODS This retrospective cross-sectional study covered 301 geriatric patients who underwent drug optimization in line with the Beers and STOPP/START criteria. The numbers of drugs per individual at hospital admission and discharge were compared using the Wilcoxon signed-rank test...
February 14, 2018: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29388528/completed-audit-cycle-to-explore-the-use-of-the-stopp-start-toolkit-to-optimise-medication-in-psychiatric-in-patients-with-dementia
#2
Victor M Aziz, Natalie Hill, Sugandha Kumar
Aims and method To explore the use of the STOPP/START toolkit in older psychiatric in-patients with dementia. Clinical records and current drug charts were reviewed against STOPP/START criteria for all in-patients (n = 86) on six specialist dementia wards. RESULTS: Benzodiazepines, antipsychotics and opiates were most commonly prescribed inappropriately. The most common unprescribed medication groups were statins, calcium supplements and vitamin D supplements. There was an overall reduction of 7% in comorbidities and 8% in the number of prescriptions...
February 2018: BJPsych Bulletin
https://www.readbyqxmd.com/read/29360070/-reduction-of-inappropriate-prescriptions-and-adverse-effects-to-medications-in-hospitalized-elderly-patients
#3
Ana Fajreldines, Eduardo Schnitzler, Jorge T Insua, Mariana Valerio, Laura Davide, Marcelo Pellizzari
Together, potentially inappropriate prescribing of medications (PIP) and appropriate prescribing omission (APO) constitute a problem that requires multiple interventions to reduce its size and the occurrence of adverse drug events (ADE). This study aims to assess PIP, APO, ADE before and after the intervention of a clinical pharmacist over medical prescriptions for elderly hospitalized patients. In a before-after study, a total of 16 542 prescriptions for 1262 patients were analyzed applying the criteria defined in both STOPP- START (screening tool of older people's prescriptions and screening tool to alert to right treatment)...
2018: Medicina
https://www.readbyqxmd.com/read/29301226/impact-of-pharmacist-conducted-comprehensive-medication-reviews-for-older-adult-patients-to-reduce-medication-related-problems
#4
Whitney J Kiel, Shaun W Phillips
Older adults are demanding increased healthcare attention with regards to prescription use due in large part to highly complex medication regimens. As patients age, medications often have a more pronounced effect on older adults, negatively impacting patient safety and increasing healthcare costs. Comprehensive medication reviews (CMRs) optimize medications for elderly patients and help to avoid inappropriate medication use. Previous literature has shown that such CMRs can successfully identify and reduce the number of medication-related problems and improve acute healthcare utilization...
December 31, 2017: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29182733/corrigendum-stopp-start-criteria-for-potentially-inappropriate-prescribing-in-older-people-version-2
#5
Denis O' Mahony, David O' Sullivan, Stephen Byrne, Marie Noelle O' Connor, Cristin Ryan, Paul Gallagher
No abstract text is available yet for this article.
November 22, 2017: Age and Ageing
https://www.readbyqxmd.com/read/29177646/longitudinal-patterns-of-potentially-inappropriate-prescribing-in-early-old-aged-people
#6
Christina Raae Hansen, Stephen Byrne, Shane Cullinan, Denis O'Mahony, Laura J Sahm, Patricia M Kearney
PURPOSE: It is contentious whether potentially inappropriate prescribing (PIP) is predominantly a phenomenon of late life or whether it has its origins in early old age. This study examined the pattern of PIP in an early old-aged population over 5 years. METHODS: Secondary data analysis of a population-based primary care cohort, of patients aged 60-74 years. Medication data were extracted from electronic patient records in addition to information on comorbidities and demographics...
November 25, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29170978/implementing-a-screening-tool-to-improve-prescribing-in-hospitalized-older-patients-a-pilot-study
#7
Anne-Laure Sennesael, Olivia Dalleur, Séverine Henrard, Charline Artoisenet, Didier Schoevaerdts, Anne Spinewine
Background The use of STOPP-START criteria during hospitalization reduced inappropriate medications in randomized controlled trials. Objective To evaluate whether the implementation of a screening tool (short version of STOPP-START criteria) in routine geriatric practice reduces potentially inappropriate medications (PIM) and potential prescribing omissions (PPO) at discharge. Methods We conducted a retrospective interrupted time series analysis. Four periods were selected between February and September 2013: (1) baseline situation; (2) screening tool made available to physicians; (3) 3 months later; (4) weekly meetings with junior doctors and a clinical pharmacist to review treatments according to the tool...
November 23, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29162290/reduction-of-pharmaceutical-expenditure-by-a-drug-appropriateness-intervention-in-polymedicated-elderly-subjects-in-catalonia-spain
#8
Lluís Campins, Mateu Serra-Prat, Elisabet Palomera, Ignasi Bolibar, Miquel Àngel Martínez, Pedro Gallo
OBJECTIVE: To assess the monetary savings resulting from a pharmacist intervention on the appropriateness of prescribed drugs in community-dwelling polymedicated (≥8 drugs) elderly people (≥70 years). METHOD: An evaluation of pharmaceutical expenditure reduction was performed within a randomised, multicentre clinical trial. The study intervention consisted of a pharmacist evaluation of all drugs prescribed to each patient using the "Good Palliative-Geriatric Practice" algorithm and the "Screening Tool of Older Persons Prescriptions/Screening Tool to Alert doctors to Right Treatment" criteria (STOPP/START)...
November 18, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/29096573/drug-related-problems-and-changes-in-drug-utilization-after-medication-reviews-in-nursing-homes-in-oslo-norway
#9
Amura Francesca Fog, Gunnar Kvalvaag, Knut Engedal, Jørund Straand
OBJECTIVE: We describe the drug-related problems (DRPs) identified during medication reviews (MRs) and the changes in drug utilization after MRs at nursing homes in Oslo, Norway. We explored predictors for the observed changes. DESIGN: Observational before-after study. SETTING: Forty-one nursing homes. INTERVENTION: MRs performed by multidisciplinary teams during November 2011 to February 2014. SUBJECTS: In all, 2465 long-term care patients...
November 2, 2017: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/29092735/potentially-inappropriate-prescribing-of-drugs-in-elderly-patients-on-chronic-hemodialysis-treatment%C3%A2
#10
Gorana Nedin Ranković, Slobodan M Janković, Radmila Veličković Radovanović, Zorica Jović, Gordana Pešić, Svetlana Pavlović, Branislava Ranković, Jasmina Ranković, Dragana Stokanović, Dane Krtinić
PURPOSE: The aim of this study was to determine the prevalence of potentially inappropriate drug prescription (PIP) in older patients who were on chronic hemodialysis treatment and to explore the factors that lead to PIP. MATERIALS AND METHODS: The study was performed at the Department of Nephrology, Clinical Center Niš, Serbia. It included patients who were 65 years old and older who suffered from the end-stage of kidney failure and were treated by hemodialysis...
October 26, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29079010/-impact-of-medium-term-outcomes-of-inappropriate-prescribing-in-older-patients-discharged-from-a-short-stay-unit
#11
Elena Rodríguez Del Río, Javier Perdigones, Manuel Fuentes Ferrer, Juan González Del Castillo, Juan González Armengol, M Isabel Borrego Hernando, M Lourdes Arias Fernández, Francisco Javier Martín-Sánchez
OBJECTIVE: To study the association between the potential inappropriate prescriptions (PIP) and the 30 and 180-day adverse event rate after discharge from a Short Stay Unit (SSU). METHODOLOGY: A retrospective cohort observational study was conducted on patients aged ≥75years discharged from an SSU from February to April, 2014. STOPP-START criteria version2 was used. The main outcome was 30 and 180-day adverse event rate after being discharged. RESULTS: A total of 179 patients, with a mean age of 84 (SD5) years were included...
October 25, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28971492/drug-related-problems-identified-during-medication-review-before-and-after-the-introduction-of-a-clinical-decision-support-system
#12
S Verdoorn, H F Kwint, P Hoogland, J Gussekloo, M L Bouvy
WHAT IS KNOWN AND OBJECTIVE: To facilitate the identification of drug-related problems (DRPs) during medication review, several tools have been developed. Explicit criteria, like Beers criteria or STOPP (Screening Tool of Older Peoples' Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment) criteria, can easily be integrated into a clinical decision support system (CDSS). The aim of this study was to investigate the effect of adding a CDSS to medication review software on identifying and solving DRPs in daily pharmacy practice...
October 2, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28939983/-drug-therapy-for-older-people-choosing-wisely
#13
REVIEW
Martin Wehling
Elderly people are the most rapidly growing sector of our society. Due to their multimorbidity they are exposed to a multitude of medications, which are accompanied by chances and risks. The problem of inappropriate medication in the elderly is exacerbated by the fact that only a holistic view can help these patients and that this is predominantly the responsibility of the general practitioner. The closely measured paid contact time is often insufficient to optimize complex medications. Clinically successfully tested aids in the form of lists give reason for hope: in particular, the positive/negative assessment of limitations of the elderly with respect to drugs by the STOPP/START criteria and the FORTA classification are clinically successful aids...
December 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28905171/pharmacist-intervention-acceptance-for-the-reduction-of-potentially-inappropriate-drug-prescribing-in-acute-psychiatry
#14
Sophia Hannou, Pierre Voirol, André Pannatier, Marie-Laure Weibel, Farshid Sadeghipour, Armin von Gunten, Jean-Frédéric Mall, Isabella De Giorgi Salamun
Background Prescribing for the elderly is challenging. A previous observational study conducted in our geriatric psychiatry admission unit (GPAU) using STOPP/START criteria showed a high number of potentially inappropriate drug prescriptions (PIDPs). A clinical pharmacist was added to our GPAU as a strategy to reduce PIDPs. Objective The objective of the present study was to assess the impact of a clinical pharmacist on PIDPs by measuring acceptance rates of pharmacist interventions (PhIs). Setting This study was conducted at the GPAU of Lausanne University Hospital...
December 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28799295/application-of-the-stopp-start-criteria-to-a-medical-record-database
#15
Katinka J Nauta, Feikje Groenhof, Jan Schuling, Jacqueline G Hugtenburg, Hein P J van Hout, Flora M Haaijer-Ruskamp, Petra Denig
PURPOSE: The STOPP/START criteria are increasingly used to assess prescribing quality in elderly patients at practice level. Our aim was to test computerized algorithms for applying these criteria to a medical record database. METHODS: STOPP/START criteria-based computerized algorithms were defined using Anatomical-Therapeutic-Chemical (ATC) codes for medication and International Classification of Primary Care (ICPC) codes for diagnoses. The algorithms were applied to a Dutch primary care database, including patients aged ≥65 years using ≥5 chronic drugs...
October 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28748106/a-feasibility-study-of-a-theory-based-intervention-to-improve-appropriate-polypharmacy-for-older-people-in-primary-care
#16
Cathal A Cadogan, Cristín Ryan, Gerard J Gormley, Jill J Francis, Peter Passmore, Ngaire Kerse, Carmel M Hughes
BACKGROUND: A general practitioner (GP)-targeted intervention aimed at improving the prescribing of appropriate polypharmacy for older people was previously developed using a systematic, theory-based approach based on the UK Medical Research Council's complex intervention framework. The primary intervention component comprised a video demonstration of a GP prescribing appropriate polypharmacy during a consultation with an older patient. The video was delivered to GPs online and included feedback emphasising the positive outcomes of performing the behaviour...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28535241/management-of-depression-in-older-adults-a-review
#17
REVIEW
Rob M Kok, Charles F Reynolds
Importance: Depression in older adults is a common psychiatric disorder affecting their health-related quality of life. Major depression occurs in 2% of adults aged 55 years or older, and its prevalence rises with increasing age. In addition, 10% to 15% of older adults have clinically significant depressive symptoms, even in the absence of major depression. Observations: Depression presents with the same symptoms in older adults as it does in younger populations...
May 23, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28458417/evaluation-of-polypharmacy-and-appropriateness-of-prescription-in-geriatric-patients-a-cross-sectional-study-at-a-tertiary-care-hospital
#18
K B Rakesh, Mukta N Chowta, Ashok K Shenoy, Rajeshwari Shastry, Sunil B Pai
OBJECTIVES: To assess the polypharmacy and appropriateness of prescriptions in geriatric patients in a tertiary care hospital. METHODS: An observational study was done in geriatric patients (>60 years) of either gender. The data collected from patients included: Socio-demographic data such as age, gender, marital status, educational status, socioeconomic status, occupation, nutritional status, history of alcohol/smoking, exercise history, details of comorbid diseases, medication history, findings of clinical examination etc...
January 2017: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/28458294/deprescribing-using-the-guidelines-for-medical-treatment-and-its-safety-in-the-elderly-and-changes-in-patient-qol-and-activities-of-daily-living
#19
Shigeru Ohshima, Ayaka Hara, Takumi Abe, Hayato Akimoto, Kousuke Ohara, Akio Negishi, Mitsuyoshi Okita, Shinji Oshima, Naoko Inoue, Sachihiko Numajiri, Etsushi Ogawa, Minoru Saiki, Daisuke Kobayashi
Pharmacists applied deprescribing, which is a process for the rational use of drugs, for 13 at-home patients. The standard used for the rational use of drugs was the "Guidelines for Medical Treatment and Its Safety in the Elderly" (the Guidelines). The results of the deprescribing were discussed with physicians to determine prescriptions. After the prescription change, activities of daily living (ADL) and QOL were assessed using the Barthel Index and SF-36v2, respectively. Potentially inappropriate medications (PIMs) were detected in 10 of the 13 patients (76...
2017: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/28423857/the-association-between-the-stopp-start-criteria-and-gastro-intestinal-track-bleedings-in-elderly-patients
#20
Anouk Veldhuis, Danielle Sent, Linette Bruin-Huisman, Erna Beers, Ameen Abu-Hanna
Potentially inappropriate prescribing is a common problem, especially in elderly care. To tackle this problem, Irish medical experts have developed a list of criteria when medication should be added or omitted based upon the patient's physical condition and medication use, known as the STOPP and START criteria. The STOPP and START criteria have been formulated to identify the prescribing of potentially inappropriate medicines (PIMs) and potential prescribing omissions (PPOs). One of the most common problems of inappropriate prescribing is gastro-intestinal track bleedings...
2017: Studies in Health Technology and Informatics
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