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https://www.readbyqxmd.com/read/29330585/potentially-inappropriate-medications-in-community-dwelling-older-adults-undertaken-as-a-comprehensive-geriatric-risk-assessment
#1
Sharmin S Bala, Sujita W Narayan, Prasad S Nishtala
PURPOSE: The prescription of potentially inappropriate medications (PIMs) is associated with an increase in adverse events, prescribing cascades, high health-care costs, morbidity, and mortality in the elderly. The overarching objective of this study is to examine the prevalence of PIMs in the elderly, applying the 2012 American Geriatrics Society Beers criteria for the study period 2012-2014, and the updated 2015 Beers criteria for 2015. METHODS: The study population (N = 70,479) included a continuously recruited national cohort of community-dwelling older (aged ≥ 65 years) New Zealanders who had undertaken the International Resident Assessment Instrument-Home Care (interRAI-HC) assessments between September 2012 and October 2015...
January 12, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29326146/prior-authorization-requirements-for-proprotein-convertase-subtilisin-kexin-type-9-inhibitors-across-us-private-and-public-payers
#2
Jalpa A Doshi, Justin T Puckett, Michael S Parmacek, Daniel J Rader
BACKGROUND: Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9is) are an innovative treatment option for patients with familial hypercholesterolemia or clinical atherosclerotic cardiovascular disease who require further lowering of low-density lipoprotein cholesterol. However, the high costs of these agents have spurred payers to implement utilization management policies to ensure appropriate use. We examined prior authorization (PA) requirements for PCSK9is across private and public US payers...
January 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29325708/promising-roles-for-pharmacists-in-addressing-the-u-s-opioid-crisis
#3
Wilson M Compton, Christopher M Jones, Jack B Stein, Eric M Wargo
Overdoses of prescription or illicit opioids claimed the lives of 116 Americans each day in 2016, and the crisis continues to escalate. As healthcare systems evolve to address the crisis, the potential of pharmacists to make a positive difference is significant. In addition to utilizing available prescription drug monitoring programs to help prevent diversion of opioids, practicing pharmacists can be alert for signs of opioid misuse by patients (e.g., multiple prescriptions from different physicians) as well as inappropriate prescribing or hazardous drug combinations that physicians may not be aware of (e...
December 31, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29324733/antibiotics-dispensed-to-privately-insured-pregnant-women-with-urinary-tract-infections-united-states-2014
#4
Elizabeth C Ailes, April D Summers, Emmy L Tran, Suzanne M Gilboa, Kathryn E Arnold, Dana Meaney-Delman, Jennita Reefhuis
Urinary tract infections (UTIs) occur in about 8% of pregnant women, and untreated UTIs can have serious consequences, including pyelonephritis, preterm labor, low birth weight, and sepsis (1). Pregnant women are typically screened for UTIs during early pregnancy, and those with bacteriuria are treated with antibiotics (1,2). Antibiotic stewardship is critical to improving patient safety and to combating antibiotic resistance. Because of the potential risk for birth defects, including anencephaly, heart defects, and orofacial clefts, associated with use of sulfonamides and nitrofurantoin during pregnancy (3), a 2011 committee opinion from the American College of Obstetricians and Gynecologists (ACOG) recommended that sulfonamides and nitrofurantoin may be prescribed in the first trimester of pregnancy only when other antimicrobial therapies are deemed clinically inappropriate (4)...
January 12, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29318696/an-underutilised-resource-for-antimicrobial-stewardship-a-snapshot-of-the-community-pharmacists-role-in-delayed-or-wait-and-see-antibiotic-prescribing
#5
Minyon L Avent, Jasmina Fejzic, Mieke L van Driel
OBJECTIVES: Various strategies have been implemented in primary care to address the inappropriate use of antibiotics, with varying degrees of success. One such intervention is delayed or 'wait and see' prescribing, where the prescriber indicates to wait a few days before dispensing the antibiotic. The aim of this study was to explore community pharmacists' perceptions and practice experiences with delayed antibiotic prescribing. METHODS: An online survey was advertised in two professional pharmacy organisations' e-newsletters for community and internship pharmacists in Queensland, Australia, from January to April 2016...
January 10, 2018: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29301226/impact-of-pharmacist-conducted-comprehensive-medication-reviews-for-older-adult-patients-to-reduce-medication-related-problems
#6
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/29278992/comorbidity-polytherapy-and-drug-interactions-in-a-neurological-context-an-example-of-a-multidisciplinary-approach-to-promote-the-rational-use-of-drugs
#7
Giulia Busa, Alessandro Burlina, Vera Damuzzo, Marco Chiumente, Angelo C Palozzo
PURPOSE: A high number of adverse drug reactions (ADRs), mainly caused by drug-drug interactions (DDIs), occur in neurological wards and few data are available about incidence and prevalence of DDIs in this context. This study investigated-(1) the prevalence of drug-drug and drug-disease interactions in patients admitted to a neurological unit in Italy, (2) the risk factors for DDIs, and (3) the diseases and the drug classes mostly involved in drug-drug and drug-disease interactions. METHODS: For 2 months, we performed a retrospective, observational study in the neurological unit of St Bassiano Hospital, enrolling 79 patients who received a drug prescription at discharge...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29278890/prevalence-of-potentially-inappropriate-medication-use-in-older-inpatients-with%C3%A2-and%C3%A2-without-cognitive-impairment-a%C3%A2-systematic-review
#8
Mitchell R Redston, Sarah N Hilmer, Andrew J McLachlan, Alexander J Clough, Danijela Gnjidic
BACKGROUND: Older people with cognitive impairment, including dementia and delirium, are high users of acute care services internationally. Potentially inappropriate medication (PIM) use may be associated with adverse outcomes, including hospital re-admission, functional disability, and mortality. OBJECTIVE: This systematic review aimed to quantify and compare the prevalence of PIMs in older inpatients with and without cognitive impairment. METHODS: A systematic search of observational studies was performed independently assessed by two reviewers in Embase, Medline, PsycINFO, International Pharmaceutical Abstracts, Scopus, and Informit...
December 16, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29273329/validation-of-the-friedewald-formula-for-the-estimation-of-low-density-lipoprotein-cholesterol-in-a-sub-saharan-african-population
#9
Simeon-Pierre Choukem, Tasha Manases, Jean-Pierre Nda-Mefo, Christian Akem Dimala, Yannick Mboue-Djieka, Eugene Sobngwi, Andre-Pascal Kengne
BACKGROUND: Low density lipoprotein cholesterol (LDL-C) levels are used to estimate cardiovascular disease (CVD) risk and to guide prescriptions. To circumvent the challenges of direct LDL-C measurement, guidelines recommend the use of Friedewald formula derived LDL-C levels. Despite reported limitations of this formula, its validity in sub-Saharan Africans has not been adequately investigated. OBJECTIVE: To assess the validity of the Friedewald formula derived against directly (homogeneous) measured LDL-C in adult Cameroonians...
December 19, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/29273072/monitoring-adherence-to-guidelines-of-antibiotic-use-in-pediatric-pneumonia-the-marea-study
#10
Pasquale Di Pietro, Ornella Della Casa Alberighi, Michela Silvestri, Maria Angela Tosca, Anna Ruocco, Giorgio Conforti, Giovanni A Rossi, Elio Castagnola, Maria Caterina Merlano, Simona Zappettini, Salvatore Renna
BACKGROUND: Children are the most vulnerable population exposed to the use of antibiotics often incorrectly prescribed for the treatment of infections really due to viruses rather than to bacteria. We designed the MAREA study which consisted of two different studies: i) a surveillance study to monitor the safety/efficacy of the antibiotics for the treatment of pneumonia (CAP), pharyngotonsillitis and acute otitis media in children younger than 14 yrs old, living in Liguria, North-West Italy and ii) a pre-/post-interventional study to evaluate the appropriateness of antibiotic prescription for the treatment these infections...
December 22, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29259056/socioeconomic-differences-in-self-medication-among-middle-aged-and-older-people-data-from-the-china-health-and-retirement-longitudinal-study
#11
Jie Chang, Qing Wang, Yu Fang
OBJECTIVES: Self-medication with over-the-counter medicines (OTCs) and prescription-only medicines (POMs) are both pervasive in China, although the latter is an inappropriate practice. We examined the relationship between socioeconomic status (SES) and self-medication with OTCs versus POMs. METHODS: Multivariate logistic regressions based on the Andersen framework were estimated using a subsample of respondents aged 45 years and over from the China Health and Retirement Longitudinal Study collected between 2011 and 2013 (n=23 699)...
December 19, 2017: BMJ Open
https://www.readbyqxmd.com/read/29246708/prescription-of-dpp-4-inhibitors-to-type-2-diabetes-mellitus-patients-with-renal-impairment-a-uk-primary-care-experience
#12
Dionysis Spanopoulos, Brendan Barrett, Michael Busse, Toni Roman, Chris Poole
Members of the dipeptidyl peptidase-4 inhibitor drug class are indicated for glycemic control in patients with type 2 diabetes mellitus and all, except linagliptin, require dose adjustment in renal impairment. A cross-sectional analysis of a cohort of type 2 diabetes mellitus patients treated with dipeptidyl peptidase-4 inhibitors identified in the Clinical Practice Research Datalink was conducted to explore compliance with the renal adjustment requirements of the Summaries of Product Characteristics. Approximately one third of type 2 diabetes mellitus patients with creatinine clearance <50 mL/min who were at risk of inappropriate prescribing, were initiated on a DPP-4 inhibitor at a higher dose than the specified in their respective Summary of Product Characteristics...
December 12, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/29246247/intervention-to-improve-the-appropriate-use-of-polypharmacy-for-older-patients-with-hip-fractures-an-observational-study
#13
Junpei Komagamine, Kazuhiko Hagane
BACKGROUND: Polypharmacy is frequently observed in hip fracture patients. Although it is associated with an increased risk of hip fracture, polypharmacy often continues after hip fracture recovery. This study aimed to evaluate the effectiveness of an intervention to improve appropriate polypharmacy for elderly patients admitted to the hospital for hip fractures. METHODS: We conducted a retrospective observational study to compare the outcomes of patients receiving the intervention (n = 32) with those of patients who received usual care (n = 132)...
December 16, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29240799/inappropriate-self-medication-among-adolescents-and-its-association-with-lower-medication-literacy-and-substance-use
#14
Chun-Hsien Lee, Fong-Ching Chang, Sheng-Der Hsu, Hsueh-Yun Chi, Li-Jung Huang, Ming-Kung Yeh
BACKGROUND: While self-medication is common, inappropriate self-medication has potential risks. This study assesses inappropriate self-medication among adolescents and examines the relationships among medication literacy, substance use, and inappropriate self-medication. METHOD: In 2016, a national representative sample of 6,226 students from 99 primary, middle, and high schools completed an online self-administered questionnaire. Multiple logistic regression analysis was used to examine factors related to inappropriate self-medication...
2017: PloS One
https://www.readbyqxmd.com/read/29237045/informing-antimicrobial-stewardship-factors-associated-with-inappropriate-antimicrobial-prescribing-in-primary-care
#15
Alexander Singer, Sergio Fanella, Leanne Kosowan, Jamie Falk, Brenden Dufault, Kevin Hamilton, Ashley Walus
Background: Antimicrobial stewardship (AS) programs promote the optimal use of antimicrobials and safe patient care. With most antimicrobials prescribed in the ambulatory setting, establishing benchmark data is imperative to gauge the impact of future AS initiatives. Objectives: To determine the frequency of potentially inappropriate antimicrobial prescribing in primary care practices in Manitoba, Canada and to assess the association between potentially inappropriate antimicrobial prescribing and patient, prescriber and practice-related factors...
December 10, 2017: Family Practice
https://www.readbyqxmd.com/read/29221946/-facing-a-dilemma-in-elderly-complex-and-vulnerable-patients-to-stop-or-not-to-stop-prevention
#16
Laura Llobet Vila, Josep Maria Manresa Domínguez, José Manuel Carmona Segado, Alícia Franzi Sisó, Rosa Vallès Balasch, Isabel Martínez Díaz
OBJECTIVES: 1-To know the preventive prescription (statin, antiplatelet drugs, bisphosphonates, calcium and vitamin D and Vit B12) of elderly patients previously identified as a CCD (with a complex chronic disease) and ACD (with advanced chronic disease and lifetime expectancy of less than 12 months) who died during 2015. 2-To assess the correct indication of Proton Pump Inhibitors (PPI) to determine potentially avoidable medication. DESIGN: Retrospective observational study...
December 5, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/29215370/opioid-use-after-discharge-in-postoperative-patients-a-systematic-review
#17
Adina E Feinberg, Tyler R Chesney, Sanjho Srikandarajah, Sergio A Acuna, Robin S McLeod
BACKGROUND: Over the past 2 decades, there has been an increase in opioid use and subsequently, opioid deaths. The amount of opioid prescribed to surgical patients has also increased. The aim of this systematic review was to determine postdischarge opioid consumption in surgical patients compared with the amount of opioid prescribed. Secondary outcomes included adequacy of pain control and disposal methods for unused opioids. OBJECTIVE: The objective of this study is to characterize postdischarge opioid consumption and prescription patterns in surgical patients...
December 5, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29208206/prospective-study-of-nsaids-prescribing-in%C3%A2-saudi-arabia-cardiovascular-and-gastrointestinal-risk-in-patients-with-diabetes%C3%A2-mellitus%C3%A2
#18
Faizan Mazhar, Nafis Haider, Jabeen Sultana, Shahzad Akram, Yousif Ahmed
OBJECTIVES: The purpose of this study was to investigate the patterns of nonsteroidal anti-inflammatory drug (NSAID) prescriptions in diabetes mellitus (DM) patients and to evaluate their suitability based on patient gastrointestinal/cardiovascular (GI/CV) risk profiles. MATERIALS AND METHODS: We retrospectively identified patients with DM, who were seen at a primary care facility from March 1 to 31, 2016. GI risk factors, CV histories, and current medications were recorded...
December 6, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29205419/community-pharmacists-leaders-for-antibiotic-stewardship-in-respiratory-tract-infection
#19
S Essack, J Bell, A Shephard
WHAT IS KNOWN AND OBJECTIVE: Hospital-based pharmacists are established antibiotic stewards, but the potential for community pharmacists is largely untapped. This commentary explores the potential leadership role of the community pharmacist in antibiotic stewardship using upper respiratory tract infection (URTI) as an example. COMMENT: Community pharmacists are well placed for antibiotic stewardship, possessing the capability (knowledge of medicines), opportunity (contact with prescribers and patients) and inherent commitment...
December 4, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29202811/high-prevalence-of-prescription-of-psychotropic-drugs-for-older-patients-in-a-general-hospital
#20
Inken Arnold, Kati Straube, Wolfgang Himmel, Stephanie Heinemann, Vivien Weiss, Laura Heyden, Eva Hummers-Pradier, Roland Nau
BACKGROUND: Many elderly patients receive psychotropic drugs. Treatment with psychotropic agents is associated with serious side effects including an increased risk of falls and fractures. Several psychotropic drugs are considered potentially inappropriate for treatment of the elderly. METHODS: A retrospective chart review was conducted covering all patients aged ≥ 65 years who were admitted to Evangelisches Krankenhaus Göttingen-Weende between 01/01/2013 and 03/31/2013...
December 4, 2017: BMC Pharmacology & Toxicology
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