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https://www.readbyqxmd.com/read/29160460/polypharmacy-a-challenge-for-the-primary-health-care-of-the-brazilian-unified-health-system
#1
Renata Cristina Rezende Macedo do Nascimento, Juliana Álvares, Augusto Afonso Guerra, Isabel Cristina Gomes, Micheline Rosa Silveira, Ediná Alves Costa, Silvana Nair Leite, Karen Sarmento Costa, Orlando Mario Soeiro, Ione Aquemi Guibu, Margô Gomes de Oliveira Karnikowski, Francisco de Assis Acurcio
OBJECTIVE: To characterize the polypharmacy in primary health care patients and to identify its associated factors. METHODS: This is a cross-sectional, exploratory, and evaluative study, part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos - Serviços, 2015 (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines - Services, 2015). The variable of interest was polypharmacy, defined as the use of five or more medicines...
November 13, 2017: Revista de Saúde Pública
https://www.readbyqxmd.com/read/29159488/inter-rater-reliability-of-stoppfrail-screening-tool-of-older-persons-prescriptions-in-frail-adults-with-limited-life-expectancy-criteria-amongst-12-physicians
#2
Amanda Hanora Lavan, Paul Gallagher, Denis O'Mahony
PURPOSE: STOPPFrail is an explicit tool, developed by Delphi consensus, to assist physicians with deprescribing medications in frail older adults with poor survival prognosis. This study aimed to determine the inter-rater reliability (IRR), amongst physicians, of STOPPFrail application. METHODS: Twenty clinical cases were collated to represent frail older patients. Eighteen cases met STOPPFrail inclusion criteria. They had a mean age of 79.5 (SD6) years and a median of 7 (IQR6-8...
November 20, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29152233/inappropriate-use-of-antibiotics-among-communities-of-gondar-town-ethiopia-a-threat-to-the-development-of-antimicrobial-resistance
#3
Daniel Asfaw Erku, Abebe Basazn Mekuria, Sewunet Admasu Belachew
Background: The emergence of antimicrobial resistance, the main cause of morbidity and mortality from otherwise treatable infections, is largely attributed to the inappropriate use of antimicrobials. However, data on the extent of inappropriate use of antibiotics in the community is scarce in Ethiopia. The aim of present study is to document the extent of inappropriate use of antibiotics and its associated factors among the communities of Gondar, Northwest Ethiopia. Methods: A community based cross-sectional survey was conducted on a total of 650 participants in Gondar town, northwest Ethiopia from December 1, 2016 to January 30, 2017...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29147963/inappropriate-anticholinergic-drugs-prescriptions-in-older-patients-analysing-a-hospital-database
#4
Laurie Ferret, Gregoire Ficheur, Emeline Delaviez, Michel Luyckx, Sophie Quenton, Regis Beuscart, Emmanuel Chazard, Jean-Baptiste Beuscart
Background Although many anticholinergics are inappropriate in older patients, the prescription of these drugs in a hospital setting has not been extensively studied. Objective To describe prescriptions of anticholinergic drugs in terms of frequency, at risk situations and constipation in hospitalized, older adults. Setting Using a database from a French general hospital (period 2009-2013), we extracted information on 14,090 hospital stays by patients aged 75 and over. Methods Anticholinergic drug prescriptions were automatically detected, with a focus on prescriptions in three well-known at-risk situations: falls, dementia, and benign prostatic hyperplasia...
November 17, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29147805/can-clinical-practice-indicator-relating-to-long-acting-benzodiazepine-use-in-the-elderly-be-easily-generated-in-a-hospital-setting
#5
Badria Kadri, Antonio Teixeira, Christelle Duteil, Annabelle Tan, Hélène Barreteau, Christophe Segouin, Pénélope Troude
BACKGROUND: To improve the appropriate use of long-acting benzodiazepine (la.bzd) prescriptions in the elderly, the Haute Autorité de Santé (HAS) has developed clinical practice indicators (CPI). The alert indicator (AI) evaluates the prevalence of la.bzd prescription among older people. The mastering indicator (MI) corresponds to the prevalence of elderly with a justified, i.e., appropriate, la.bzd prescription among all the elderly with la.bzd prescriptions. OBJECTIVE: The objective of this study was to test the feasibility of routine generation of CPI regarding la...
November 16, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29146149/recent-patterns-in-antibiotic-use-for-children-with-group-a-streptococcal-infections
#6
Yusuke Okubo, Nobuaki Michihata, Naho Morisaki, Noriko Kinoshita, Isao Miyairi, Kevin Y Urayama, Hideo Yasunaga
BACKGROUND: Antibiotics are the most frequently prescribed medications for children, but inappropriate prescribing of antibiotics is prevalent. This study investigated recent trends in antibiotic use and factors associated with appropriate antibiotic selection among children with group A streptococcal infections. METHODS: We obtained records of outpatients aged under 18 years with diagnoses of group A streptococcal infections, using the Japan Medical Data Center database...
November 13, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/29145919/potentially-inappropriate-prescription-of-antidepressants-in-old-people-characteristics-associated-factors-and-impact-on-mortality
#7
Anne Hiance-Delahaye, Florence Muller de Schongor, Laurent Lechowski, Laurent Teillet, Jean-Jacques Arvieu, Jean-Marie Robine, Joël Ankri, Marie Herr
BACKGROUND: The increasing use of antidepressants (ADs) has raised concerns about their inappropriate use in old people. OBJECTIVE: To examine the prevalence of potentially inappropriate prescribing (PIP) of ADs, their associated factors, and their impact on mortality in a sample of old people in France. METHODS: The analysis used data from the SIPAF study, a cross-sectional study consisting of 2,350 people aged ≥ 70 years. Trained nurses interviewed participants at home between 2008 and 2010...
November 17, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/29145237/the-impact-of-the-government-health-funding-on-prescribing-behaviors-in-community-health-institutions-in-china
#8
Gang Sun, Zuxun Lu, Yong Gan, Xiaoxin Dong, Yongbin Li, Yunxia Wang, Liqing Li
Government health funding (GHF) is a cosmopolitan problem. It is especially conspicuous in China, where drug sales become a main source of medical institutions' incomes due to limited GHF. This is well known as China's "drug maintain medical institutions (DMMIs)" system which results directly in very high use of antibiotics, injections, and corticosteroids. However, few statistical data existed in China on the association between the GHF and the prevalence of inappropriate drug prescribing, despite widespread acknowledgment of its existence...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29138901/-which-factors-are-associated-with-the-use-of-potentially-inadequate-medications-pim-in-the-elderly-results-from-the-german-health-interview-and-examination-survey-degs1
#9
Heinz G Endres, Petra Kaufmann-Kolle, Hildtraud Knopf, Petra A Thürmann
BACKGROUND: Recent studies demonstrate a relationship between the prescription of potentially inappropriate medications (PIM) for patients 65 years or older and an increased risk for adverse events, in particular hospitalisations. The RKI conducted DEGS1-Survey ("German health interview and examination survey for adults") provides a representative sample of the target population to identify determinants for PIM use. OBJECTIVE: The aim of this study was to determine characteristics of older persons in Germany, who currently use PIM, and if there are subpopulations among older persons with a particularly high PIM use...
November 14, 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/29133312/exploring-perceptions-and-experiences-of-patients-who-have-chronic-pain-as-state-prescription-opioid-policies-change-a-qualitative-study-in-indiana
#10
Morhaf Al Achkar, Debra Revere, Barbara Dennis, Palmer MacKie, Sumedha Gupta, Shaun Grannis
OBJECTIVES: The misuse and abuse of prescription opioids (POs) is an epidemic in the USA today. Many states have implemented legislation to curb the use of POs resulting from inappropriate prescribing. Indiana legislated opioid prescribing rules that went into effect in December 2013. The rules changed how chronic pain is managed by healthcare providers. This qualitative study aims to evaluate the impact of Indiana's opioid prescription legislation on the patient experiences around pain management...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29128999/impact-of-potentially-inappropriate-medications-and-polypharmacy-on-3-month-readmission-among-older-patients-discharged-from-acute-care-hospital-a-prospective-study
#11
Paolo Fabbietti, Giuseppina Di Stefano, Raffaella Moresi, Laura Cassetta, Mirko Di Rosa, Filippo Fimognari, Valentina Bambara, Giovanni Ruotolo, Alberto Castagna, Carmen Ruberto, Fabrizia Lattanzio, Andrea Corsonello
BACKGROUND: Polypharmacy and potentially inappropriate medications (PIMs) are known to affect several negative outcomes in older patients. However, studies comparatively assessing polypharmacy and PIMs in relation to readmission are distinctively lacking. AIMS: To compare the impact of polypharmacy and PIMs on 3-month readmission among older patients discharged from acute care hospital. METHODS: Our series consisted of 647 patients consecutively enrolled in a multicenter observational study...
November 11, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29123310/worldwide-pattern-of-antibiotic-prescription-in-endodontic-infections
#12
(no author information available yet)
Antibiotic prescribing practices are frequently inappropriate in endodontic therapy.
November 10, 2017: British Dental Journal
https://www.readbyqxmd.com/read/29121626/wh%C3%A4-nau-perceptions-and-experiences-of-acute-rheumatic-fever-diagnosis-for-m%C3%A4-ori-in-northland-new-zealand
#13
Anneka Anderson, Clair Mills, Kyle Eggleton
AIM: In New Zealand, acute rheumatic fever (ARF) remains a significant health problem with persistent ethnic inequities. Māori children 5-15 years of age in Northland have some of the highest ARF rates nationally. This study explored Māori whānau experiences of ARF, including pathways to primary healthcare and barriers and facilitators for diagnosis of ARF. METHODS: The study applied a qualitative kaupapa Māori approach including eight whānau, two individual interviews and participant observations with 36 participants...
November 10, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29120540/-detecting-and-assessing-the-impactof-anticholinergic-medications
#14
Chantal Csajka, Catherine Brémond, Pierre Olivier Lang
Limitation of inappropriate prescribing must be a medical concern in daily practice especially in older patients. In particular, anti-cholinergic drugs (anti-ACh), which are not all explicitly classified as anti-ACh, are commonly prescribed for a wide range of indications (pulmonary obstructive diseases, anxiety, insomnia, urinary incontinence, Parkinson's disease, congestive heart failure). Their prescription is however associated with a reduced quality of life and increased morbidity and mortality. Tools detecting inappropriate prescriptions and clinical scales that quantify the anti-ACh burden contribute, despite some limitations, to secure and optimize these drugs' prescription in this vulnerable population...
November 8, 2017: Revue Médicale Suisse
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
#15
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/29107890/potentially-inappropriate-prescribing-according-to-stopp-2-criteria-among-patients-discharged-from-internal-medicine-prevalence-involved-drugs-and-economic-cost
#16
Alfredo José Pardo-Cabello, Victoria Manzano-Gamero, Mónica Zamora-Pasadas, Francisco Gutiérrez-Cabello, David Esteva-Fernández, Juan de Dios Luna-Del Castillo, Juan Jiménez-Alonso
AIM: This study aims to determine the prevalence of potentially inappropriate prescribing (PIP) among patients discharged from Internal Medicine, the drugs and factors associated and economic cost of PIP. METHODS: This retrospective cross-sectional, single-center study included participants aged ≥65 years consecutively discharged from the Internal Medicine Unit in a tertiary hospital of Southern Spain. PIP was defined by the Screening Tool for Older Persons Prescriptions (STOPP-2) criteria version 2 (2015 update)...
November 2, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29105270/inappropriate-inhaled-corticosteroid-prescribing-in-chronic-obstructive-pulmonary-disease-patients
#17
Amelia Harrison, Brigitte Borg, Bruce Thompson, Mark Hew, Eli Dabscheck
The Australian National Chronic Obstructive Pulmonary Disease (COPD) guidelines recommend that inhaled corticosteroids (ICS) be reserved for patients with a post-bronchodilator forced expiratory volume in 1 s (FEV1 ) less than 50% predicted and those who experience ≥2 exacerbations in 12 months. In total, 707 COPD patients were identified from the lung function test database at our tertiary hospital; 52.4% of patients with a post-bronchodilator FEV1 ≥50% were prescribed an ICS. Significant discordance exists between guideline recommendations and inhaler prescription...
November 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29102353/effect-of-a-training-and-educational-intervention-for-physicians-and-caregivers-on-antibiotic-prescribing-for-upper-respiratory-tract-infections-in-children-at-primary-care-facilities-in-rural-china-a-cluster-randomised-controlled-trial
#18
Xiaolin Wei, Zhitong Zhang, John D Walley, Joseph P Hicks, Jun Zeng, Simin Deng, Yu Zhou, Jia Yin, James N Newell, Qiang Sun, Guanyang Zou, Yan Guo, Ross E G Upshur, Mei Lin
BACKGROUND: Inappropriate antibiotic prescribing contributes to the generation of drug resistance worldwide, and is particularly common in China. We assessed the effectiveness of an antimicrobial stewardship programme aiming to reduce inappropriate antibiotic prescribing in paediatric outpatients by targeting providers and caregivers in primary care hospitals in rural China. METHODS: We did a pragmatic, cluster-randomised controlled trial with a 6-month intervention period...
December 2017: Lancet Global Health
https://www.readbyqxmd.com/read/29092735/potentially-inappropriate-prescribing-of-drugs-in-elderly-patients-on-chronic-hemodialysis-treatment%C3%A2
#19
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/29091149/interventions-of-the-clinical-pharmacist-in-an-intermediate-care-unit-for-elderly-patients
#20
Stéphanie de Souza Costa Viana, Tiago Arantes, Sabrina Corrêa da Costa Ribeiro
OBJECTIVE: To discuss the role of the clinical pharmacist in hospital care of critical elderly patients. METHODS: Critical patients aged 60 years and over admitted by the clinical staff to an Intermediate Care Unit were followed-up for 4 months regarding their drug therapies. Medical prescriptions were reviewed daily on the basis of patients' clinical conditions, with the view to identify opportunities for optimization of drug therapies, contributing to safer prescribing, reduced discomfort and correct and rational use of drugs...
July 2017: Einstein
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