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https://www.readbyqxmd.com/read/27910294/medication-management-in-the-older-adult-a-narrative-exploration
#1
Johnanna Hernandez
BACKGROUND AND PURPOSE: The purpose of this study was to characterize the meaning nurse practitioners (NPs) ascribed to personal experiences providing care to older adults who take multiple medications to manage complex conditions. The study illuminated the NP experience in caring for the older adult while addressing the complexities of medication management through narrative stories in practice. METHODS: NPs self-identifying as caring for older adults were interviewed (N=15)...
December 2, 2016: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/27907210/assessing-potentially-inappropriate-prescribing-in-community-dwelling-older-patients-using-the-updated-version-of-stopp-start-criteria-a-comparison-of-profiles-and-prevalences-with-respect-to-the-original-version
#2
Encarnación Blanco-Reina, Maria Rosa García-Merino, Ricardo Ocaña-Riola, Lorena Aguilar-Cano, Jennifer Valdellós, Inmaculada Bellido-Estévez, Gabriel Ariza-Zafra
Emerging and changing evidence made it necessary to update STOPP-START criteria, and version 2 was published recently. In this study the objectives were to determine the prevalence of potentially inappropriate medication prescribing (PIM) in primary care using STOPP versions 1 (v1) and 2 (v2), as well as 2012 AGS Beers criteria, and analyze the factors associated with inappropriate prescribing according to STOPP/START v2. A cross-sectional study was carried out including community-dwelling older adults over the age of 65...
2016: PloS One
https://www.readbyqxmd.com/read/27902720/intervention-to-improve-appropriate-prescribing-and-reduce-polypharmacy-in-elderly-patients-admitted-to-an-internal-medicine-unit
#3
Milena Urfer, Luigia Elzi, Salome Dell-Kuster, Stefano Bassetti
BACKGROUND: Polypharmacy and inappropriate medication prescriptions are associated with increased morbidity and mortality. Most interventions proposed to improve appropriate prescribing are time and resource intensive and therefore hardly applicable in daily clinical practice. OBJECTIVE: To test the efficacy of an easy-to-use checklist aimed at supporting the therapeutic reasoning of physicians in order to reduce inappropriate prescribing and polypharmacy. METHODS: We assessed the efficacy and safety of a 5-point checklist to be used by all physicians on the internal medicine wards of a Swiss hospital by comparing outcomes in 450 consecutive patients aged ≥65 years hospitalized after the introduction of the checklist, and in 450 consecutive patients ≥65 years hospitalized before the introduction of the checklist...
2016: PloS One
https://www.readbyqxmd.com/read/27900070/potentially-inappropriate-medications-by-beers-criteria-in-older-outpatients-prevalence-and-risk-factors
#4
Yeon-Jung Lim, Ha-Yeon Kim, Jaekyung Choi, Ji Sun Lee, Ah-Leum Ahn, Eun-Jung Oh, Dong-Yung Cho, Hyuk-Jung Kweon
BACKGROUND: Prescription of inappropriate medicine to elderly patients is a major public health care concern. The Beers criteria have been commonly employed as a screening tool to identify the use of potentially inappropriate medications (PIMs). The present study investigated the prevalence of PIM use according to the Beers criteria as well as factors related to PIM use. METHODS: Data obtained from a retrospective survey included 25,810 outpatients aged ≥65 years from a university medical center in Seoul, Korea...
November 2016: Korean Journal of Family Medicine
https://www.readbyqxmd.com/read/27894225/agreement-between-the-2009-stopp-criteria-and-the-2003-beers-criteria-at-the-time-of-hospital-admission
#5
María Muñoz García, Eva Delgado Silveira, Sagrario Martín-Aragón Álvarez, Teresa Bermejo Vicedo, Alfonso José Cruz-Jentoft
: Potentially inappropriate prescription in elderly patients can be evaluated by different methods. The STOPP Criteria and Beers Criteria stand out among the explicit criteria most widely used. OBJECTIVE: The main objective of this study is to identify the agreement in the detection of potentially inappropriate prescribing between the STOPP criteria and the Beers Criteria, in elderly patients assessed at the time of hospital admission. METHOD: An observational retrospective study was designed in order to estimate the prevalence of potentially inappropriate prescription in the habitual treatment before admission, and to compare the agreement in detection capability between the 2003 Beers Criteria and the 2009 STOPP Criteria, in >70-yearold patients with an emergency hospital admission...
November 1, 2016: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/27890352/residential-aged-care-medication-review-to-improve-the-quality-of%C3%A2-medication-use-a-systematic-review
#6
REVIEW
Kaeshaelya Thiruchelvam, Syed Shahzad Hasan, Pei Se Wong, Therese Kairuz
BACKGROUND: Aging is often associated with various underlying comorbidities that warrant the use of multiple medications. Various interventions, including medication reviews, to optimize pharmacotherapy in older people residing in aged care facilities have been described and evaluated. Previous systematic reviews support the positive impact of various medication-related interventions but are not conclusive because of several factors. OBJECTIVES: The current study aimed to assess the impact of medication reviews in aged care facilities, with additional focus on the types of medication reviews, using randomized controlled trials (RCTs) and observational studies...
November 24, 2016: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/27888429/inappropriateness-of-diagnostic-imaging-examinations-in-the-inpatient-setting-a-case-study-research
#7
Ettore Squillaci, Francesca Bolacchi, Jacopo Scaggiante, Francesca Ricci, Luca Pugliese, Alberto Bergamini, Francesco Garaci, Roberto Floris
OBJECTIVE: The purpose of our study was to audit the clinical appropriateness of the prescriptions of whole body CT (WB-CT), PET-CT and chest X-rays (CXRs) performed at Tor Vergata University Hospital in the inpatient setting. MATERIALS AND METHODS: WB-CT, PET-CT and CXRs examinations were retrospectively analysed in the period between January and December 2014. CXR examinations were divided into bedside CXRs and traditional CXRs. The appropriateness of the examinations was defined according the American College of Radiology Appropriateness Criteria...
November 25, 2016: La Radiologia Medica
https://www.readbyqxmd.com/read/27888304/the-wearable-cardioverter-defibrillator-in-a-real-world-clinical-setting-experience-in-102-consecutive-patients
#8
Julia W Erath, Mate Vamos, Abdul Sami Sirat, Stefan H Hohnloser
BACKGROUND: The wearable cardioverter-defibrillator (WCD) is used for temporary protection of patients deemed to be at high risk for sudden death (SCD) not yet meeting indications for the implantable defibrillator (ICD). OBJECTIVES: To evaluate the efficacy, safety, and compliance of/to WCD use and subsequent medium-term outcome of patients in a single-center observational study. METHODS: A total of 102 consecutive patients were fitted with the WCD from 2012 to 2015 and followed for a mean of 11 months (±8 months)...
November 25, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/27877048/utilization-of-gastroprotective-strategies-for-nonsteroidal-anti-inflammatory-drug-induced-gastrointestinal-events-in-a-major-teaching-hospital
#9
Hooi Leng Lee, Siew Siang Chua, Sanjiv Mahadeva
BACKGROUND AND PURPOSE: Clinical guidelines recommend the prescribing of gastroprotective strategies in nonsteroidal anti-inflammatory drug (NSAID) users with risk factors for gastrointestinal (GI) ulcer or ulcer complications. However, these guidelines are not often translated into clinical practice. Therefore, the aim of this study was to investigate the utilization of gastroprotective strategies for NSAID-induced upper GI events in at-risk users in a major teaching hospital. PATIENTS AND METHODS: A cross-sectional, observational, pharmacy-based study was conducted in a major Asian institution with both primary and secondary health care services...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/27836969/knowledge-and-attitudes-towards-the-use-of-antibiotics-in-the-paediatric-age-group-a-multicenter-survey-in-italy
#10
Fabrizio Bert, Maria R Gualano, Renata Gili, Giacomo Scaioli, Emanuela Lovato, Italo F Angelillo, Silvio Brusaferro, Elisabetta De Vito, Giuseppe La Torre, Lamberto Manzoli, Francesco Vitale, Walter Ricciardi, Roberta Siliquini
BACKGROUND: The misuse of antibiotics is one of the leading causes of antibiotic resistance. Paediatric patients are highly involved in this issue, as they are those who receive the largest amount of prescriptions of these drugs. Therefore, this study aimed to investigate the general knowledge regarding the use of antibiotics, as well as the attitudes related to the administration of these drugs to children, amongst parents of children in the paediatric age-group. METHODS: In 2014, a multicentre cross-sectional study was conducted amongst parents of children aged 0-14...
November 11, 2016: European Journal of Public Health
https://www.readbyqxmd.com/read/27825595/effect-of-a-national-4c-antibiotic-stewardship-intervention-on-the-clinical-and-molecular-epidemiology-of-clostridium-difficile-infections-in-a-region-of-scotland-a-non-linear-time-series-analysis
#11
Timothy Lawes, José-María Lopez-Lozano, Cesar A Nebot, Gillian Macartney, Rashmi Subbarao-Sharma, Karen D Wares, Carolyn Sinclair, Ian M Gould
BACKGROUND: Whereas many antibiotics increase risk of Clostridium difficile infection through dysbiosis, epidemic C difficile ribotypes characterised by multidrug resistance might depend on antibiotic selection pressures arising from population use of specific drugs. We examined the effect of a national antibiotic stewardship intervention limiting the use of 4C antibiotics (fluoroquinolones, clindamycin, co-amoxiclav, and cephalosporins) and other infection prevention and control strategies on the clinical and molecular epidemiology of C difficile infections in northeast Scotland...
November 4, 2016: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/27825371/effective-and-safe-proton-pump-inhibitor-therapy-in-acid-related-diseases-a-position-paper-addressing-benefits-and-potential-harms-of-acid-suppression
#12
EDITORIAL
Carmelo Scarpignato, Luigi Gatta, Angelo Zullo, Corrado Blandizzi
BACKGROUND: The introduction of proton pump inhibitors (PPIs) into clinical practice has revolutionized the management of acid-related diseases. Studies in primary care and emergency settings suggest that PPIs are frequently prescribed for inappropriate indications or for indications where their use offers little benefit. Inappropriate PPI use is a matter of great concern, especially in the elderly, who are often affected by multiple comorbidities and are taking multiple medications, and are thus at an increased risk of long-term PPI-related adverse outcomes as well as drug-to-drug interactions...
November 9, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27819205/iron-deficiency-anemia-in-the-emergency-department-over-utilization-of-red-blood-cell-transfusion-and-infrequent-use-of-iron-supplementation
#13
Jordan Spradbrow, Yulia Lin, Dominick Shelton, Jeannie Callum
OBJECTIVES: Three are no clinical practice guidelines that specifically address the management of patients with iron deficiency anemia (IDA) in the emergency department (ED). The goal of this study was to describe the characteristics of IDA patients who present to the ED, documentation of IDA by emergency physicians, utilization of iron supplementation, and the appropriateness of red blood cell (RBC) transfusions ordered in the ED. METHODS: A retrospective medical chart review was performed of IDA patients who visited the ED of a large tertiary center over a three-month period...
November 7, 2016: CJEM
https://www.readbyqxmd.com/read/27818680/identifying-risk-factors-associated-with-inappropriate-use-of-acid-suppressive-therapy-at-a-community-hospital
#14
Amandeep Singh, Vijay Bodukam, Kirit Saigal, Jaya Bahl, Yvette Wang, Alexandra Hanlon, Yinghui Lu, Michael Davis
Purpose. By examining the prescribing patterns and inappropriate use of acid suppressive therapy (AST) during hospitalization and at discharge we sought to identify the risk factors associated with such practices. Methods. In this retrospective observational study, inpatient records were reviewed from January 2011 to December 2013. Treatment with AST was considered appropriate if the patient had a known specific indication or met criteria for stress ulcer prophylaxis. Results. In 2011, out of 58 patients who were on AST on admission, 32 were newly started on it and 23 (72%) were inappropriate cases...
2016: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/27815152/has-asthma-medication-use-caught-up-with-the-evidence-a-12-year-population-based-study-of-trends
#15
Mohsen Sadatsafavi, Hamid Tavakoli, Larry Lynd, J Mark FitzGerald
BACKGROUND: The importance of balance between controller and reliever medications in asthma is recognized. However, to what extent real-world practice has caught up with evidence-based guidelines is not studied. METHODS: This was a retrospective cohort study of individuals 15 to 67 years old who satisfied a validated case definition of asthma in the administrative health data of British Columbia, Canada, between 2002 and 2013. Each patient-year was assessed for inappropriate and excessive prescription of SABAs and the balance between controller and reliever medications...
November 1, 2016: Chest
https://www.readbyqxmd.com/read/27812804/paediatric-antibiotic-prescriptions-in-primary-care-in-the-alpes-maritimes-area-of-southeastern-france-between-2008-and-2013
#16
P Touboul-Lundgren, P Bruno, L Bailly, B Dunais, C Pradier
France has remained among the top five European countries for ambulatory antibiotic consumption since such monitoring began in 1998. Young children are major antibiotic consumers, in spite of the viral origin of most infections in this population. Recommendations were updated in 2011 to limit prescriptions. In order to assess their impact, diagnoses and prescriptions were compared in a population of children attending daycare centres in southeastern France in 2008 and 2012. Trends in the reimbursement of paediatric antibiotic prescriptions by the national health insurance (NHI) for the whole area were also studied...
November 3, 2016: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/27809770/knowledge-attitudes-and-practices-towards-antibiotic-use-in-upper-respiratory-tract-infections-among-patients-seeking-primary-health-care-in-singapore
#17
Darius Shaw Teng Pan, Joyce Huixin Huang, Magdalene Hui Min Lee, Yue Yu, Mark I-Cheng Chen, Ee Hui Goh, Lili Jiang, Joash Wen Chen Chong, Yee Sin Leo, Tau Hong Lee, Chia Siong Wong, Victor Weng Keong Loh, Adrian Zhongxian Poh, Tat Yean Tham, Wei Mon Wong, Fong Seng Lim
BACKGROUND: Patients' expectations can influence antibiotic prescription by primary healthcare physicians. We assessed knowledge, attitude and practices towards antibiotic use for upper respiratory tract infections (URTIs), and whether knowledge is associated with increased expectations for antibiotics among patients visiting primary healthcare services in Singapore. METHODS: Data was collected through a cross-sectional interviewer-assisted survey of patients aged ≥21 years waiting to see primary healthcare practitioners for one or more symptoms suggestive of URTI (cough, sore throat, runny nose or blocked nose) for 7 days or less, covering the demographics, presenting symptoms, knowledge, attitudes, beliefs and practices of URTI and associated antibiotic use...
November 3, 2016: BMC Family Practice
https://www.readbyqxmd.com/read/27795305/carbapenem-resistant-acinetobacter-baumannii-and-enterobacteriaceae-in-south-and-southeast-asia
#18
REVIEW
Li-Yang Hsu, Anucha Apisarnthanarak, Erum Khan, Nuntra Suwantarat, Abdul Ghafur, Paul Anantharajah Tambyah
Carbapenem-resistant Gram-negative bacteria, in particular the Acinetobacter baumannii-calcoaceticus complex and Enterobacteriaceae, are escalating global public health threats. We review the epidemiology and prevalence of these carbapenem-resistant Gram-negative bacteria among countries in South and Southeast Asia, where the rates of resistance are some of the highest in the world. These countries house more than a third of the world's population, and several are also major medical tourism destinations. There are significant data gaps, and the almost universal lack of comprehensive surveillance programs that include molecular epidemiologic testing has made it difficult to understand the origins and extent of the problem in depth...
January 2017: Clinical Microbiology Reviews
https://www.readbyqxmd.com/read/27792075/reducing-inappropriate-antibiotic-prescribing-for-adults-with-acute-bronchitis-in-an-urgent-care-setting-a-quality-improvement-initiative
#19
Tamara L Link, Mary L Townsend, Eugene Leung, Sekhar Kommu, Rhonda Y Vega, Cristina C Hendrix
Acute bronchitis is a predominantly viral illness and, according to clinical practice guidelines, should not be treated with antibiotics. Despite clear guidelines, acute bronchitis continues to be the most common acute respiratory illness for which antibiotics are incorrectly prescribed. Although the national benchmark for antibiotic prescribing for adults with acute bronchitis is 0%, a preliminary record review before implementing the intervention at the project setting showed that 96% (N = 30) of adults with acute bronchitis in this setting were prescribed an antibiotic...
October 2016: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/27785039/inappropriateness-of-medication-prescriptions-about-chronic-kidney-disease-patients-without-dialysis-therapy-in-a-chinese-tertiary-teaching-hospital
#20
Ping Yang, Na Chen, Rong-Rong Wang, Lu Li, Sai-Ping Jiang
BACKGROUND: With the increasing incidence rate of chronic kidney disease (CKD), inappropriate use of medicine in CKD patients is an important issue, as it may cause adverse effects in patients and progression to chronic renal failure. OBJECTIVE: The aim of this study is to assess the frequency of inappropriate medicine use among CKD patients. METHODS: A cross-sectional study was conducted from November 1 to December 1, 2014 in a Chinese teaching tertiary hospital...
2016: Therapeutics and Clinical Risk Management
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