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https://www.readbyqxmd.com/read/28432600/potentially-inappropriate-antihypertensive-prescriptions-to-elderly-patients-results-of-a-prospective-observational-study
#1
Paola H Ponte Márquez, Olga H Torres, Anonio San-José, Xavier Vidal, Antonia Agustí, Francesc Formiga, Alfonso López-Soto, Nieves Ramírez-Duque, Antonio Fernández-Moyano, Juana Garcia-Moreno, Juan A Arroyo, Domingo Ruiz
INTRODUCTION: Previous studies of antihypertensive treatment of older patients have focused on blood pressure control, cardiovascular risk or adherence, whereas data on inappropriate antihypertensive prescriptions to older patients are scarce. OBJECTIVES: The aim of the study was to assess inappropriate antihypertensive prescriptions to older patients. METHODS: An observational, prospective multicentric study was conducted to assess potentially inappropriate prescription of antihypertensive drugs, in patients aged 75 years and older with arterial hypertension (HTN), in the month prior to hospital admission, using four instruments: Beers, Screening Tool of Older Person's Prescriptions (STOPP), Screening Tool to Alert Doctors to the Right Treatment (START) and Assessing Care of Vulnerable Elders 3 (ACOVE-3)...
April 21, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28431157/agreement-between-renal-prescribing-references-and-determination-of-prescribing-appropriateness-in-hospitalised-patients-with-chronic-kidney-disease
#2
Michelle O'Shaughnessy, Niamh Allen, John O'Regan, Edwina Payne-Danson, Lise Mentre, Dawn Davin, Peter Lavin, Tamasine Grimes
Background: Chronic kidney disease (CKD) is a risk factor for adverse drug events. The clinical significance of discordance between renal prescribing references is unknown. Aim: We determined the prevalence of potentially inappropriate prescribing (PIP) in CKD, measured agreement between two prescribing references, and assessed potential for harm consequent to PIP. Design: Single-centre observational study. Methods: A random sample of hospitalised patients with CKD were grouped according to baseline CKD stage (3, 4, or 5)...
April 18, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28423857/the-association-between-the-stopp-start-criteria-and-gastro-intestinal-track-bleedings-in-elderly-patients
#3
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
https://www.readbyqxmd.com/read/28422415/impact-of-hospitalization-in-an-acute-geriatric-unit-on-polypharmacy-and-potentially-inappropriate-prescriptions-a-retrospective-study
#4
Marta Gutiérrez-Valencia, Mikel Izquierdo, Vincenzo Malafarina, Javier Alonso-Renedo, Belén González-Glaría, Beatriz Larrayoz-Sola, María Pilar Monforte-Gasque, Pello Latasa-Zamalloa, Nicolás Martínez-Velilla
AIM: Polypharmacy is a highly prevalent geriatric syndrome, and hospitalizations can worsen it. The aim of the present study was to analyze the influence of hospitalization on polypharmacy and indicators of quality of prescribing, and their possible association with health outcomes. METHODS: A retrospective study of 200 patients discharged from an acute geriatric unit was carried out. Indicators of quality of prescription were registered at admission and discharge: polypharmacy defined as ≥5 medications, hyperpolypharmacy (≥10), potentially inappropriate prescribing by Beers and Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria, potentially prescribing omissions by Screening Tool to Alert doctors to the Right Treatment (START) criteria, drug interactions and anticholinergic burden measured with the Anticholinergic Risk Scale...
April 19, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28420365/social-determinants-of-antibiotic-misuse-a-qualitative-study-of-community-members-in-haryana-india
#5
Anna K Barker, Kelli Brown, Muneeb Ahsan, Sharmila Sengupta, Nasia Safdar
BACKGROUND: Antibiotic resistance is a global public health crisis. In India alone, multi-drug resistant organisms are responsible for over 58,000 infant deaths each year. A major driver of drug resistance is antibiotic misuse, which is a pervasive phenomenon worldwide. Due to a shortage of trained doctors, access to licensed allopathic doctors is limited in India's villages. Pharmacists and unlicensed medical providers are commonly the primary sources of healthcare. Patients themselves are also key participants in the decision to treat an illness with antibiotics...
April 19, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28418482/effect-of-oral-dexamethasone-without-immediate-antibiotics-vs-placebo-on-acute-sore-throat-in-adults-a-randomized-clinical-trial
#6
Gail Nicola Hayward, Alastair D Hay, Michael V Moore, Sena Jawad, Nicola Williams, Merryn Voysey, Johanna Cook, Julie Allen, Matthew Thompson, Paul Little, Rafael Perera, Jane Wolstenholme, Kim Harman, Carl Heneghan
Importance: Acute sore throat poses a significant burden on primary care and is a source of inappropriate antibiotic prescribing. Corticosteroids could be an alternative symptomatic treatment. Objective: To assess the clinical effectiveness of oral corticosteroids for acute sore throat in the absence of antibiotics. Design, Setting, and Participants: Double-blind, placebo-controlled randomized trial (April 2013-February 2015; 28-day follow-up completed April 2015) conducted in 42 family practices in South and West England, enrolled 576 adults recruited on the day of presentation to primary care with acute sore throat not requiring immediate antibiotic therapy...
April 18, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28414065/effects-of-depression-screening-on-diagnosing-and-treating-mood-disorders-among-older-adults-in-office-based-primary-care-outpatient-settings-an-instrumental-variable-analysis
#7
Taeho Greg Rhee, Benjamin D Capistrant, Jon C Schommer, Ronald S Hadsall, Donald L Uden
Existing literature shows mixed findings regarding the efficacy and effectiveness of depression screening, and relatively little is known about the effectiveness of depression screening among older adults in primary care visits in the U.S. This study examines the effects of depression screening on the three following outcomes: mood disorder diagnoses, overall antidepressant prescriptions, and potentially inappropriate antidepressant prescriptions among older adults ages 65 or older in office-based outpatient primary care settings...
April 14, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28412043/assessment-of-high-priced-systemic-antifungal-prescriptions
#8
C Poulat, Y Nivoix, A Launoy, P Lutun, P Bachellier, S Rohr, M-L Woehl, D Levêque, V Bru, R Herbrecht, B Gourieux
OBJECTIVES: To assess compliance with international guidelines for costly antifungal prescriptions and to compare these results with a first study performed in 2007. METHODS: Retrospective study including all costly antifungal prescriptions made in surgical and medical intensive care units and in a hepatobiliary, pancreatic, and digestive surgery unit. Prescriptions were assessed in terms of indication, dosage, and antifungal de-escalation. RESULTS: Seventy-four treatments were analyzed...
April 12, 2017: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/28405697/potentially-inappropriate-medicines-in-elderly-hospitalised-patients-according-to-the-eu-7-pim-list-stopp-version-2-criteria-and-comprehensive-protocol
#9
Iva Mucalo, Maja Ortner Hadžiabdić, Andrea Brajković, Sonja Lukić, Patricia Marić, Ivana Marinović, Vesna Bačić-Vrca
PURPOSE: The aim of this study was to measure the prevalence of potentially inappropriate medications (PIMs) by using the EU(7)-PIM list, STOPP (Screening Tool of Older Persons' potentially inappropriate Prescriptions) version 2 criteria and the new comprehensive protocol. METHODS: This prospective study involved a sample of 276 consecutive elderly patients discharged from the university teaching hospital. Age, gender, diagnoses, medication history and medicines at discharge were recorded...
April 12, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28403114/prevalence-of-inappropriate-antibiotic-prescriptions-after-the-great-east-japan-earthquake-2011
#10
Kentaro Iwata, Takahiko Fukuchi, Midori Hirai, Kenichi Yoshimura, Yasuhiro Kanatani
Few studies have investigated the appropriateness of antibiotic use in postdisaster settings. We retrospectively evaluated clinical databases on health care delivered at clinics near shelters set up after the Great East Japan Earthquake, 2011. We defined appropriate, acceptable, and inappropriate antibiotic use for each diagnostic category, by applying and adopting precedent studies and clinical guidelines. From March to July, 2011, a total of 23,704 clinic visits occurred at 98 shelters with 7934 residents...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28398408/-uno-studio-sul-processo-di-riconciliazione-terapeutica-del-paziente-in-un-ospedale-oncologico
#11
Frida Gorreja, Vera Damuzzo, Umberto Gallo, Alberto Russi, Francesco Lo Re, Susanna Ciampalini, Lucia Guidotti, Marta Serena, Angelo Claudio Palozzo
Riassunto. Obiettivi. Lo scopo di questo studio è stato valutare l'impatto della riconciliazione terapeutica nella pratica clinica dal punto di vista del farmacista ospedaliero. Metodi. È stata condotta un'indagine riguardante i trattamenti farmacologici assunti dai pazienti al momento dell'ammissione e della dimissione in un ospedale oncologico. Il farmacista ha inserito i dati raccolti in un supporto informatico che, impiegando i criteri di STOPP (Screening Tool of Older Persons' Potentially Inappropriate Prescriptions) e il database Micromedex™, utile per valutare le interazioni farmacologiche, ha prodotto automaticamente un report che indicava le possibili incongruenze farmacologiche...
March 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/28392925/antibiotic-knowledge-attitudes-and-behaviours-of-albanian-health-care-professionals-and-patients-a-qualitative-interview-study
#12
Susanne Kaae, Admir Malaj, Iris Hoxha
BACKGROUND: The inappropriate use of antimicrobials is a problem worldwide. To target future interventions, a thorough understanding of the reasons behind this current behaviour is needed. Within the EU, the culture of antimicrobial use has been intensely studied, but this is not the case in non-EU southeastern European countries, despite the frequent use of (broad-spectrum) antibiotics (ABs) in this region. The aim of this study was to explore AB knowledge, attitudes and behaviours of health care professionals (HCPs) and patients in one southeastern European country, Albania...
2017: Journal of Pharmaceutical Policy and Practice
https://www.readbyqxmd.com/read/28388818/enhancing-quality-of-provider-practices-for-older-adults-in-the-emergency-department-equipped
#13
Melissa Stevens, Susan N Hastings, Alayne D Markland, Ula Hwang, William Hung, Ann E Vandenberg, William Bryan, Dewayne Cross, James Powers, Gerald McGwin, Noor Fattouh, William Ho, Carolyn Clevenger, Camille P Vaughan
EQUiPPED is a multicomponent quality improvement initiative combining education, electronic clinical decision support, and individual provider feedback to influence prescribing and improve medication safety for older adults. The objective here was to evaluate the effectiveness and sustainability of EQUiPPED to reduce the use of potentially inappropriate medications (PIMs), as defined by the American Geriatrics Society 2012 Beers Criteria, prescribed to older Veterans at the time of emergency department (ED) discharge...
April 7, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28387656/wheelchair-appropriateness-in-children-with-cerebral-palsy-a-single-center-experience
#14
Timur Ekiz, Sibel Özbudak Demir, Hatice Gözde Sümer, Neşe Özgirgin
BACKGROUND: Although wheelchair appropriateness has been studied in general wheelchair users and spinal cord injury patients, it has not been studied in children with cerebral palsy yet. OBJECTIVE: To describe the wheelchair appropriateness in children with cerebral palsy. MATERIALS AND METHODS: Thirty children with cerebral palsy were included. Demographical and clinical features of the children were noted. All wheelchair parts were evaluated by the same rehabilitation physician who has attended a wheelchair-training course...
March 31, 2017: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/28371121/clinical-medication-review-tool-for-polypharmacy-mapping-approach-for-pharmacotherapeutic-classifications
#15
Fumihiro Mizokami, Tomohiro Mizuno, Tomoyo Mori, Tadashi Nagamatsu, Hideharu Endo, Tomoyuki Hirashita, Takanobu Ichino, Masahiro Akishita, Katsunori Furuta
AIM: Polypharmacy is an extremely important problem, because it increases the risk of adverse drug reactions. The aim of the current study was to create a clinical medication review tool to detect inappropriate medication use, and assess this new method with elderly Japanese patients. METHODS: The new method involves optimizing prescription drugs from indications, based on the chronic disease-anatomical therapeutic class code list. The present study investigated the prevalence of potentially inappropriate medications in 5667 Japanese patients aged ≥65 years with polypharmacy (≥5 drugs) in comparison with the Beers criteria 2012...
March 30, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28369370/diagnostic-performance-and-clinical-feasibility-of-a-point-of-care-test-for-respiratory-viral-infections-in-primary-health-care
#16
Andrea H L Bruning, Wilhelmina B de Kruijf, Henk C P M van Weert, Wim L M Willems, Menno D de Jong, Dasja Pajkrt, Katja C Wolthers
Background.: Inappropriately high levels of antibiotics are still prescribed in primary health care for respiratory tract infections (RTIs). Access to diagnostic point-of-care tests (POCTs) for RTIs might reduce this over-prescription. Objective.: The purpose of our study was to determine the diagnostic performance and clinical feasibility of a recently developed diagnostic POCT for respiratory viruses, the mariPOC®, in a Dutch primary healthcare setting. Methods...
March 24, 2017: Family Practice
https://www.readbyqxmd.com/read/28363317/validation-of-prescriber-risk-indicators-obtained-from-prescription-drug-monitoring-program-data
#17
Peter W Kreiner, Gail K Strickler, Eduardo A Undurraga, Maria E Torres, Ruslan V Nikitin, Anne Rogers
BACKGROUND: Prescription opioids are commonly overprescribed. However, validated measures of inappropriate controlled substance prescribing are lacking. This study examined associations between prescriber risk indicators developed as part of a public health surveillance project and medical board disciplinary actions against prescribers. METHODS: We compiled 12 prescriber risk indicators using data from the Maine prescription drug monitoring program (PDMP) for 2010...
April 1, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28360995/inappropriate-prescribing-in-outpatient-healthcare-an-evaluation-of-respiratory-infection-visits-among-veterans-in-teaching-versus-non-teaching-primary-care-clinics
#18
Diane M Parente, Tristan T Timbrook, Aisling R Caffrey, Kerry L LaPlante
A recent study led by the Centers for Disease Control and Prevention (CDC) revealed at least 30% of antibiotic prescriptions in the outpatient setting were inappropriate. In this study of all ages, among adult patients, results were similar to the overall population, with the majority of inappropriate prescribing relating to respiratory infections. We applied the same methodology to investigate rates of antibiotic prescribing for respiratory tract infections in outpatient primary care clinics at the Providence Veterans Affairs Medical Center...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28353386/the-effects-of-computerized-clinical-decision-support-systems-on-laboratory-test-ordering-a-systematic-review
#19
REVIEW
Nicolas Delvaux, Katrien Van Thienen, Annemie Heselmans, Stijn Van de Velde, Dirk Ramaekers, Bert Aertgeerts
CONTEXT: - Inappropriate laboratory test ordering has been shown to be as high as 30%. This can have an important impact on quality of care and costs because of downstream consequences such as additional diagnostics, repeat testing, imaging, prescriptions, surgeries, or hospital stays. OBJECTIVE: - To evaluate the effect of computerized clinical decision support systems on appropriateness of laboratory test ordering. DATA SOURCES: - We used MEDLINE, Embase, CINAHL, MEDLINE In-Process and Other Non-Indexed Citations, Clinicaltrials...
April 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28346296/antipsychotic-drug-use-in-nursing-home-residents-with-and-without-dementia-keep-an-eye-on-the-pro-re-nata-medication
#20
Katharina Allers, Michael Dörks, Guido Schmiemann, Falk Hoffmann
Behavioral and psychological symptoms of dementia often lead to the prescription of antipsychotics, especially in nursing homes, but their use remains controversial. This study aimed to assess antipsychotic drug use in residents with dementia compared with those without dementia. Data were obtained through the cross-sectional 'inappropriate medication in patients with renal insufficiency in nursing homes' (IMREN) study including data from 21 nursing homes. Descriptive statistics were used and factors associated with the prescription of antipsychotics were identified by logistic regression...
March 24, 2017: International Clinical Psychopharmacology
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