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Polypharmacy

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https://www.readbyqxmd.com/read/28646457/national-survey-among-radiation-oncology-residents-related-to-their-needs-in-geriatric-oncology
#1
Rachel Leifer, Bonnie Bristow, Martine Puts, Shabbir Alibhai, Xingshan Cao, Barbara-Ann Millar, Meredith Giuliani, Tina Hsu, Maureen Trudeau, Rajin Mehta, Ines Menjak, Mireille Norris, Barbara Liu, Francois Gallant, Ewa Szumacher
Currently, there is no formal curriculum addressing geriatric oncology within Canadian radiation oncology (RO) residency programs. Knowledge related to geriatric medicine may help radiation oncologists modify RT based on frailty status and geriatric considerations. Understanding specific learning needs allow program coordinators to align the current curriculum with residents' geriatric oncology learning needs. The purpose of this study is to determine the geriatric oncology educational needs of the Canadian RO residents and to inform Canadian RO residency training...
June 24, 2017: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/28643174/natural-language-processing-for-ehr-based-pharmacovigilance-a-structured-review
#2
REVIEW
Yuan Luo, William K Thompson, Timothy M Herr, Zexian Zeng, Mark A Berendsen, Siddhartha R Jonnalagadda, Matthew B Carson, Justin Starren
The goal of pharmacovigilance is to detect, monitor, characterize and prevent adverse drug events (ADEs) with pharmaceutical products. This article is a comprehensive structured review of recent advances in applying natural language processing (NLP) to electronic health record (EHR) narratives for pharmacovigilance. We review methods of varying complexity and problem focus, summarize the current state-of-the-art in methodology advancement, discuss limitations and point out several promising future directions...
June 22, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28641051/beneficial-role-of-citrus-fruit-polyphenols-against-hepatic-dysfunctions-a-review
#3
Md Mohabbulla Mohib, Kazi Afnan, Tasfiq Zaman Paran, Salma Khan, Juthika Sarker, Nahid Hasan, Istiaque Hasan, Md Abu Taher Sagor
Alcoholic liver diseases and virus-induced hepatic dysfunctions are prevalent in western countries. Evidence also suggests that hyperglycemia and insulin resistance are key players in the development of hepatic diseases and their complications. Since the comorbid diseases like obesity, diabetes and vascular dysfunctions primarily affect liver, the modern therapies against other hepatic dysfunctions are becoming a major challenge to treat. In addition to these, polypharmacy and adverse drug reactions (ADRs) are further aggravating the phenomenon...
June 22, 2017: Journal of Dietary Supplements
https://www.readbyqxmd.com/read/28640946/physicians-non-uniform-approach-to-prescribing-drugs-to-older-patients-a-qualitative-study
#4
Line Due Christensen, Janne Petersen, Ove Andersen, Susanne Kaae
Multi-morbidity and polypharmacy are common in older patients and increase their susceptibility to adverse drug events and hospitalizations. Rational drug prescription is critical, however, little is known about physicians' perspectives on how to prescribe drugs for older patients. The aim of this study was to explore physicians' approach to prescribe drugs to older patients, including identifying the drugs that physicians perceive to be risk drugs for older patients and comparing them with established lists of potentially inappropriate medications...
June 22, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28640591/managing-psychotropic-medications-in-complex-real-world-patients-using-comprehensive-therapeutic-drug-monitoring
#5
Jeffrey J Sutherland, Ryan D Morrison, J Scott Daniels, Stephen B Milne, Timothy P Ryan
There are multiple treatment options for depression, anxiety, psychosis, and other psychiatric disorders, and psychiatry patients are often comorbid with complex, polypharmacy treatment regimens. Unlike cardiovascular disease and diabetes, there are no readily available biomarkers to gauge treatment success with psychotropic medications, often resulting in subjective determination of medication therapy effectiveness. The physiochemical properties of psychiatric medications in general lend themselves to quantitative measurement in blood, offering an avenue to optimize treatment for each patient...
June 22, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/28639298/prevalence-patterns-and-factors-associated-with-psychotropic-use-in-older-adults-with-intellectual-disabilities-in-ireland
#6
M O'Dwyer, J Peklar, N Mulryan, P McCallion, M McCarron, M C Henman
BACKGROUND: People with intellectual disability (ID) are at increased risk of exposure to psychotropic drugs and psychotropic polypharmacy because of the higher prevalence of mental health conditions present and more controversially, the use of these agents to treat challenging behaviours. Despite the fact that many adults with ID are exposed to psychotropic polypharmacy, few studies to date have focused on the patterns of use of multiple psychotropics, or factors associated with psychotropic polypharmacy, particularly in the older population...
June 21, 2017: Journal of Intellectual Disability Research: JIDR
https://www.readbyqxmd.com/read/28637234/a-baseline-assessment-by-healthcare-professionals-of-dutch-pharmacotherapeutic-care-for-the-elderly-with-polypharmacy
#7
Lutien Bakker, Peter F Kemper, Cordula Wagner, Gepke O Delwel, Martine C de Bruijne
Polypharmacy is common in the elderly population and is associated with an increased risk of adverse drug events. To diminish this risk, the guideline 'Polypharmacy in the Elderly' has been developed in 2012. This study examines, to what extent Dutch pharmacotherapeutic practice amongst elderly with polypharmacy mirrors the best practice described in this guideline and which barriers threaten it. An observational study was conducted in 2013/14 using a questionnaire distributed amongst Dutch healthcare professionals and elderly patients with polypharmacy...
June 14, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/28636569/diabetic-ketoacidosis-associated-with-antipsychotic-drugs-case-reports-and-a-review-of-literature
#8
Antonia Vuk, Martina Rojnic Kuzman, Maja Baretic, Martina Matovinovic Osvatic
BACKGROUND: Second generation antipsychotics (SGAs) are associated with metabolic disturbances. Diabetic ketoacidosis (DKA) is a rare, but potentially fatal sign of acute glucose metabolism dysregulation linked to the use of SGAs. The aims of this article are to present patients with a history of psychotic disorders and of severe metabolic diabetic ketoacidosis, possibly associated with the use of antipsychotics, and to review the current literature on the topic of antipsychotic-induced DKA...
June 2017: Psychiatria Danubina
https://www.readbyqxmd.com/read/28635299/prevalence-and-geographic-variations-of-polypharmacy-among-west-virginia-medicaid-beneficiaries
#9
Xue Feng, Xi Tan, Brittany Riley, Tianyu Zheng, Thomas K Bias, James B Becker, Usha Sambamoorthi
BACKGROUND: West Virginia (WV) residents are at high risk for polypharmacy given its considerable chronic disease burdens. OBJECTIVE: To evaluate the prevalence, correlates, outcomes, and geographic variations of polypharmacy among WV Medicaid beneficiaries. METHODS: In this cross-sectional study, we analyzed 2009-2010 WV Medicaid fee-for-service (FFS) claims data for adults aged 18-64 (N=37,570). We defined polypharmacy as simultaneous use of drugs from five or more different drug classes on a daily basis for at least 60 consecutive days in one year...
June 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28635169/potential-drug-drug-interactions-in-older-adults-a-population-based-study
#10
Thalyta Renata Araújo Santos, Erika Aparecida Silveira, Lílian Varanda Pereira, Mércia Pandolfo Provin, Dione Marçal Lima, Rita Goreti Amaral
AIM: To evaluate the potential drug-drug interactions (PDDI) between drugs used by older adults, any associated factors and recommended clinical management. METHODS: A cross-sectional, population-based study was carried out through a home survey of 934 older adults (from December 2009 to April 2010). A questionnaire was applied, and the participants were asked to show all the drugs used and their respective prescriptions, thus providing data to identify polypharmacy, self-medication and PDDI...
June 21, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28634824/association-of-parkinsonism-or-parkinson-disease-with-polypharmacy-in-the-year-preceding-diagnosis-a-nested-case-control-study-in-south-korea
#11
Hae-Young Park, Ji-Won Park, Hyun Soon Sohn, Jin-Won Kwon
INTRODUCTION: Published studies on the association between polypharmacy and parkinsonism or Parkinson disease are very limited. OBJECTIVE: The objective of this study was to investigate whether polypharmacy is associated with parkinsonism or Parkinson disease in elderly patients. METHODS: From a South Korean national health insurance sample cohort database for 2002-2013, we matched parkinsonism cases (defined by diagnosis codes for parkinsonism/Parkinson disease) and Parkinson disease cases (patients who had records for both Parkinson disease diagnosis and anti-Parkinson disease drug prescriptions) with controls...
June 20, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28634642/determinants-of-change-in-polypharmacy-status-in-switzerland-the-population-based-colaus-study
#12
Nazanin Abolhassani, Julien Castioni, Pedro Marques-Vidal, Peter Vollenweider, Gérard Waeber
OBJECTIVES: This study aimed to assess the prevalence, the change, and the determinants of change in polypharmacy in a population-based sample. METHODS: Baseline (2003-2006) and follow-up (2009-2012) data are from 4679 participants aged between 35 and 75 years (53.5% women, mean age 52.6 ± 10.6 years) from the population of Lausanne, Switzerland. Polypharmacy was defined by the regular use of ≥5 drugs. Four categories of change were defined: never (no polypharmacy at baseline and follow-up), initiating (no polypharmacy at baseline but at follow-up), maintaining, or quitting...
June 21, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28632340/prescribing-in-the-oldest-old-inpatients-a-retrospective-analysis-of-patients-referred-for-specialist-geriatric-consultation
#13
Sivarajah Ilango, Peter Pillans, Nancye M Peel, Ian Scott, Leonard C Gray, Ruth E Hubbard
INTRODUCTION: While medications may prolong life and prevent morbidity in older people, adverse effects of polypharmacy are increasingly recognised. As patients age and become frail, prescribing may be expected to focus more on symptom control and minimise potentially harmful preventive medication use that confer little benefit within a short lifespan. Whether prescribing practice shifts to one of symptom control among the oldest old admitted to hospital remains unclear. METHODS: Retrospective analysis of all patients aged ≥85 years referred for comprehensive geriatric assessment at a tertiary care hospital between May 2006 and December 2014 for whom all prescribed medications were documented...
June 20, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28630771/polypharmacy-among-underserved-older-african-american-adults
#14
Mohsen Bazargan, James Smith, Masoud Movassaghi, David Martins, Hamed Yazdanshenas, Seyede Salehe Mortazavi, Gail Orum
The purpose of the present study was to examine correlates of polypharmacy among underserved community-dwelling older African American adults. Methods. This study recruited 400 underserved older African Americans adults living in South Los Angeles. The structured face-to-face interviews collected data on participants' characteristics and elicited data pertaining to the type, frequency, dosage, and indications of all medications used by participants. Results. Seventy-five and thirty percent of participants take at least five and ten medications per day, respectively...
2017: Journal of Aging Research
https://www.readbyqxmd.com/read/28629285/acute-movement-disorders-in-the-medical-setting
#15
Ifrah Zawar, Mario A Caro, Lara Feldman, Xavier F Jimenez
Objective Psychosomatic medicine psychiatrists are often tasked with the evaluation and treatment of complex neuropsychiatric states which may be motoric in phenotype. Little energy has been dedicated to understanding acute movement disorders in the hospital environment. Method Recognizing the importance of frontal-subcortical (corticostriatothalamocortical) circuitry and basal ganglia structures, we present a case series of acute movement disorder phenotypes resulting from underlying medical conditions, commonly-administered medications, or the interaction of both...
July 2016: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/28628769/complex-psychotropic-polypharmacy-in-bipolar-disorder-across-varying-mood-polarities-a-prospective-cohort-study-of-2712-inpatients
#16
Julia C Golden, John W Goethe, Stephen B Woolley
BACKGROUND: It is common for patients with bipolar disorder (BP) to receive multiple psychotropics, but few studies have assessed demographic and clinical features associated with risk for receiving complex psychotropic polypharmacy. METHODS: This longitudinal cohort study examined 2712 inpatients with a DSM-IV clinical diagnosis of BP to assess associations between complex polypharmacy (defined as ≥4 psychotropics) and demographic and clinical features; associations with risk of rehospitalization were also examined...
June 13, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28626269/the-addition-of-amphetamine-to-potentially-sedating-medication-regimens-an-exploratory-investigation-of-the-impact-upon-reaction-time-and-sustained-attention
#17
James W Price
OBJECTIVES: The addition of amphetamine to a sedating medication may reduce sedation but does it augment reaction time and sustained attention for workers? The purpose of this exploratory study was gain insight into between group differences that would assist hypothesis formation for a subsequent hypothesis testing study. METHODS: This study examined psychomotor vigilance task (PVT) performance for a group taking potentially sedating medications (opiates, benzodiazepines, anticholinergics, barbiturates or polypharmacy) while taking amphetamine to a group not taking amphetamine...
May 15, 2017: Psychopharmacology Bulletin
https://www.readbyqxmd.com/read/28625935/evaluation-of-prescription-along-three-health-care-periods-in-the-elderly
#18
Fannie Santoni, Valéry Antoine, Alberto di Castri, Maurice Viala, Laetitia Geronimi-Robelin, Cédric LeGuillou, Christine de Taddeo, Sophie Bastide, Claude Jeandel, Benoit de Wazieres
Polypharmacy, potentially inappropriate prescriptions and inadequate coordination between prescribers are among main factors explaining the occurrence of adverse drug events in elderly patients. Prospective and descriptive study of medication prescriptions for elderly patients during a continuous period of health-care: entry in an acute geriatric unit (T1), at discharge (T2) and two months after hospitalization (T3). A global iatrogenic risk was defined: presence of poly-pharmacy and/or PPI (Laroche criteria) and/or absence of quality indicators for prescription according to the French health authority...
June 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28623152/singapore-healthy-older-people-everyday-hope-study-prevalence-of-frailty-and-associated-factors-in-older-adults
#19
Reshma A Merchant, Matthew Zhixuan Chen, Linda Wei Lin Tan, Moses YiDong Lim, Han Kwee Ho, Rob M van Dam
BACKGROUND: In the context of a rapidly ageing population, Singapore is anticipating a rise in multimorbidity, disability, and dependency, which are driven by physical frailty. Healthy Older People Everyday (HOPE) is an epidemiologic population-based study on community-dwelling older adults aged 65 years and older in Singapore. OBJECTIVE: To investigate the prevalence of frail and prefrail states and their association with polypharmacy, multimorbidity, cognitive and functional status, and perceived health status among community-dwelling older adults in Singapore...
June 13, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28622547/co-morbidity-and-clinically-significant-interactions-between-antiepileptic-drugs-and-other-drugs-in-elderly-patients-with-newly-diagnosed-epilepsy
#20
Emmi Bruun, Lauri J Virta, Reetta Kälviäinen, Tapani Keränen
PURPOSE: A study was conducted to investigate the frequency of potential pharmacokinetic drug-to-drug interactions in elderly patients with newly diagnosed epilepsy. We also investigated co-morbid conditions associated with epilepsy. METHOD: From the register of Kuopio University Hospital (KUH) we identified community-dwelling patients aged 65 or above with newly diagnosed epilepsy and in whom use of the first individual antiepileptic drug (AED) began in 2000-2013 (n=529)...
June 13, 2017: Epilepsy & Behavior: E&B
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