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Polypharmacy

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https://www.readbyqxmd.com/read/28101318/prevalence-and-correlates-of-antipsychotic-polypharmacy-among-outpatients-with-schizophrenia-attending-a-tertiary-psychiatric-facility-in-nigeria
#1
Nosa Godwin Igbinomwanhia, Sunday Osasu Olotu, Bawo Onesirosan James
BACKGROUND: The study aimed to determine the prevalence, pattern and correlates of antipsychotic polypharmacy (APP) among outpatients with schizophrenia attending a tertiary psychiatric facility in Nigeria. METHOD: A cross-sectional study of 250 patients with schizophrenia attending the outpatient clinic of a regional tertiary psychiatric facility in Nigeria was undertaken. They were administered a sociodemographic questionnaire, the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning (GAF) scale and the Liverpool University Side Effects Rating Scale (LUNSERS)...
January 2017: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/28100176/effect-of-training-and-structured-medication-review-on-medication-appropriateness-in-nursing-home-residents-and-on-cooperation-between-health-care-professionals-the-intherakt-study-protocol
#2
Angelika Mahlknecht, Nadja Nestler, Ulrike Bauer, Nadine Schüßler, Jochen Schuler, Sebastian Scharer, Ralf Becker, Isabel Waltering, Georg Hempel, Oliver Schwalbe, Maria Flamm, Jürgen Osterbrink
BACKGROUND: Pharmacotherapy in residents of nursing homes is critical due to the special vulnerability of this population. Medical care and interprofessional communication in nursing homes are often uncoordinated. As a consequence, polypharmacy and inappropriate medication use are common and may lead to hospitalizations and health hazards. The aim of this study is to optimize communication between the involved professional groups by specific training and by establishing a structured medication review process, and to improve medication appropriateness and patient-relevant health outcomes for residents of nursing homes...
January 18, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28095959/general-aviation-pilots-over-70-years-old
#3
Alpo Vuorio, Saryani Asmayawati, Bruce Budowle, Robin Griffiths, Timo Strandberg, Jaana Kuoppala, Antti Sajantila
BACKGROUND: Currently it is not unusual for general aviation pilots in the United States to continue to fly beyond the age of 70, even into their 80s and 90s. Pilots have regular examinations according to protocols which do not specify special or additional requirements for pilots over 70 yr of age. Additionally, the third class medical reforms passed by the U.S. Senate on 15 July 2016 could potentially result in even less stringent medical certification requirements for general aviation pilots...
February 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28095780/effectiveness-of-medication-review-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#4
Victor Johan Bernard Huiskes, David Marinus Burger, Cornelia Helena Maria van den Ende, Bartholomeus Johannes Fredericus van den Bemt
BACKGROUND: Medication review is often recommended to optimize medication use. In clinical practice it is mostly operationalized as an intervention without co-interventions during a short term intervention period. However, most systematic reviews also included co-interventions and prolonged medication optimization interventions. Furthermore, most systematic reviews focused on specific patient groups (e.g. polypharmacy, elderly, hospitalized) and/or on specific outcome measures (e.g. hospital admissions and mortality)...
January 17, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28093640/polypharmacy-and-potentially-inappropriate-medications-a-cross-sectional-analysis-among-451-nursing-homes-in-france
#5
Marie Herr, Helene Grondin, Stéphane Sanchez, Didier Armaingaud, Caroline Blochet, Antoine Vial, Philippe Denormandie, Joël Ankri
PURPOSE: The quality of drug therapy is an important issue for nursing homes. This study aimed to assess the prevalence of polypharmacy and potentially inappropriate medications (PIMs) in a large sample of nursing home residents by using the data recorded during the preparation of pill dispensers. METHODS: This is a cross-sectional study that included 451 nursing homes across France. Information about the medications received by the 30,702 residents (73.8% women) living in these nursing homes was extracted from the system that assists in the preparation of pill dispensers in pharmacies...
January 16, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28091333/an-ecological-approach-to-reducing-potentially-inappropriate-medication-use-canadian-deprescribing-network
#6
Cara Tannenbaum, Barbara Farrell, James Shaw, Steve Morgan, Johanna Trimble, Jane Currie, Justin Turner, Paula Rochon, James Silvius
Polypharmacy is growing in Canada, along with adverse drug events and drug-related costs. Part of the solution may be deprescribing, the planned and supervised process of dose reduction or stopping of medications that may be causing harm or are no longer providing benefit. Deprescribing can be a complex process, involving the intersection of patients, health care providers, and organizational and policy factors serving as enablers or barriers. This article describes the justification, theoretical foundation, and process for developing a Canadian Deprescribing Network (CaDeN), a network of individuals, organizations, and decision-makers committed to promoting the appropriate use of medications and non-pharmacological approaches to care, especially among older people in Canada...
January 16, 2017: Canadian Journal on Aging, la Revue Canadienne du Vieillissement
https://www.readbyqxmd.com/read/28090687/prevalence-of-psychotropic-medication-use-and-association-with-challenging-behaviour-in-adults-with-an-intellectual-disability-a-total-population-study
#7
D L Bowring, V Totsika, R P Hastings, S Toogood, M McMahon
BACKGROUND: There is a high prevalence of psychotropic medication use in adults with Intellectual Disabilities (ID), often in the absence of psychiatric disorder, also associated with challenging behaviour. Previous research has focused on specific sample frames or data from primary care providers. There is also a lack of consistency in the definition of challenging behaviour used. METHODS: We adopted a total population sampling method. Medication data on 265 adults with ID were classified according to the Anatomical Therapeutic Chemical classification system...
January 16, 2017: Journal of Intellectual Disability Research: JIDR
https://www.readbyqxmd.com/read/28088178/health-related-quality-of-life-and-associated-factors-in-functionally-independent-older-people
#8
Mónica Machón, Isabel Larrañaga, Miren Dorronsoro, Kalliopi Vrotsou, Itziar Vergara
BACKGROUND: Health-related quality of life (HRQL) is a key indicator of elderly people's health status that can be affected by different factors. However, little is known about which variables are associated with it in functionally independent elderly people. The aim of this project was to study HRQL and a wide variety of health, lifestyle, social and contextual aspects and their relation to HRQL in a sample of functionally independent, non-cognitively impaired community-dwelling adults, over 65 years of age, from a northern region of Spain...
January 14, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28086976/impact-of-a-tailored-program-on-the-implementation-of-evidence-based-recommendations-for-multimorbid-patients-with-polypharmacy-in-primary-care-practices-results-of-a-cluster-randomized-controlled-trial
#9
Cornelia Jäger, Tobias Freund, Jost Steinhäuser, Christian Stock, Johannes Krisam, Petra Kaufmann-Kolle, Michel Wensing, Joachim Szecsenyi
BACKGROUND: Multimorbid patients receiving polypharmacy represent a growing population at high risk for negative health outcomes. Tailoring is an approach of systematic intervention development taking account of previously identified determinants of practice. The aim of this study was to assess the effect of a tailored program to improve the implementation of three important processes of care for this patient group: (a) structured medication counseling including brown bag reviews, (b) the use of medication lists, and (c) structured medication reviews to reduce potentially inappropriate medication...
January 13, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28078393/antipsychotic-use-is-a-risk-factor-for-hyponatremia-in-patients-with-schizophrenia-a-15-year-follow-up-study
#10
Hang-Ju Yang, Wan-Ju Cheng
RATIONALE: Hyponatremia affects 10% of patients with chronic schizophrenia and can lead to severe consequences. However, the role of antipsychotics and other risk factors in hyponatremia occurrence has remained inconsistent. OBJECTIVE: This study examined the association between antipsychotic use and hyponatremia occurrence in patients with schizophrenia. METHODS: We utilized the National Health Insurance Research Database to follow 2051 patients with schizophrenia from 1998 to 2013...
January 11, 2017: Psychopharmacology
https://www.readbyqxmd.com/read/28073041/major-depressive-disorder-with-subthreshold-hypomanic-mixed-features-a-real-world-assessment-of-treatment-patterns-and-economic-burden
#11
Roger S McIntyre, Daisy Ng-Mak, Chien-Chia Chuang, Rachel Halpern, Pankaj A Patel, Krithika Rajagopalan, Antony Loebel
BACKGROUND: To compare outcomes for individuals with major depressive disorder (MDD) with or without subthreshold hypomania (mixed features) in naturalistic settings. METHODS: Using the Optum Research Database (1/1/2009─10/31/2014), a retrospective analysis of individuals newly diagnosed with MDD was conducted. Continuous enrollment for 12-months before and after the initial MDD diagnosis was required. MDD with subthreshold hypomania (mixed features) (MDD-MF) was defined based on ≥1 hypomania diagnosis within 30 days after an MDD diagnosis during the one-year follow-up period, in the absence of bipolar I diagnoses...
December 23, 2016: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28065184/long-term-outcomes-in-the-management-of-painful-diabetic-neuropathy
#12
Lauren M Mai, A John Clark, Allan S Gordon, Mary E Lynch, Pat K Morley-Forster, Howard Nathan, Catherine Smyth, Larry W Stitt, Cory Toth, Mark A Ware, Dwight E Moulin
BACKGROUND: Painful diabetic neuropathy (PDN) is a frequent complication of diabetes mellitus. Current treatment recommendations are based on short-term trials, generally of ≤3 months' duration. Limited data are available on the long-term outcomes of this chronic disease. The objective of this study was to determine the long-term clinical effectiveness of the management of chronic PDN at tertiary pain centres. METHODS: From a prospective observational cohort study of patients with chronic neuropathic non-cancer pain recruited from seven Canadian tertiary pain centres, 60 patients diagnosed with PDN were identified for analysis...
January 9, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28063660/deprescribing-a-narrative-review-of-the-evidence-and-practical-recommendations-for-recognizing-opportunities-and-taking-action
#13
REVIEW
Emily Reeve, Wade Thompson, Barbara Farrell
Deprescribing can be defined as the process of withdrawal or dose reduction of medications which are considered inappropriate in an individual. The aim of this narrative review is to provide an overview of "deprescribing"; firstly discussing the potential benefits and harms followed by the barriers to and enablers of deprescribing. We also provide practical recommendations to recognise opportunities and strategies for deprescribing in practice. Studies focused on minimizing polypharmacy indicate that deprescribing may be associated with potential benefits including resolution of adverse drug reactions, improved quality of life and medication adherence and a reduction in drug costs...
January 4, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28063386/attitudes-towards-and-rationale-for-antipsychotic-polypharmacy-among-psychiatrists-in-nigeria-characteristics-associated-with-high-reported-antipsychotic-polypharmacy
#14
B O James, J O Omoaregba, S O Raji, O E Imishue, K M Okonoda, Y I Nyamali, P A Famuyiwa, C U Correll
Antipsychotic polypharmacy (APP) is commonplace despite lacking evidence of its effectiveness. We aimed to identify psychiatrists' rationale for and attitudes towards APP and to determine if attitudes influence antipsychotic polypharmacy prescription rates in a survey of a nationally representative sample of Nigerian psychiatrists (of which a majority were senior trainees: 74.2%). Prescriber characteristics, practices and attitudes were compared in 'high' (>30%) vs. 'low' (≤30%) antipsychotic polypharmacy prescribers and results were adjusted for multiple comparisons...
December 27, 2016: Psychiatry Research
https://www.readbyqxmd.com/read/28057620/a-pooled-analysis-of-the-efficacy-of-fesoterodine-for-the-treatment-of-overactive-bladder-and-the-relationship-between-safety-co-morbidity-and-polypharmacy-in-patients-aged-65-years-or-older
#15
Adrian Wagg, Daniel Arumi, Sender Herschorn, Javier Angulo Cuesta, Francois Haab, Fady Ntanios, Martin Carlsson, Matthias Oelke
BACKGROUND: overactive bladder (OAB) is a common condition in older persons. Antimuscarinic treatment remains the mainstay of treatment of OAB but clinicians have been reluctant to prescribe this to older patients. This study examined efficacy and safety information from patients >65 in fesoterodine trials to reaffirm efficacy and to explore the relationships between treatment emergent adverse events (TEAEs), coexisting medication and co-morbidity. METHODS: data from 10 double-blind, placebo-controlled studies were analysed...
January 4, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28056068/the-association-between-polypharmacy-and-dementia-a-nested-case-control-study-based-on-a-12-year-longitudinal-cohort-database-in-south-korea
#16
Hae-Young Park, Ji-Won Park, Hong Ji Song, Hyun Soon Sohn, Jin-Won Kwon
Dementia is a major concern among growing chronic diseases in the aging society and its association with polypharmacy has not been adequately assessed. The objective of this study was to determine the association between polypharmacy and dementia through multiple statistical approaches. We conducted a nested case-control study for newly diagnosed dementia cases using the South Korean National Health Insurance Service sample cohort database (2002-2013, n = 1,025,340). Interactions between polypharmacy (an average use of ≥5 prescription drugs daily) and comorbidities or potentially inappropriate medications (PIMs) were tested...
2017: PloS One
https://www.readbyqxmd.com/read/28053514/clinical-outcome-and-predictors-of-adverse-events-of-an-enhanced-older-adult-psychiatric-liaison-service-rapid-assessment-interface-and-discharge-newport
#17
Inderpal Singh, Priya Fernando, Jane Griffin, Chris Edwards, Kathryn Williamson, Patrick Chance
BACKGROUND: Hospitals are currently admitting an increasing number of older people, and more than one-third could have an underlying mental health problem. The existing Older Adult Mental Health (OAMH) liaison service was increasingly unable to meet the escalating needs of older and frail patients. Therefore, the service was modernized and enhanced on an "invest-to-save" principle to provide a prompt holistic assessment for older adults with mental health problems. The objective of this study was a service evaluation to appraise clinical outcome, minimize the length of stay, and measure the predictors of adverse outcomes to streamline this enhanced service...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28050136/a-user-s-guide-to-cannabinoid-therapies-in-oncology
#18
REVIEW
V Maida, P J Daeninck
"Cannabinoid" is the collective term for a group of chemical compounds that either are derived from the Cannabis plant, are synthetic analogues, or occur endogenously. Although cannabinoids interact mostly at the level of the currently recognized cannabinoid receptors, they might have cross reactivity, such as at opioid receptors. Patients with malignant disease represent a cohort within health care that have some of the greatest unmet needs despite the availability of a plethora of guideline-driven disease-modulating treatments and pain and symptom management options...
December 2016: Current Oncology
https://www.readbyqxmd.com/read/28044008/immediate-vs-gradual-discontinuation-in-antipsychotic-switching-a-systematic-review-and-meta-analysis
#19
Hiroyoshi Takeuchi, Navot Kantor, Hiroyuki Uchida, Takefumi Suzuki, Gary Remington
BACKGROUND: Antipsychotic switching is routine in clinical practice, although it remains unclear which is the preferable switching method: immediate discontinuation of the current antipsychotic or a gradual tapering approach. The first strategy has been implicated in rebound/withdrawal symptoms and emergence/exacerbation of symptoms, whereas the gradual approach is thought to pose a risk of additive or synergistic side effects if employed in the context of a crossover approach. METHODS: MEDLINE, Embase, and Cochrane Central Register of Controlled Trials were systematically searched...
January 1, 2017: Schizophrenia Bulletin
https://www.readbyqxmd.com/read/28042169/the-problem-of-polypharmacy-in-female-patients-with-overactive-bladders-cross-sectional-study-in-a-specialist-outpatient-department
#20
C S Schneidinger, W Umek, B Böhmdorfer
Background: The consumption of certain drugs can cause urinary incontinence. The aim of this study is to determine the frequency of consumption of drugs that can favour incontinence, the incidence of polypharmacy and the incidence of potentially dangerous drug-drug interactions in female patients suffering from overactive bladder (OAB) who presented to a urogynaecological outpatient department. Methods: We undertook a retrospective case series study. The data from 100 female patients who attended the urogynaecological outpatient department of the Vienna General Hospital [VGH; Allgemeinen Krankenhauses Wien (AKH)] in the period from 20...
December 2016: Geburtshilfe und Frauenheilkunde
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