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Polypharmacy

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https://www.readbyqxmd.com/read/29139041/drug-safety-analysis-in-a-real-life-cohort-of-parkinson-s-disease-patients-with-polypharmacy
#1
Saskia Müller-Rebstein, Claudia Trenkwalder, Jens Ebentheuer, Wolfgang H Oertel, Carsten Culmsee, Günter U Höglinger
BACKGROUND: Polypharmacy is common in geriatric Parkinson's disease (PD) patients in advanced disease stages with multiple comorbidities, bearing multiple risks for drug safety in theory. OBJECTIVE: The aim of this study was to empirically identify the most frequent and relevant contraindications and drug interactions actually occurring and compromising drug safety in PD in real life. METHODS: We conducted a prospective observational study in a multimorbid cohort of PD patients with polypharmacy admitted to a specialized hospital...
November 14, 2017: CNS Drugs
https://www.readbyqxmd.com/read/29135584/concomitant-medication-polypharmacy-interactions-and-imperfect-adherence-are-common-in-australian-adults-on-suppressive-art
#2
Krista J Siefried, Limin Mao, Lucette A Cysique, John Rule, Michelle L Giles, Don E Smith, James Mcmahon, Tim R Read, Catriona Ooi, Ban K Tee, Mark Bloch, John de Wit, Andrew Carr
OBJECTIVES: We quantified concomitant medication (CM) polypharmacy, pharmacokinetic (PK) and pharmacodynamic (PD) interactions, adverse effects and adherence in Australian adults on effective ART. DESIGN: Cross-sectional. METHODS: Patients recruited into a nation-wide cohort and assessed for prevalence and type of CM (including polypharmacy, defined as ≥5 CMs), PK or PD interactions, potential CM adverse effects and CM adherence. Factors associated with CM polypharmacy and with imperfect adherence were identified using multivariable logistic regression...
November 10, 2017: AIDS
https://www.readbyqxmd.com/read/29133562/ritonavir-boosted-protease-inhibitors-but-not-cobicistat-appear-safe-in-hiv-positive-patients-ingesting-dabigatran
#3
Payal P Kakadiya, Robert T Higginson, Patricia Pecora Fulco
Patients with human immunodeficiency virus (HIV) have a near normal life expectancy and as a result are experiencing common age-related medical conditions (e.g., atrial fibrillation) and polypharmacy.1,2 ….
November 13, 2017: Antimicrobial Agents and Chemotherapy
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
#4
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/29127560/characteristics-of-medicaid-recipients-receiving-persistent-antipsychotic-polypharmacy
#5
Robert O Cotes, David R Goldsmith, Sarah L Kopelovich, Cathy A Lally, Benjamin G Druss
Antipsychotic polypharmacy (APP) is a common strategy despite guidelines advising against this practice. This article seeks to quantify the prevalence and correlates of APP using Medicaid Analytic eXtract files from 2003 to 2004. Nineteen percent of Medicaid recipients who received an antipsychotic were treated with APP. Individuals who received APP were more likely to be white, male, disabled, between the ages of 18-29, diagnosed with a psychotic disorder, and diagnosed with a higher number of psychiatric conditions...
November 10, 2017: Community Mental Health Journal
https://www.readbyqxmd.com/read/29124918/approaches-to-acute-pain-management-in-older-people
#6
Angela Telford
Pain is a diverse, individual experience and is associated with distress and suffering. Uncontrolled acute pain has been linked to delayed recovery and prolonged hospital stay. Nurses have a duty of care to their patients and acute pain management is integral to this. However, acute pain in older people can be difficult to manage, often because of under-reporting or difficulties in assessment. Older people have altered physiology often compounded by multiple co-morbidities and polypharmacy, all of which affect the appropriateness of, and available, pharmacological pain management strategies...
October 31, 2017: Nursing Older People
https://www.readbyqxmd.com/read/29123600/activities-performed-by-pharmacists-integrated-in-family-health-teams-results-from-a-web-based-survey
#7
Ulrika Gillespie, Lisa Dolovich, Simone Dahrouge
Objectives: Family health teams (FHTs), an interprofessional primary care practice model, were established in Ontario in 2005. As of October 2014, 191 FHT organizations were in operation, and 111 (58%) included one or several pharmacists. The objective of this study was to document the focus of pharmacist activities in FHTs. Approach: We invited all 155 known FHT pharmacists to a web-based survey. The survey was constructed using information obtained from previously done semi-structured telephone interviews with pharmacists working in FHTs...
November 2017: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
https://www.readbyqxmd.com/read/29123429/assessment-of-prescribed-medications-and-pattern-of-distribution-for-potential-drug-drug-interactions-among-chronic-kidney-disease-patients-attending-the-nephrology-clinic-of-lagos-university-teaching-hospital-in-sub-saharan-west-africa
#8
Olumuyiwa John Fasipe, Peter Ehizokhale Akhideno, Obiyo Nwaiwu, Alex Adedotun Adelosoye
Introduction: Life expectancy has increased significantly among chronic kidney disease (CKD) patients due to the extensive use of polypharmacy practice for medication prescriptions. This predisposes them to potential drug-drug interactions (DDIs), which can lead to an increase in morbidity, mortality, length of hospital stay, and health care cost. Methods: This was a 30-month retrospective study that reviewed the medical case records of consenting adult CKD patients from January 2014 to June 2016...
2017: Clinical Pharmacology: Advances and Applications
https://www.readbyqxmd.com/read/29122637/side-effect-burden-of-antipsychotic-drugs-in-real-life-impact-of-gender-and-polypharmacy
#9
Trude Seselie Jahr Iversen, Nils Eiel Steen, Ingrid Dieset, Sigrun Hope, Ragni Mørch, Erlend Strand Gardsjord, Kjetil Nordbø Jørgensen, Ingrid Melle, Ole A Andreassen, Espen Molden, Erik G Jönsson
BACKGROUND: Antipsychotic-associated side effects are well known and represent a significant treatment challenge. Still, few large studies have investigated the overall side effect burden of antipsychotics in real-life settings. OBJECTIVE: To describe the occurrence of side effects and perceived burden of antipsychotics in a large naturalistic sample, taking polypharmacy and patient characteristics into account. METHOD: Patients (n=1087) with psychotic disorders were assessed for side effects using the Udvalg for Kliniske Undersøgelser (UKU) side effect rating scale in addition to assessment of clinical and pharmacological data...
November 6, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/29122047/antipsychotic-polypharmacy-in-older-australians
#10
Lisa M Kalisch Ellett, Nicole L Pratt, Mhairi Kerr, Elizabeth E Roughead
BACKGROUND: Antipsychotics are commonly used, and the rate of use is highest, among those aged 65 years or over, where the risk of adverse events is also high. Up to 20% of younger adults use more than one antipsychotic concurrently; however there are few studies on the prevalence of antipsychotic polypharmacy in older people. We aimed to analyze antipsychotic use in elderly Australians, focusing on the prevalence of antipsychotic polypharmacy and the use of medicines to manage adverse events associated with antipsychotics...
November 10, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/29121732/quality-of-life-improvement-in-older-patients-with-heart-failure-initiated-on-ivabradine-results-from-the-uk-multi-centre-live-life-prospective-cohort-study
#11
D Zachariah, D Stevens, G Sidorowicz, C Spooner, N Rowell, J Taylor, R Kay, M S Salek, P R Kalra
AIMS: LIVE:LIFE is a multi-centre, open-label, prospective observational cohort study assessing health-related quality of life (HRQoL) in older patients with chronic heart failure (CHF) following initiation of ivabradine. The primary endpoint is change in Minnesota Living with Heart Failure Questionnaire (MLWHFQ) total score after 6months. METHODS AND RESULTS: Consenting patients aged ≥70years with CHF, in whom ivabradine was initiated within its licensed indication, were enrolled...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29121197/higher-accuracy-of-complex-medication-reconciliation-through-improved-design-of-electronic-tools
#12
Jan Horsky, Elizabeth A Drucker, Harley Z Ramelson
Objective: Investigate the accuracy of 2 different medication reconciliation tools integrated into electronic health record systems (EHRs) using a cognitively demanding scenario and complex medication history. Materials and Methods: Seventeen physicians reconciled medication lists for a polypharmacy patient using 2 EHRs in a simulation study. The lists contained 3 types of discrepancy and were transmitted between the systems via a Continuity of Care Document. Participants updated each EHR and their interactions were recorded and analyzed for the number and type of errors...
November 7, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29120894/advances-in-pharmacotherapies-for-movement-disorders-in-children-current-limitations-and-future-progress
#13
Jean-Pierre Lin
PURPOSE OF REVIEW: In childhood, movement disorders are generated by a very large number of disorders of the nervous system, and the very different developmental ages at which these occur make studies of pharmacotherapy efficacy extremely difficult. In most clinical practices, medication used in management is by trial and error, and limited by lack of efficacy and/or adverse drug reactions leading to drug intolerance. Nevertheless, symptom reduction using polypharmacy must be balanced against any accompanying comorbidities such as poor attention and concentration, constipation, ileus, urinary retention, blurred vision sedation and respiratory depression...
December 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29114834/polypharmacy
#14
Graziano Onder, Alessandra Marengoni
No abstract text is available yet for this article.
November 7, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29112499/-polypharmacy-and-potential-drug-drug-interactions-in-an-hiv-infected-elderly-population
#15
Carla Bastida, Ana Grau, Mònica Márquez, Montse Tuset, Elisa De Lazzari, Esteban Martínez, Josep Maria Gatell
No abstract text is available yet for this article.
November 1, 2017: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/29110295/prevalence-and-variability-in-medications-contributing-to-polypharmacy-in-long-term-care-facilities
#16
Natali Jokanovic, Kris M Jamsen, Edwin C K Tan, Michael J Dooley, Carl M Kirkpatrick, J Simon Bell
BACKGROUND: Research into which medications contribute to polypharmacy and the variability in these medications across long-term care facilities (LTCFs) has been minimal. OBJECTIVE: Our objective was to investigate which medications were more prevalent among residents with polypharmacy and to determine the variability in prescribing of these medications across LTCFs. METHODS: This was a cross-sectional study of 27 LTCFs in regional and rural Victoria, Australia...
December 2017: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/29110264/optimization-of-drug-prescription-and-medication-management-in-older-adults-with-cardiovascular-disease
#17
Nanette K Wenger, Caroline Lloyd Doherty, Jerry H Gurwitz, Glenn A Hirsch, Holly M Holmes, Matthew S Maurer, Michael D Murray
Cardiovascular disease increases incrementally with age and elderly patients concomitantly sustain multimorbidities, with resultant prescription of multiple medications. Despite conforming with disease-specific cardiovascular clinical practice guidelines, this polypharmacy predisposes many elderly individuals with cardiovascular disease to adverse drug events and non-adherence. Patient-centered care requires that the clinician explore with each patient his or her goals of care and that this shared decision-making constitutes the basis for optimization of medication management...
November 6, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29109936/a-study-of-harmful-drug-drug-interactions-due-to-polypharmacy-in-hospitalized-patients-in-goa-medical-college
#18
Akshay Khandeparkar, Padmanabh V Rataboli
Introduction: Concomitant use of multiple drugs is often indicated to manage comorbid conditions and enhance efficacy. Such concomitant use of multiple drugs (five or more drugs) has been defined as "polypharmacy." Polypharmacy has been associated with adverse consequences such as greater healthcare costs, increased risk of adverse drug events, drug-drug interactions (DDIs), medication nonadherence, reduced functional capacity, and multiple geriatric syndromes. This study evaluated number of potential harmful DDIs due to polypharmacy...
October 2017: Perspectives in Clinical Research
https://www.readbyqxmd.com/read/29108407/periprocedural-analgesic-efficacy-of-a-single-pre-emptive-administration-of-propacetamol-in-catheter-ablation-for-atrial-fibrillation-a-randomized-controlled-trial
#19
Sung Yeon Ham, Jong-Wook Song, Jae-Kwang Shim, Woo Kyung Lee, Hee-Jung Kim, Young-Lan Kwak
BACKGROUND: Anesthetic care for termination of atrial fibrillation with catheter ablation poses significant challenges due to significant pain lengthy procedure. A delicate polypharmacy combining anaesthetic agents to minimize respiratory depression and hemodynamic changes and to provide satisfactory sedation and analgesia is needed. METHODS: Ninety-eight patients were randomized into two groups receiving either two gram of propacetamol or normal saline intravenously for 20 min before anesthesia...
November 6, 2017: Minerva Anestesiologica
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
#20
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
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