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Polypharmacy

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https://www.readbyqxmd.com/read/29785710/insomnia-in-community-living-persons-with-advanced-age
#1
Brienne Miner, Thomas M Gill, H Klar Yaggi, Nancy S Redeker, Peter H Van Ness, Ling Han, Carlos A Vaz Fragoso
OBJECTIVE: To evaluate the epidemiology of insomnia, including demographic and clinical correlates, in older adults. DESIGN: Cross-sectional. SETTING: Community. PARTICIPANTS: Yale Precipitating Events Project participants (N=379; mean age 84.3; 67.8% female; 11.9% African American). MEASUREMENTS: Insomnia Severity Index (ISI), with scores of 8 and higher indicating insomnia, which was further stratified according to ISI score as mild (8-14), moderate (15-21), or severe (22-28)...
May 21, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29784023/delayed-presentation-of-severe-rhabdomyolysis-leading-to-acute-kidney-injury-following-atorvastatin-gemfibrozil-combination-therapy-a-case-report
#2
Chamara Dalugama, Manoji Pathirage, S A M Kularatne
BACKGROUND: Rhabdomyolysis is a rare but serious complication of lipid-lowering therapy. Statin and fibrate combination increases the risk of rhabdomyolysis possibly by pharmacodynamic interactions. Advanced age, diabetes, hypothyroidism, polypharmacy, and renal impairment are known to increase the risk of rhabdomyolysis. Management strategies include fluid resuscitation and urine alkalinization. Renal indications such as refractory hyperkalemia, acidosis, fluid overload, or uremic complications mandate renal replacement therapy in rhabdomyolysis...
May 22, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29777797/polypharmacy-defined-as-taking-five-or-more-drugs-is-inadequate-in-the-cardiovascular-setting
#3
Nazanin Abolhassani
BACKGROUND: By how much polypharmacy (defined by number of drugss) differs from polyactive ingredient use (defined by the number of pharmacologically active ingredients) has not been assessed. OBJECTIVES: to compare the extent of polypharmacy vs. polyactive ingredients among patients taking CV medicines. METHODS: Prospective, 10-year follow-up study conducted among 880 participants of the CoLaus study taking CV drugs at baseline. Polypharmacy was defined as the use of 5 or more CV medicines; polyactive ingredient use was defined as the use of 5 or more pharmacologically active CV ingredients...
May 16, 2018: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/29771699/the-optimal-time-of-day-for-statin-administration-a-review-of-current-evidence
#4
Kamal Awad, Maciej Banach
PURPOSE OF REVIEW: In humans, cholesterol biosynthesis varies diurnally, reaching its peak at night. Therefore, choosing the time of statin administration is critical because of their different half-lives. Dose timing becomes more important in patients with polypharmacy because it might affect their adherence to the statin therapy. RECENT FINDINGS: Herein, we narratively summarized the available clinical studies (n = 17) and meta-analyses (n = 2) that compared the morning with the evening dose of statins in terms of safety and efficacy, with special focus on their low-density lipoprotein-lowering effects...
May 15, 2018: Current Opinion in Lipidology
https://www.readbyqxmd.com/read/29770718/a-systematic-literature-review-comparing-methods-for-the-measurement-of-patient-persistence-and-adherence
#5
Carol A Forbes, Sohan Deshpande, Francesc Sorio-Vilela, Lucie Kutikova, Steven Duffy, Ioanna Gouni-Berthold, Emil Hagström
OBJECTIVES: A systematic literature review was conducted comparing different approaches estimating persistence and adherence in chronic diseases with polypharmacy of oral and subcutaneous treatments. METHODS: This work followed published guidance on performing systematic reviews. Twelve electronic databases and grey literature sources were used to identify studies and guidelines for persistence and adherence of oral and subcutaneous therapies in hypercholesterolemia, type 2 diabetes, hypertension, osteoporosis and rheumatoid arthritis...
May 17, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29770474/improving-medication-safety-for-home-nursing-clients-a-prospective-observational-study-of-a-novel-clinical-pharmacy-service-the-visiting-pharmacist-vip-study
#6
C Y Lee, C Beanland, D Goeman, N Petrie, B Petrie, F Vise, J Gray, R A Elliott
WHAT IS KNOWN AND OBJECTIVE: Polypharmacy, medication errors and adverse events are common in older people receiving home nursing medication management support. Access to clinical pharmacists is limited. In Australia, few home nursing clients receive a general practitioner (GP)-initiated pharmacist-led Home Medicines Review, despite their eligibility and community nurses' (CN) efforts to facilitate this. An integrated home nursing clinical pharmacy service, in which CNs directly referred clients to a pharmacist, was therefore developed and piloted...
May 16, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29769020/the-prevalence-and-determinants-of-polypharmacy-at-age-69-a-british-birth-cohort-study
#7
Mark James Rawle, Marcus Richards, Daniel Davis, Diana Kuh
BACKGROUND: To describe the development of polypharmacy and its components in a British birth cohort in its seventh decade and to investigate socioeconomic and gender differences independent of disease burden. METHODS: Data from the MRC National Survey for Health and Development were analysed to determine the prevalence and composition of polypharmacy at age 69 and changes since ages 60 to 64. Multinomial regression was used to test associations between gender, education and occupational social class and total, cardiological and non-cardiological polypharmacy controlling for disease burden...
May 16, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29766391/medication-related-problems-among-adult-chronic-kidney-disease-patients-in-a-sub-saharan-tertiary-hospital
#8
Lisper Wangeci Njeri, William Otieno Ogallo, David Gitonga Nyamu, Sylvia Adisa Opanga, Alfred Rugendo Birichi
BACKGROUND: Chronic kidney disease (CKD) patients are prone to medication-related problems (MRPs). Few studies address the clinical relevance of MRPs among CKD patients in sub-Saharan Africa. OBJECTIVE: To investigate the frequency and predictors of MRPs among adult CKD patients treated at a tertiary care facility in an urban sub-Saharan setting. SETTING: Kenyatta National Hospital in Nairobi, Kenya. METHOD: A cross-sectional study involving 60 adult patients with CKD was carried out...
May 15, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29765871/optimizing-medicine-use-for-people-who-are-homebound-an-evaluation-of-a-pilot-domiciliary-medicine-use-review-dmur-service-in-england
#9
Asam Latif, Baguiasri Mandane, Emma Anderson, Caroline Barraclough, Samantha Travis
Background: As global life expectancy increases, older people with chronic diseases are being required to manage multiple and complex medicine regimes. However, polypharmacy raises the risk of medicine-related problems and preventable hospital admissions. To improve medicine use, English community pharmacies are commissioned to deliver Medicines Use Reviews (MURs), which are typically delivered from the pharmacy. People who are homebound rarely receive the service. This paper describes the uptake and impact of a pilot project that seeks to provide domiciliary Medicines Use Reviews (dMURs)...
2018: Integrated Pharmacy Research and Practice
https://www.readbyqxmd.com/read/29761596/the-electronic-pharmaceutical-record-a-new-method-for-medication-reconciliation
#10
Camille Jurado, Violaine Calmels, Emilie Lobinet, Elodie Divol, Hélène Hanaire, David Metsu, Brigitte Sallerin
RATIONALE, AIM, AND OBJECTIVE: There are several ways to establish an accurate medication list in the hospital admission medication reconciliation (MedRec). The challenge for MedRec lies in the availability, reliability, and completeness of the data used. In France, the Electronic Pharmaceutical Record (ePR) was developed to register each medication taken by ambulatory patients, primarily to make dispensation in community pharmacies safe. We evaluated the suitability of this tool in the MedRec when patients were admitted to the hospital...
May 15, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29761577/polypharmacy-and-psychotropic-drug-loading-in-patients-with-schizophrenia-in-asian-countries-the-reap-ap4-study
#11
Shu-Yu Yang, Lian-Yu Chen, Eunice Najoan, Roy Abraham Kallivayalil, Kittisak Viboonma, Ruzita Jamaluddin, Afzal Javed, Duong Thi Quynh Hoa, Hitoshi Iida, Kang Sim, Thiha Swe, Yan-Ling He, Yongchon Park, Helal Uddin Ahmed, Angelo De Alwis, Helen Fung-Kum Chiu, Norman Sartorius, Chay-Hoon Tan, Mian-Yoon Chong, Naotaka Shinfuku, Shih-Ku Lin
AIM: The aim of the present study was to survey the prevalence of antipsychotic polypharmacy and combined medication use across 15 Asian countries and areas in 2016. METHODS: By using the results from the fourth survey of Research on Asian Prescription Patterns on antipsychotics (REAP-AP4), the rates of polypharmacy and combined medication use in each country were analyzed. Daily medications prescribed for the treatment of inpatients or outpatients with schizophrenia, including antipsychotics, mood stabilizers, anxiolytics, hypnotics, and antiparkinson agents, were collected...
May 14, 2018: Psychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/29752625/polypharmacy-among-headache-patients-a-cross-sectional-study
#12
Anna Ferrari, Carlo Baraldi, Manuela Licata, Cecilia Rustichelli
BACKGROUND: Polypharmacy can appropriately treat multiple chronic conditions, but it can also increase potential harm. Polypharmacy information for primary headaches is minimal, despite drugs being the main tools to manage headaches. OBJECTIVE: The aim was to evaluate the prevalence, characteristics and risk factors of polypharmacy in patients with primary headaches and examine whether these variables differ between episodic and chronic headache patients. METHODS: We analysed polypharmacy (simultaneous use of five or more medications), medication type, comorbidity, and risk factors in 300 patients (mean age 42...
May 11, 2018: CNS Drugs
https://www.readbyqxmd.com/read/29747709/polimedication-applicability-of-a-computer-tool-to-reduce-polypharmacy-in-nursing-homes
#13
Tomás M García-Caballero, Juan Lojo, Carlos Menéndez, Roberto Fernández-Álvarez, Raimundo Mateos, Alejandro Garcia-Caballero
ABSTRACTBackground:The risks of polypharmacy can be far greater than the benefits, especially in the elderly. Comorbidity makes polypharmacy very prevalent in this population; thus, increasing the occurrence of adverse effects. To solve this problem, the most common strategy is to use lists of potentially inappropriate medications. However, this strategy is time consuming. METHODS: In order to minimize the expenditure of time, our group devised a pilot computer tool (Polimedication) that automatically processes lists of medication providing the corresponding Screening Tool of Older Persons' potentially inappropriate Prescriptions alerts and facilitating standardized reports...
May 11, 2018: International Psychogeriatrics
https://www.readbyqxmd.com/read/29746153/association-between-polypharmacy-and-dementia-a-systematic-review-and-meta-analysis
#14
Nattawut Leelakanok, Ronilda R D'Cunha
OBJECTIVE: The association between polypharmacy and dementia is controversial. This systematic review and meta-analysis aims to summarize existing literature concerning the association between polypharmacy and dementia. METHODS: A systematic literature review was performed by searching the EMBASE, PubMed, Scopus and International Pharmaceutical Abstract databases using terms related to polypharmacy and dementia. A meta-analysis was performed using random effect models...
May 10, 2018: Aging & Mental Health
https://www.readbyqxmd.com/read/29743832/management-of-inflammatory-bowel-disease-in-older-persons-evolving-paradigms
#15
REVIEW
Saurabh Kedia, Jimmy K Limdi, Vineet Ahuja
The incidence and prevalence of inflammatory bowel disease (IBD) is increasing, and considering the aging population, this number is set to increase further in the future. The clinical features and natural history of elderly-onset IBD have many similarities with those of IBD in younger patients, but with significant differences including a broader differential diagnosis. The relative lack of data specific to elderly patients with IBD, often stemming from their typical exclusion from clinical trials, has made clinical decision-making somewhat challenging...
April 2018: Intestinal Research
https://www.readbyqxmd.com/read/29741195/polypharmacy-but-not-potential-inappropriate-prescription-was-associated-with-frailty-in-older-adults-from-a-middle-income-country-outpatient-clinic
#16
I Aprahamian, M M Biella, G Vano Aricó de Almeida, F Pegoraro, A V Alves Pedrini, B Cestari, L H Bignotto, B Alvarez Ribeiro de Melo, J E Martinelli
OBJECTIVES: the aims of the present study were: (1) investigate the prevalence and association of polypharmacy and pre-frailty or frailty in a middle-income country sample of older adults; and (2) evaluate the prevalence of potential inappropriate prescription (PIP) and its association with pre-frailty or frailty. DESIGN: Cross-sectional observational study. SETTING: Outpatient center at a university-based hospital in the state of São Paulo, Brazil...
2018: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/29740921/hospitalization-and-morbidity-due-to-adverse-drug-reactions-in-elderly-patients-a-single-center-study
#17
Silvia Ognibene, Natale Vazzana, Claudio Giumelli, Luisa Savoldi, Luca Braglia, Giuseppe Chesi
BACKGROUND AND AIMS: Adverse drug reaction (ADRs) is a leading but underrecognized cause of illness particularly in frail subjects with multiple comorbidities. We aimed to investigate the frequency, patterns and outcomes of ADRs as a cause of hospitalization in elderly patients admitted to an internal medicine ward. METHODS: We performed a retrospective observational study including every patient aged over 65 years who was admitted to our Department during a 12-month period...
May 9, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29734517/rosuvastatin-induced-rhabdomyolysis-possible-role-of-ticagrelor-and-patients-pharmacogenetic-profile
#18
Majda Vrkić Kirhmajer, Viola Macolić Šarinić, Livija Šimičević, Iva Ladić, Krešimir Putarek, Ljiljana Banfić, Nada Božina
Up to the beginning of 2018, a total of eight cases describing rare but clinically important drug interactions between rosuvastatin and ticagrelor which resulted in rhabdomyolysis have been noted in the Global World Health Organization (WHO) adverse drug reaction (ADR) database (VigiBase) as well as in available literature. There are several possible factors which could contribute to the onset of rhabdomyolysis: old age, initially excessive rosuvastatin dose, drug-drug interactions (DDI) on metabolic enzymes (CYPs and UGTs) and drug transporter levels (ABCB1, ABCG2, OATP1B1) and pharmacogenetic predisposition...
May 7, 2018: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29731614/comprehensive-geriatric-assessment-prediction-of-postoperative-complications-in-gastrointestinal-cancer-patients-a-meta-analysis
#19
REVIEW
Dan-Dan Xue, Yun Cheng, Mei Wu, Yan Zhang
Background: Gastrointestinal cancer is an age-associated disease, and geriatric patients are mostly likely to suffer from postoperative complications. Some studies indicated that comprehensive geriatric assessment (CGA) could predict postoperative complications in gastrointestinal cancer patients. However, the evidence is mixed. Objective: This study aimed to conduct a meta-analysis to identify the effectiveness of CGA for predicting postoperative complications in gastrointestinal cancer patients...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29730983/the-challenge-of-aging-and-pharmacoterapeutic-complexity-in-the-hiv-patient
#20
Ramón Morillo-Verdugo, José Ramón Blanco Ramos, Laila Abdel-Kader Martín, María Álvarez de Sotomayor
OBJECTIVE: To describe the current knowledge and management of aging and  pharmacotherapeutic complexity in HIV + patients. METHOD: A review of literature was carried out, including articles, originals or  reviews, published in English or Spanish, from 2007 to 2017, which analysed the aging and pharmacotherapeutic complexity in HIV + patients. The terms  «Polypharmacy»/»Polypharmacy», «Aging»/»Aging», «Frailty»/»Fragility»,  «Pharmacotherapeutic Complexity»/»Medication Regimen Complexity» and  «HIV»/"HIV» were combined...
May 1, 2018: Farmacia Hospitalaria
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