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Polypharmacy

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https://www.readbyqxmd.com/read/28422415/impact-of-hospitalization-in-an-acute-geriatric-unit-on-polypharmacy-and-potentially-inappropriate-prescriptions-a-retrospective-study
#1
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/28421953/multiple-morbidities-assessment
#2
Erin Dean
Essential facts Multimorbidity, when a person has two or more long-term health conditions, is associated with a reduced quality of life, higher mortality, polypharmacy and high treatment burden, higher rates of adverse drug events, and much greater health service use.
April 19, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28416498/deprescribing-anticholinergic-and-sedative-medicines-protocol-for-a-feasibility-trial-defeat-polypharmacy-in-residential-aged-care-facilities
#3
Nagham Ailabouni, Dee Mangin, Prasad S Nishtala
INTRODUCTION: Targeted deprescribing of anticholinergic and sedative medicines can lead to positive health outcomes in older people; as they have been associated with cognitive and physical functioning decline. This study will examine whether the proposed intervention is feasible at reducing the prescription of anticholinergic and sedative medicines in older people. METHODS AND ANALYSIS: The Standard Protocol Items: Recommendations for Interventional trials (SPIRIT checklist) was used to develop and report the protocol...
April 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28416321/targeted-deprescribing-in-an-outpatient-hemodialysis-unit-a%C3%A2-quality-improvement-study-to-decrease-polypharmacy
#4
Caitlin McIntyre, Rory McQuillan, Chaim Bell, Marisa Battistella
BACKGROUND: Polypharmacy in hemodialysis patients can result in adverse patient outcomes. Deprescribing tools can reduce polypharmacy, yet no method exists for an outpatient hemodialysis population. DESIGN: Quality improvement study. SETTING & PARTICIPANTS: 240 patients in a tertiary-care outpatient hemodialysis unit. QUALITY IMPROVEMENT PLAN: We aimed to: (1) develop a deprescribing tool for target medications with poor evidence for efficacy and safety, (2) determine its effectiveness in decreasing polypharmacy, and (3) monitor patient safety and satisfaction...
April 14, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28414538/part-3-impact-of-systemic-conditions-and-medications-on-oral-health
#5
Diana Critchlow
The people who are treated in the community setting will often have multiple comorbidities. Systemic medical conditions can have a negative impact on oral health. In addition, the medications used to treat systemic conditions may also themselves cause oral symptoms. As a large proportion of patients treated by the community nursing team will be elderly, this paper will focus on common geriatric conditions that can display oral or dental symptoms. The effects of medications will be discussed and linked to oral complaints patients may express...
April 2, 2017: British Journal of Community Nursing
https://www.readbyqxmd.com/read/28405956/the-impact-of-polypharmacy-and-drug-interactions-among-the-elderly-population-in-western-sicily-italy
#6
Giulia Scondotto, Fanny Pojero, Sebastiano Pollina Addario, Mauro Ferrante, Maurizio Pastorello, Michele Visconti, Salvatore Scondotto, Alessandra Casuccio
AIM: Primary endpoint was to report polypharmacy distribution in the general population vs ≥65 years old people and to examine the frequency of drug-drug interactions (DDIs) in the Health Local Unit of Palermo, Italy, in relationship with patients' age. METHODS: Drug prescription data for the year 2014 were extracted from the database of the Local Health Unit of Palermo Province, Italy. Patients were divided into five age groups (0-13, 14-64, 65-69, 70-74, and ≥75 year old)...
April 12, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28405159/validation-of-an-instrument-to-measure-patients-experiences-of-medicine-use-the-living-with-medicines-questionnaire
#7
Janet Krska, Barbra Katusiime, Sarah A Corlett
BACKGROUND: Medicine-related burden is an increasingly recognized concept, stemming from the rising tide of polypharmacy, which may impact on patient behaviors, including nonadherence. No instruments currently exist which specifically measure medicine-related burden. The Living with Medicines Questionnaire (LMQ) was developed for this purpose. OBJECTIVE: This study validated the LMQ in a sample of adults using regular prescription medicines in the UK. METHODS: Questionnaires were distributed in community pharmacies and public places in southeast England or online through UK health websites and social media...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28401418/development-of-a-care-guidance-index-based-on-what-matters-to-patients
#8
John H Wasson, Laura Soloway, L Gordon Moore, Paul Labrec, Lynn Ho
INTRODUCTION: Targeting resources for a designated higher-risk subgroup is a strategy for chronic care management. However, risk-designation has several limitations: it is inaccurate, seldom helpful for care guidance, and potentially misallocates care away from many patients. METHODS: To address limitations of risk designation, we tested a "what matters index" (WMI) in 19,593 adult patients with chronic conditions. The WMI contains five binary measures: insufficient confidence to manage health problems, level of pain, emotional problems, polypharmacy, and adverse medication effects...
April 11, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28400969/antipsychotic-prescribing-of-consultant-forensic-psychiatrists-working-in-different-levels-of-secure-care-with-patients-with-schizophrenia
#9
Anna Machin, Lucy McCarthy
Aims and method To detect any differences in the antipsychotic prescribing practices of consultant forensic psychiatrists working in different levels of secure care with patients diagnosed with schizophrenia, and to identify potential reasons for any differences. Prescribing data were collected from four secure hospitals within one National Health Service trust. A questionnaire was sent to consultant forensic psychiatrists working at those hospitals as well as those working in the trust's community forensic services...
April 2017: BJPsych Bulletin
https://www.readbyqxmd.com/read/28397994/prevalence-of-obesity-hypoventilation-syndrome-in-ambulatory-obese-patients-attending-pathology-laboratories
#10
Jean-Christian Borel, Fabrice Guerber, Ingrid Jullian-Desayes, Marie Joyeux-Faure, Nathalie Arnol, Nellie Taleux, Renaud Tamisier, Jean-Louis Pépin
BACKGROUND AND OBJECTIVE: The prevalence of obesity hypoventilation syndrome (OHS) in the unselected obese is unknown. Our objectives were: (i) to determine the prevalence of OHS in ambulatory obese patients not previously referred to a pulmonologist for suspicion of sleep breathing disorders and (ii) to assess whether venous bicarbonate concentration [HCO3(-)v ] can be used to detect OHS. METHODS: In this prospective multicentric study, we measured [HCO3(-)v ] in consenting obese patients attending pathology analysis laboratories...
April 11, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28396366/comorbidity-and-polypharmacy-in-chronic-heart-failure-a-large-cross-sectional-study-in-primary-care
#11
Bosco Baron-Franco, Gary McLean, Frances S Mair, Veronique L Roger, Bruce Guthrie, Stewart W Mercer
BACKGROUND: Comorbidity is common in heart failure, but previous prevalence estimates have been based on a limited number of conditions using mainly non-primary care data sources.Aim To compare prevalence rates of comorbidity and polypharmacy in those with and without chronic heart failure due to left ventricular systolic dysfunction (LVSD).Design and setting A cross-sectional study of 1.4 million patients in primary care in Scotland. METHOD: Data on the presence of LVSD, 31 other physical, and seven mental health comorbidities, and prescriptions were extracted from a database of 1 424 378 adults...
April 10, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28396180/polypharmacy-is-associated-with-higher-frailty-risk-in-older-people-an-8-year-longitudinal-cohort-study
#12
Nicola Veronese, Brendon Stubbs, Marianna Noale, Marco Solmi, Alberto Pilotto, Alberto Vaona, Jacopo Demurtas, Christoph Mueller, Jonathan Huntley, Gaetano Crepaldi, Stefania Maggi
OBJECTIVE: To investigate whether polypharmacy is associated with a higher incidence of frailty in a large cohort of North Americans during 8 years of follow-up. DESIGN: Longitudinal study, follow-up of 8 years. PARTICIPANTS: A total of 4402 individuals at high risk or having knee osteoarthritis free from frailty at baseline. MEASUREMENTS: Details regarding medication prescription were captured and categorized as 0-3, 4-6, and ≥7...
April 7, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28387102/-how-i-treat-delirium-in-the-aged
#13
S Christelbach, J Petermans, S Allepaerts
Delirium is an acute psycho-organic disorder, most of the time reversible, that happens in various situations (acute disease, drugs ... ). It can also result from an acute or long term stress when the patient is already in an unstable homeostatic balance. Delirium is common in the geriatric population and can have serious consequences in terms of morbidity and mortality. Unfortunately, it is often not well known by hospital doctors. It is the consequence of predisposing factors (age, polypharmacy, multiple illnesses, neurodegenerative diseases, ...
November 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28386401/the-efficacy-and-safety-of-intravenous-lidocaine-for-analgesia-in-the-older-adult-a-literature-review
#14
REVIEW
Harriet Daykin
Opioids remain the mainstay of analgesia for the treatment of moderate to severe acute pain. Even in the young, the use of opioids can be associated with an increased incidence of post-operative complications such as respiratory depression, vomiting, pruritus, excessive sedation, slowing of gastrointestinal function, and urinary retention. The need to manage acute pain in the older patient is becoming more common as the population ages, and increasingly older patients are undergoing more major surgery. Medical conditions are more common in older people and can result in the requirement of systemic analgesia for fractures, malignancy, nociceptive or neuropathic pain and peripheral vascular disease...
February 2017: British Journal of Pain
https://www.readbyqxmd.com/read/28382861/metabolism-of-drugs-used-in-the-therapy-of-seizures-an-analytical-point-of-view-part-1
#15
Roberto Mandrioli, Laura Mercolini
BACKGROUND: Seizures are aetiologically and clinically heterogeneous neurological disorders that are currently treated using a wide array of drugs, belonging to equally heterogeneous chemical classes. Some of them are known as "antiepileptic drugs" (AEDs), due to their main field of use, while others (such as benzodiazepines) are frequently used for other conditions as well as for seizures. Due to their different chemical properties and mechanisms of activity, the metabolic characteristics of anti-seizure drugs can vary widely, also producing big differences in terms of safety, efficacy and therapeutic suitability...
April 6, 2017: Current Drug Metabolism
https://www.readbyqxmd.com/read/28382196/the-senator-project-developing-and-trialling-a-novel-software-engine-to-optimize-medications-and-nonpharmacological-therapy-in-older-people-with-multimorbidity-and-polypharmacy
#16
EDITORIAL
Roy L Soiza, Selvarani Subbarayan, Cherubini Antonio, Alfonso J Cruz-Jentoft, Mirko Petrovic, Adalsteinn Gudmundsson, Denis O'Mahony
No abstract text is available yet for this article.
March 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/28377808/the-outcomes-of-home-treatment-for-borderline-personality-disorder
#17
Sibel Turhan, Mark Taylor
Aims and method There is currently no trial or other scientific evidence informing the efficacy of any crisis intervention for people with borderline personality disorder (BPD). We aimed to assess the patterns of service use by patients with BPD taken on for crisis resolution and home treatment between 2010 and 2013. Patients with a diagnosis of BPD were identified and demographic and clinical data were collected. Results All patients were female, and a high proportion had recurrent presentations to crisis and home treatment services in Edinburgh...
December 2016: BJPsych Bulletin
https://www.readbyqxmd.com/read/28377541/depression-and-associated-factors-in-hospitalized-elderly-a-cross-sectional-study-in-a-saudi-teaching-hospital
#18
Sultan Hassan Alamri, Abdulaziz Ihsan Bari, Abdulrahman Talal Ali
BACKGROUND: Depression in the elderly is a serious and often underdiagnosed psychiatric disorder that has been linked to adverse outcomes in the hospital setting. OBJECTIVES: To determine the prevalence of depression and possible associated factors among hospitalized elderly. DESIGN: An analytical cross-sectional study. SETTINGS: Medical and surgical wards of King Abdulaziz University Hospital, Jeddah, Saudi Arabia. PATIENTS AND METHODS: The study included 200 consecutively hospitalized patients aged 60 years and older...
March 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/28375065/antipsychotic-polypharmacy-in-psychiatric-practice-is-it-really-doomed
#19
Ahmed Naguy
No abstract text is available yet for this article.
April 2017: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/28375036/new-developments-in-the-pharmacotherapeutic-management-of-heart-failure-in-elderly-patients-concerns-and-considerations
#20
Elles M Screever, Wouter C Meijers, Dirk J van Veldhuisen, Rudolf A de Boer
Heart failure (HF) remains a major public health problem worldwide, affecting approximately 23 million patients, and is predominantly a disease of the elderly population. Elderly patients mostly suffer from HF with preserved ejection fraction (HFpEF), which often presents with multiple co-morbidities and they require multiple medical treatments. This, together with the heterogeneous phenotype of HFpEF, makes it a difficult syndrome to diagnose and treat. Areas covered: Although HF is most abundant in the elderly, this group is still underrepresented in clinical trials, which results in the lack of evidence-based medical regimens...
April 17, 2017: Expert Opinion on Pharmacotherapy
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