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Polypharmacy

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https://www.readbyqxmd.com/read/29353187/medication-use-in-a-cohort-of-newly-admitted-nursing-home-residents-ageing-nh-in-relation-to-evolving-physical-and-mental-health
#1
Ivana Ivanova, Maarten Wauters, Robert Vander Stichele, Thierry Christiaens, Jonas De Wolf, Tine Dilles, Monique Elseviers
BACKGROUND: Medication use is high among nursing home (NH) residents, but there is a lack of longitudinal studies, determining medication use at admission and its evolution over time. AIM: Describing the evolution of the medication use two years after entering a NH, compared to the baseline observations and exploring the relation to the physical and mental health. METHODS: Data from the observational prospective Ageing@NH study, based on an inception cohort of newly admitted residents at NHs (65+) was used, selecting those consenting and with medication chart available...
January 17, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29352620/family-caregivers-facilitation-of-daily-adult-prescription-medication-use
#2
Debra L Roter, Siva Narayanan, Katherine Smith, Ray Bullman, Paula Rausch, Jennifer L Wolff, G Caleb Alexander
OBJECTIVE: To describe ways family members assist adult patients with prescription medications at home, during medical visits and at the pharmacy. METHODS: Online survey of 400 adults (caregivers) who help another adult (care recipient) with prescription medication use. Regression modeled the contribution of caregiver communication during recipients' medical visits, evaluation of physicians' medication communication and discussions with the dispensing pharmacist on caregivers' assistance with home medication management...
December 27, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/29340619/recurrent-serious-infections-in-patients-with-rheumatoid-arthritis-results-from-the-british-society-for-rheumatology-biologics-register
#3
Sujith Subesinghe, Andrew Ian Rutherford, Rachel Byng-Maddick, Kimme Leanne Hyrich, James Benjamin Galloway
Objectives: To establish the rate of recurrent infection in RA patients recruited to the British Society for Rheumatology Biologics Register - Rheumatoid Arthritis. Secondary objectives were to establish whether the organ class of index infection predicted future serious infection (SI). Methods: Using data from the British Society for Rheumatology Biologics Register - Rheumatoid Arthritis, a prospective observational cohort, we identified patients with at least one episode of SI...
January 10, 2018: Rheumatology
https://www.readbyqxmd.com/read/29338277/assessment-of-inpatient-psychiatric-readmission-risk-among-patients-discharged-on-an-antipsychotic-polypharmacy-regimen-a-retrospective-cohort-study
#4
Esad Boskailo, Aldin Malkoc, Dustin B McCurry, Jacob Venter, David Drachman, Gilbert M Ramos
OBJECTIVE: Patients are frequently prescribed multiple antipsychotic medications, leading to higher healthcare costs and increased risk for side effects. The efficacy of multiple versus single antipsychotics to prevent acute relapse, measured by incidence of inpatient readmission, is investigated in Arizona, USA. METHOD: A retrospective chart review compared socio-demographic and clinical data from 1,010 patients discharged on a single and 377 discharged on multiple antipsychotic medications...
November 2017: Acta Medica Academica
https://www.readbyqxmd.com/read/29335932/the-euro-forta-fit-for-the-aged-list-international-consensus-validation-of-a-clinical-tool-for-improved-drug-treatment-in-older-people
#5
Farhad Pazan, Christel Weiss, Martin Wehling
BACKGROUND: Drug treatment of older people is still potentially inappropriate in many cases as multimorbidity and related polypharmacy are highly prevalent. To increase the quality of drug treatment in older people, the FORTA (Fit fOR The Aged) List (first version 2012) was developed in a Delphi consensus procedure and updated (FORTA2015) by 21 experts from Germany and Austria. It has been validated in a randomized, controlled, prospective trial demonstrating significant improvement in the quality of drug treatment and clinical endpoints (VALFORTA)...
January 15, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29335089/associations-between-clinical-indicators-of-quality-and-aged-care-residents
#6
Yun-Hee Jeon, Anne-Nicole Casey, Kha Vo, Kris Rogers, Belinda Poole, Judith Fethney
Objectives To ascertain Australian multistate prevalence and incidence of five commonly collected clinical indicators of aged-care home quality and to measure associations between these clinical indicators and levels of care needs and consumer and staff satisfaction.Methods A retrospective analysis of national audit data collected from 426 facilities between 2015 and 2016 was performed. Regression models were used to examine associations between five clinical indicators (falls, pressure injury, physical restraint, unplanned weight loss and polypharmacy) and level of care needs measured by the Aged Care Funding Instrument (ACFI) and consumer and care staff survey responses...
January 16, 2018: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29334913/identifying-enablers-and-barriers-to-individually-tailored-prescribing-a-survey-of-healthcare-professionals-in-the-uk
#7
Joanne Reeve, Nicky Britten, Richard Byng, Jo Fleming, Janet Heaton, Janet Krska
BACKGROUND: Many people now take multiple medications on a long-term basis to manage health conditions. Optimising the benefit of such polypharmacy requires tailoring of medicines use to the needs and circumstances of individuals. However, professionals report barriers to achieving this in practice. In this study, we examined health professionals' perceptions of enablers and barriers to delivering individually tailored prescribing. METHODS: Normalisation Process Theory (NPT) informed an on-line survey of health professionals' views of enablers and barriers to implementation of Individually Tailored Prescribing (ITP) of medicines...
January 15, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29334745/-citalopram-and-qt-prolongation
#8
Štefan Alušík, Zoltán Paluch
In 2011/2012, the US Food and Drug Administration issued a warning about the effect of citalopram on the QT interval and decreased its dosing. Further studies addressing this issue have been published since then. The authors were interested to know whether or not the studies have furnished new information that could modify or further specify the FDA-issued recommendations. After analyzing the most relevant studies, the authors concluded that even papers published within the last 5 years confirmed that, of the SSRI class of drugs, citalopram prolongs the QT interval most significantly...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29332840/examining-patterns-of-multimorbidity-polypharmacy-and-risk-of-adverse-drug-reactions-in-chronic-obstructive-pulmonary-disease-a-cross-sectional-uk-biobank-study
#9
Peter Hanlon, Barbara I Nicholl, Bhautesh Dinesh Jani, Ross McQueenie, Duncan Lee, Katie I Gallacher, Frances S Mair
OBJECTIVE: This study aims: (1) to describe the pattern and extent of multimorbidity and polypharmacy in UK Biobank participants with chronic obstructive pulmonary disease (COPD) and (2) to identify which comorbidities are associated with increased risk of adverse drug reactions (ADRs) resulting from polypharmacy. DESIGN: Cross-sectional. SETTING: Community cohort. PARTICIPANTS: UK Biobank participants comparing self-reported COPD (n=8317) with no COPD (n=494 323)...
January 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29330715/case-series-analysis-of-new-zealand-reports-of-rapid-intense-potentiation-of-warfarin-by-roxithromycin
#10
Ruth L Savage, Michael V Tatley
INTRODUCTION: We undertook an analysis of all the reports to the New Zealand Centre for Adverse Reactions Monitoring of a roxithromycin/warfarin interaction after two recent reports described intense rapid warfarin potentiation. The interaction was first published in 1995. Cytochrome P450 3A4 inhibition has been the proposed mechanism but has limited biologic plausibility. There are suggestions that the clinical significance of the interaction may be increased by severe illness, polypharmacy, renal dysfunction, older age and increased warfarin sensitivity...
January 12, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29330585/potentially-inappropriate-medications-in-community-dwelling-older-adults-undertaken-as-a-comprehensive-geriatric-risk-assessment
#11
Sharmin S Bala, Sujita W Narayan, Prasad S Nishtala
PURPOSE: The prescription of potentially inappropriate medications (PIMs) is associated with an increase in adverse events, prescribing cascades, high health-care costs, morbidity, and mortality in the elderly. The overarching objective of this study is to examine the prevalence of PIMs in the elderly, applying the 2012 American Geriatrics Society Beers criteria for the study period 2012-2014, and the updated 2015 Beers criteria for 2015. METHODS: The study population (N = 70,479) included a continuously recruited national cohort of community-dwelling older (aged ≥ 65 years) New Zealanders who had undertaken the International Resident Assessment Instrument-Home Care (interRAI-HC) assessments between September 2012 and October 2015...
January 12, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29330364/polypharmacy-through-phage-display-selection-of-glucagon-and-glp-1-receptor-co-agonists-from-a-phage-displayed-peptide-library
#12
Anna Demartis, Armin Lahm, Licia Tomei, Elisa Beghetto, Valentina Di Biasio, Federica Orvieto, Francesco Frattolillo, Paul E Carrington, Sheena Mumick, Brian Hawes, Elisabetta Bianchi, Anandan Palani, Antonello Pessi
A promising emerging area for the treatment of obesity and diabetes is combinatorial hormone therapy, where single-molecule peptides are rationally designed to integrate the complementary actions of multiple endogenous metabolically-related hormones. We describe here a proof-of-concept study on developing unimolecular polypharmacy agents through the use of selection methods based on phage-displayed peptide libraries (PDL). Co-agonists of the glucagon (GCG) and GLP-1 receptors were identified from a PDL sequentially selected on GCGR- and GLP1R-overexpressing cells...
January 12, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29330175/development-and-validation-of-an-instrument-for-measuring-the-burden-of-medicine-on-functioning-and-well-being-the-medication-related-burden-quality-of-life-mrb-qol-tool
#13
Mohammed A Mohammed, Rebekah J Moles, Sarah N Hilmer, Lisa Kouladjian O'Donnel, Timothy F Chen
OBJECTIVE: Medication-related burden (MRB) is a negative experience with medicine, which may impact on psychological, social, physical and financial well-being of an individual. This study describes the development and initial validation of an instrument specifically designed to measure MRB on functioning and well-being-the Medication-Related Burden Quality of Life (MRB-QoL) tool. METHODS: An initial pool of 76-items for MRB-QoL was generated. The link to MRB-QoL survey was sent to a sample of consumers living with at least one chronic medical condition and taking ≥3 prescription medicines on a regular basis...
January 11, 2018: BMJ Open
https://www.readbyqxmd.com/read/29327519/psychiatric-co-morbidities-in-women-with-epilepsy
#14
Uma Sundar, Sonal Thakur Honrao, Nilesh Shah
Background: The co-existence of psychiatric co-morbidities with Epilepsy in women is multifactorial and complex, being closely related to hormonal status, medication side effects, and psychosocial factors. Aims: We aimed to study associated Psychiatric co-morbidities in women with Epilepsy (WWE), and correlate the same with seizure subtype and medication , compliance with treatment and seizure control. Material and Methods: This was a prospective, interview based study in OPD over 18 months, evaluating WWE over 13 years of age with at least 1 seizure in the last 1 year...
December 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29323832/influences-of-a-church-based-intervention-on-falls-risk-among-seniors
#15
Morgan Briggs, Jeffrey A Morzinski, Julie Ellis
BACKGROUND AND OBJECTIVES: Prior studies illustrate that community-based programs effectively decrease falls risk in older adults and that faith-based programs improve health behaviors. The literature is unclear whether faith-based initiatives reduce seniors' fall risks. To tackle this gap, a long-term partnership led by 10 urban churches, a nearby nursing school, and a medical school developed a study with 3 objectives: determine baseline health concerns associated with falls (eg, depression, polypharmacy), implement a nurse-led, faith-based health education initiative for community-dwelling African American seniors at-risk of hospitalization, and assess pre- to post -program fall frequency...
August 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29322475/the-scope-of-drug-related-problems-in-the-home-care-setting
#16
REVIEW
Carla Meyer-Massetti, Christoph R Meier, B Joseph Guglielmo
Introduction While drug-related problems (DRPs) in the inpatient setting are well known, the scope of these problems in home care has not been critically evaluated. Aim of the Review Our primary objective was to evaluate the incidence and demographics of DRPs in home care. Our specific aims were to characterize the rate of potentially inappropriate medications (PIMs), medication errors (MEs) and adverse drug events (ADEs) and to identify risk factors which contribute to DRPs in the home care setting. Methods Pubmed, Embase and CiNAHL databases were systematically searched from January 2000 to December 2016 for all publications which quantitatively characterized DRPs in the home care setting...
January 11, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29322470/associations-between-the-drug-burden-index-potentially-inappropriate-medications-and-quality-of-life-in-residential-aged-care
#17
Stephanie L Harrison, Lisa Kouladjian O'Donnell, Clare E Bradley, Rachel Milte, Suzanne M Dyer, Emmanuel S Gnanamanickam, Enwu Liu, Sarah N Hilmer, Maria Crotty
BACKGROUND: Inappropriate polypharmacy may negatively impact the quality of life of residents in aged care facilities, but it remains unclear which medications may influence this reduced quality of life. OBJECTIVE: The objective of this study was to examine whether the Drug Burden Index and potentially inappropriate medications were associated with quality of life in older adults living in residential care with a high prevalence of cognitive impairment and dementia...
January 11, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29318004/poly-de-prescribing-to-treat-polypharmacy-efficacy-and-safety
#18
Doron Garfinkel
Background: The aim of this study was to evaluate efficacy and safety of poly-de-prescribing (PDP) based on the Garfinkel method in older people with polypharmacy. Methods: A longitudinal, prospective, nonrandomized study in Israel was carried out between 2009 and 2016. Comprehensive geriatric assessments were performed at home in people age ⩾66 years consuming ⩾6 prescription drugs. Exclusion criteria were life expectancy <6 months and a seeming unwillingness to cooperate (poor compliance)...
January 2018: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/29314585/prevalence-of-sarcopenia-and-associated-factors-in-hospitalised-older-patients-a-cross-sectional-study
#19
Qiukui Hao, Xiaoyi Hu, Linlin Xie, Jing Chen, Jiaojiao Jiang, Birong Dong, Ming Yang
OBJECTIVE: To estimate the prevalence and factors associated with sarcopenia in a sample of older inpatients. METHODS: A cross-sectional study was conducted in three acute geriatric wards in 2012. Sarcopenia was defined according to the criteria of the Asian Working Group for Sarcopenia. RESULTS: We included 407 patients aged 81.0 ± 8.0 years. The prevalence of sarcopenia was 31% in the whole study population. Multiple logistic regression showed that being a female (odds ratio (OR) 4...
January 5, 2018: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/29310735/what-do-clinical-supervisors-require-to-teach-residents-in-family-medicine-how-to-care-for-seniors
#20
Anik M C Giguere, Paule Lebel, Michèle Morin, Françoise Proust, Charo Rodríguez, Valerie Carnovale, Louise Champagne, France Légaré, Pierre-Hugues Carmichael, Bernard Martineau, Philippe Karazivan, Pierre J Durand
We assessed clinicians' continuing professional development (CPD) needs at family practice teaching clinics in the province of Quebec. Our mixed methodology design comprised an environmental scan of training programs at four family medicine departments, an expert panel to determine priority clinical situations for senior care, a supervisors survey to assess their perceived CPD needs, and interviews to help understand the rationale behind their needs. From the environmental scan, the expert panel selected 13 priority situations...
January 9, 2018: Canadian Journal on Aging, la Revue Canadienne du Vieillissement
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