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Polypharmacy

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https://www.readbyqxmd.com/read/28817978/transcutaneous-electrical-nerve-stimulation-tens-as-an-adjunct-for-pain-management-in-perioperative-settings-a-critical-review
#1
Mark I Johnson
Surgical procedures are ever more complex. Day-case surgical loads are increasing and the length of hospital stays are reducing. Management of pain in perioperative settings remains a challenge. Expert panels recommend a multimodal approach which is often interpreted by medical practitioners as polypharmacy. There is variability in non-pharmacological interventions offered to patients, although transcutaneous electrical nerve stimulation (TENS) has been used since the 1970s. Recommendations from expert panels are inconsistent about the use of TENS in perioperative pain settings...
August 18, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28816923/evaluation-of-concurrent-oral-and-long-acting-injectable-antipsychotic-prescribing-at-the-minneapolis-veterans-affairs-health-care-system
#2
Erica Dimitropoulos, Lisa Drogemuller, Kara Wong
BACKGROUND: Antipsychotic polypharmacy is defined as the concomitant prescribing of more than 1 antipsychotic medication for an individual patient. Despite clinical guideline recommendations, long-acting injectable antipsychotics (LAIAs) are often used together with oral antipsychotics (OAPs) to treat a variety of psychiatric illnesses. Little research exists to address this form of antipsychotic polypharmacy, and its role in therapy is poorly understood. The purpose of this evaluation was to determine the prevalence of this prescribing pattern at our facility, identify provider rationale for polypharmacy, and analyze trends...
August 15, 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28816547/drug-utilization-among-hypertensive-patients-in-the-outpatient-department-of-medicine-in-a-tertiary-care-hospital-a-cross-sectional-study
#3
Sarika G Paradkar, Shyamal R Sinha
BACKGROUND: Hypertension is one of the leading risk factors for cardiovascular, cerebrovascular, and renal disease. Its increasing prevalence and treatment costs influence the prescribing pattern among physicians. Drug utilization studies provide insights into the current prescribing practices and help us facilitate the rational use of drugs. We carried out the present study to assess the pattern of drug utilization in hypertensive patients. METHOD: Adults seeking treatment for hypertension were recruited...
August 17, 2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/28814857/when-is-dual-bronchodilation-indicated-in-copd
#4
REVIEW
Mike Thomas, David Mg Halpin, Marc Miravitlles
Inhaled bronchodilator medications are central to the management of COPD and are frequently given on a regular basis to prevent or reduce symptoms. While short-acting bronchodilators are a treatment option for people with relatively few COPD symptoms and at low risk of exacerbations, for the majority of patients with significant breathlessness at the time of diagnosis, long-acting bronchodilators may be required. Dual bronchodilation with a long-acting β2-agonist and long-acting muscarinic antagonist may be more effective treatment for some of these patients, with the aim of improving symptoms...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28814330/novel-remote-electronic-medication-supply-model-for-opioid-dependent-outpatients-with-polypharmacy-first-long-term-case-study
#5
Samuel S Allemann, Kenneth M Dürsteler, Johannes Strasser, Marc Vogel, Marcel Stoeckle, Kurt E Hersberger, Isabelle Arnet
BACKGROUND: Patients with substance use disorders grow older thanks to effective treatments. Together with a high prevalence of comorbidities, psychological problems, and low social support, these patients are at high risk for medication non-adherence. Established treatment facilities face challenges to accommodate these complex patients within their setting. Electronic medication management aids (e-MMAs) might be appropriate to simultaneously monitor and improve adherence for these patients...
August 16, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/28805478/production-of-platelet-rich-plasma-gel-from-elderly-patients-under-antithrombotic-drugs-perspectives-in-chronic-wounds-care
#6
M Velier, J Magalon, A Daumas, M Cassar, P Francois, A Ghazouane, C Philandrianos, B Bertrand, C Frere, D Bernot, P Villani, F Dignat George, F Sabatier
Platelet-Rich Plasma (PRP) is an autologous biological therapy obtained by centrifuging the patient's own blood to concentrate platelets. The addition of autologous thrombin and calcium chloride to PRP allows the production of a semi-solid form called PRP gel. PRP gel is increasingly used in a variety of tissue defects and predominantly in the management of non-healing chronic wounds. The topical application of PRP gel seems promising due to the capability of platelets to store and secrete growth factors (GF), fibrin and cytokines, which are essentials for wound healing...
August 14, 2017: Platelets
https://www.readbyqxmd.com/read/28803378/qt-interval-prolongation-in-hospitalized-patients-on-cardiology-wards-a-prospective-observational-study
#7
Qasim Khan, Mohammad Ismail, Iqbal Haider, Inam Ul Haq, Sidra Noor
PURPOSE: Prolonged QT interval may lead to a lethal form of arrhythmia, torsades de pointes (TdP), which is associated with cardiovascular mortality. Therefore, we aimed to identify prevalence of QT interval prolongation, compare clinical characteristics of patients with normal and prolonged QT interval, and identify predictors of QT interval prolongation. METHODS: A prospective observational study was conducted in cardiology wards of two teaching hospitals in Pakistan...
August 12, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28801825/intractable-constipation-in-the-elderly
#8
REVIEW
Noemi Baffy, Amy E Foxx-Orenstein, Lucinda A Harris, Susan Sterler
Chronic constipation is a common gastrointestinal disorder disproportionately affecting the elderly. Immobility, polypharmacy, and physiologic changes contribute to its increased prevalence in this population. Unidentified and undertreated constipation leads to a significant negative impact on quality of life and an increase in healthcare spending. Careful physical examination and exploration of the clinical history can unmask primary and secondary forms of constipation, guiding diagnostic and therapeutic considerations...
August 11, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28801438/associations-between-polypharmacy-and-treatment-intensity-for-hypertension-and-diabetes-a-cross-sectional-study-of-nursing-home-patients-in-british-columbia-canada
#9
Rita McCracken, James McCormack, Margaret J McGregor, Sabrina T Wong, Scott Garrison
OBJECTIVES: Describe nursing home polypharmacy prevalence in the context of prescribing for diabetes and hypertension and determine possible associations between lower surrogate markers for treated hypertension and diabetes (overtreatment) and polypharmacy. DESIGN: Cross-sectional study. SETTING: 6 nursing homes in British Columbia, Canada. PARTICIPANTS: 214 patients residing in one of the selected facilities during data collection period...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28797369/managing-polypharmacy-in-the-15-minute-office-visit
#10
REVIEW
Demetra Antimisiaris, Timothy Cutler
Polypharmacy is an underappreciated factor in undesirable patient outcomes. In older adults, polypharmacy is considered a syndrome of harm and presents a challenge to primary care providers. The United States has one of the highest medication use rates per capita in the world. With the aging population, and polypharmacy a significant part of the lives of older adults, management of polypharmacy poses both a growing challenge and an opportunity for all health care providers. This article provides an overview of skills to improve medication use management in older adults living with polypharmacy...
September 2017: Primary Care
https://www.readbyqxmd.com/read/28795462/a-cross-sectional-evaluation-of-the-prevalence-and-detection-of-predictors-of-polypharmacy-amongst-adult-in-spain
#11
Gracia Niclós, Teresa Olivar, Vicent Rodilla
OBJECTIVE: To investigate the association between polypharmacy and sociodemographic factors as well as health status, determinants of health and healthcare use, illness and use of prescribed medicines amongst adults in Spain. METHODS: Data from the 2009 European Health Interview Survey in Spain which included 22 188 subjects were used. Polypharmacy was defined as the use of five or more prescribed medicines. The association between polypharmacy and several variables was assessed by means of bivariate analysis and logistic regression analysis (adjusted by age and gender)...
August 10, 2017: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28795285/polypharmacy-and-potential-drug-drug-interactions-in-emergency-department-patients-in-the-caribbean
#12
Darren Dookeeram, Satesh Bidaisee, Joanne F Paul, Paula Nunes, Paula Robertson, Vidya Ramcharitar Maharaj, Ian Sammy
Background Potential Drug-Drug Interactions (DDI) account for many emergency department visits. Polypharmacy, as well as herbal, over-the-counter (OTC) and combination medication may compound this, but these problems are not well researched in low-and-middle-income countries. Objective To compare the incidence of drug-drug interactions and polypharmacy in older and younger patients attending the Emergency Department (ED). Setting The adult ED of a tertiary teaching hospital in Trinidad. Methods A 4 month cross sectional study was conducted, comparing potential DDI in older and younger patients discharged from the ED, as defined using Micromedex 2...
August 9, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28793363/falls-a-fear-of-falling-and-related-factors-in-older-adults-with-complex-chronic-disease
#13
JuHee Lee, MoonKi Choi, Chang Oh Kim
AIM AND OBJECTIVES: To identify factors influencing falls and the fear of falling among older adults with chronic diseases in Korea. BACKGROUND: The fear of falling and falls in older adults are significant health problems towards which healthcare providers should direct their attention. Further investigation is needed to improve nursing practice specifically decreasing risk of falls and the fear of falling in Korea. DESIGN: Descriptive, cross-sectional survey...
August 9, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28792521/association-of-psychotropic-drug-use-with-falls-among-older-adults-in-germany-results-of-the-german-health-interview-and-examination-survey-for-adults-2008-2011-degs1
#14
Yong Du, Ingrid-Katharina Wolf, Hildtraud Knopf
PURPOSE: To investigate the association of psychotropic drug use with falls among older adults in Germany based on data from the National Health Interview and Examination Survey for Adults 2008-2011 (DEGS1). METHODS: DEGS1 collected data on drug use in the past 7 days and on falls occurred in the last 12 months. Study participants were older adults aged 65-79 years with complete data on drug use and falls (N = 1,833). Odds ratio (OR) and 95% confidence intervals (95% CI) were derived from logistic regression models adjusting for potential confounders including socio-demographic characteristics, health-related behaviors (alcohol drinking), body mass index and health conditions (frailty, vision impairment, disability, polypharmacy, blood pressure) as well as use of potential falls-risk-increasing drugs...
2017: PloS One
https://www.readbyqxmd.com/read/28791591/age-related-differences-in-non-persistence-with-statin-treatment-in-patients-after-a-transient-ischaemic-attack
#15
Martin Wawruch, Dusan Zatko, Gejza Wimmer, Jan Luha, Sona Wimmerova, Petra Matalova, Peter Kukumberg, Jan Murin, Tomas Tesar, Beata Havelkova, Rashmi Shah
BACKGROUND AND OBJECTIVE: Non-persistence with secondary preventive measures, including medications such as statins, adversely affects the prospects of successful outcomes. This study was aimed at evaluating non-persistence with statin therapy in cohorts of young and elderly patients after a transient ischaemic attack (TIA) and identifying patient-associated characteristics that influence the risk for non-persistence. METHODS: The study cohorts included 797 adult patients who were initiated on statin therapy following a TIA diagnosis between 1 January 2010 and 31 December 2010...
August 8, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28781062/value-of-geriatric-screening-and-assessment-in-predicting-postoperative-complications-in-patients-older-than-70-years-undergoing-surgery-for-colorectal-cancer
#16
Katleen Fagard, Julie Casaer, Albert Wolthuis, Johan Flamaing, Koen Milisen, Jean-Pierre Lobelle, Hans Wildiers, Cindy Kenis
OBJECTIVES: This study examines the association between geriatric screening and geriatric assessment (GA) and the risk of 30-day postoperative complications (30d-POCs) in older patients undergoing surgery for colorectal cancer (CRC). MATERIALS AND METHODS: Patients were identified from a prospectively collected database (2009-2015). All patients underwent geriatric screening with the G8 screening tool and the Flemish version of the Triage Risk Screening Tool (fTRST)...
August 3, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28779826/polypharmacy-and-medication-management-in-older-adults
#17
REVIEW
Jennifer Kim, Abby Luck Parish
Polypharmacy in older adults is a global problem that has recently worsened. Approximately 30% of adults aged 65 years and older in developed countries take 5 or more medications. Although prescribed and over-the-counter medications may improve a wide range of health problems, they also may cause or contribute to harm, especially in older adults. Polypharmacy in older adults is associated with worsening of geriatric syndromes and adverse drug events. Given the risks and burdens of polypharmacy and potentially inappropriate medications, nurses must use patient-centered approaches and nonpharmacologic strategies to treat common symptoms and to optimize patient function and quality of life...
September 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28776873/the-systematic-tool-to-reduce-inappropriate-prescribing-strip-combining-implicit-and-explicit-prescribing-tools-to-improve-appropriate-prescribing
#18
A Clara Drenth-van Maanen, Anne J Leendertse, Paul A F Jansen, Wilma Knol, Carolina J P W Keijsers, Michiel C Meulendijk, Rob J van Marum
Inappropriate prescribing is a major health care issue, especially regarding older patients on polypharmacy. Multiple implicit and explicit prescribing tools have been developed to improve prescribing, but these have hardly ever been used in combination. The Systematic Tool to Reduce Inappropriate Prescribing (STRIP) combines implicit prescribing tools with the explicit Screening Tool to Alert physicians to the Right Treatment and Screening Tool of Older People's potentially inappropriate Prescriptions criteria and has shared decision-making with the patient as a critical step...
August 4, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28776467/pharmacogenetics-and-the-treatment-of-asthma
#19
María Isidoro-García, Almudena Sánchez-Martín, Asunción García-Sánchez, Catalina Sanz, Belén García-Berrocal, Ignacio Dávila
Heterogeneity defines both the natural history of asthma as well as patient's response to treatment. Pharmacogenomics contribute to understand the genetic basis of drug response and thus to define new therapeutic targets or molecular biomarkers to evaluate treatment effectiveness. This review is initially focused on different genes so far involved in the pharmacological response to asthma treatment. Specific considerations regarding allergic asthma, the pharmacogenetics aspects of polypharmacy and the application of pharmacogenomics in new drugs in asthma will also be addressed...
August 4, 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28774549/combined-healthy-behaviors-and-healthcare-services-use-in-older-adults
#20
Ana Hernández-Aceituno, Raúl F Pérez-Tasigchana, Pilar Guallar-Castillón, Esther López-García, Fernando Rodríguez-Artalejo, José R Banegas
INTRODUCTION: Data on the combined impact of healthy behaviors on healthcare use in older adults are limited. METHODS: Study with community-dwelling individuals aged ≥60 years from the Spanish Seniors-ENRICA cohort, recruited in 2008-2010, followed through 2012-2013, and analyzed in 2016 (N=2,021). At baseline, the following healthy behaviors were self-reported: three traditional (never smoking, being physically active, having a healthy diet) and three emerging (sleeping 7-8 hours/day, sitting <8 hours/day, not living alone)...
July 31, 2017: American Journal of Preventive Medicine
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