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Polypharmacy

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https://www.readbyqxmd.com/read/27933178/assessing-medication-packaging-and-labelling-appropriateness-in-sri-lanka
#1
N Athuraliya, E J Walkom, S Dharmaratne, J Robertson
BACKGROUND: There is substantial evidence of poor dispensing practices with inadequate packaging and labelling of medicines, and limited advice on their usage in low and middle-income countries (LMICs). We examined the labelling and packaging of medicines identified during a survey of 1322 households in six regions of Sri Lanka between 2010 and 2013 conducted using the World Health Organization (WHO) methodology for household surveys. We compared medicines obtained from public and private sources and asked interviewees if they understood how to take the medicines...
2016: Journal of Pharmaceutical Policy and Practice
https://www.readbyqxmd.com/read/27932208/a-novel-approach-to-deprescribing-in-long-term-care-settings-the-smart-campaign
#2
Kathleen Abrahamson, Arif Nazir, Karis Pressler
There have been numerous calls within the medical community urging providers to consider the complex problem of inappropriate polypharmacy and inappropriate medication use among nursing home residents. It is clear that innovative, longitudinal policy-supported interventions are needed to better understand prescribing practices in long-term care settings and to curtail the negative, cascading outcomes associated with inappropriate polypharmacy among elderly patients. The Indiana Safer Medication Administration Regimens and Treatment (SMART) campaign is funded by the Indiana State Department of Health for a pilot period of 2 years (2016-18) with the objectives of: 1...
November 30, 2016: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/27924735/-clinical-medication-reviews-in-elderly-patients-with-polypharmacy-a-cross-sectional-study-in-dutch-community-pharmacies
#3
S H Chau, A P D Jansen, P M van de Ven, P Hoogland, P J M Elders, J G Hugtenburg
OBJECTIVE: To investigate the nature and prevalence of drug related problems (DRPs) in older patients with polypharmacy identified by community pharmacists in daily practice through means of a clinical medication review (CMR) and assess the implementation rate of proposed interventions to solve DRPs. DESIGN: A cross-sectional study METHOD: We analysed the CMR data of 3,807 older patients (≥ 65 years) with polypharmacy (≥ 5 drugs) completed in January-August 2012...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27920399/anticoagulation-for-stroke-prevention-in-elderly-patients-with-non-valvular-atrial-fibrillation-what-are-the-obstacles
#4
C W Wong
The elderly with atrial fibrillation are more prone to stroke. Oral anticoagulants such as warfarin are effective in the prevention of atrial fibrillation-associated stroke and systemic embolism. The CHADS2 or CHA2D2-VASc score and HAS-BLED score were developed to stratify stroke risk associated with atrial fibrillation and bleeding risk in a patient with atrial fibrillation, respectively, to facilitate the decision for and safe use of oral anticoagulant. Nonetheless, the decision for anticoagulation is not straightforward and the elderly with non-valvular atrial fibrillation are often precluded from anticoagulant prescription...
December 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/27920120/effects-of-an-intervention-s%C3%A3-kl%C3%A3-k-on-prescription-of-potentially-inappropriate-medication-in-elderly-patients
#5
Cecilia Lenander, Åsa Bondesson, Nina Viberg, Ulf Jakobsson, Anders Beckman, Patrik Midlöv
BACKGROUND: Polypharmacy is known to increase the risk for drug-related problems, and some drugs, potentially inappropriate medications (PIMs), are especially troublesome. OBJECTIVE: To analyse the effects on prescription of PIMs of the SÄKLÄK project, an intervention model created to improve medication safety for elderly patients in primary care. METHOD: The SÄKLÄK project was a multiprofessional intervention in primary care consisting of self-assessment, peer review, feedback and written agreements for change...
December 5, 2016: Family Practice
https://www.readbyqxmd.com/read/27916424/caring-for-children-with-medical-complexity-perspectives-of-primary-care-providers
#6
Carolyn C Foster, Rita Mangione-Smith, Tamara D Simon
OBJECTIVE: To describe typical care experiences and key barriers and facilitators to caring for children with medical complexity (CMC) from the perspective of community primary care providers (PCPs). STUDY DESIGN: PCPs participating in a randomized controlled trial of a care-coordination intervention for CMC were sent a 1-time cross-sectional survey that asked PCPs to (1) describe their experiences with caring for CMC; (2) identify key barriers affecting their ability to care for CMC; and (3) prioritize facilitators enhancing their ability to provide care coordination for CMC...
December 2, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27915457/combined-use-of-the-rationalization-of-home-medication-by-an-adjusted-stopp-in-older-patients-rasp-list-and-a-pharmacist-led-medication-review-in-very-old-inpatients-impact-on-quality-of-prescribing-and-clinical-outcome
#7
Lorenz Van der Linden, Liesbeth Decoutere, Karolien Walgraeve, Koen Milisen, Johan Flamaing, Isabel Spriet, Jos Tournoy
BACKGROUND: Polypharmacy and potentially inappropriate drugs have been associated with negative outcomes in older adults which might be reduced by pharmacist interventions. OBJECTIVES: Our objective was to evaluate the effect of a pharmacist intervention, consisting of the application of the Rationalization of home medication by an Adjusted STOPP in older Patients (RASP) list and a pharmacist-led medication review on polypharmacy, the quality of prescribing, and clinical outcome in geriatric inpatients...
December 3, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27915426/impact-of-a-medication-therapy-management-service-on-the-clinical-status-of-patients-with-chronic-obstructive-pulmonary-disease
#8
Kirla B Detoni, Isabela V Oliveira, Mariana M G Nascimento, Thaís R Caux, Mateus R Alves, Djenane Ramalho-de-Oliveira
Background At this moment, there is no information in the literature showing the impact of comprehensive medication management (CMM) service delivered to patients with chronic obstructive pulmonary disease. Objective This study aims to present the clinical outcomes of this service provided to patients with chronic obstructive pulmonary disease. Settings Public specialty pharmacy where high cost drug treatments are provided for medical conditions not covered by the primary care such as COPD, located in Minas Gerais State, Brazil...
December 3, 2016: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/27913982/pharmacological-management-of-allergic-rhinitis-in-the-elderly
#9
REVIEW
Andrzej Bozek
Recent studies suggest that allergic rhinitis is highly prevalent in the elderly population, but is underdiagnosed and undertreated. This review article briefly introduces allergic rhinitis in the elderly (epidemiology and pathophysiology) and identifies the main goals of treatment in these patients with respect to age-related physiological factors, comorbid conditions and polypharmacy. The primary focus of the article is a narrative review of the literature concerning the different types of treatment options in elderly patients aged 60+ years (pharmacological therapy and allergen-specific immunotherapy)...
December 3, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27913940/cost-analysis-and-cost-benefit-analysis-of-a-medication-review-with-follow-up-service-in-aged-polypharmacy-patients
#10
Amaia Malet-Larrea, Estíbaliz Goyenechea, Miguel A Gastelurrutia, Begoña Calvo, Victoria García-Cárdenas, Juan M Cabases, Aránzazu Noain, Fernando Martínez-Martínez, Daniel Sabater-Hernández, Shalom I Benrimoj
BACKGROUND: Drug related problems have a significant clinical and economic burden on patients and the healthcare system. Medication review with follow-up (MRF) is a professional pharmacy service aimed at improving patient's health outcomes through an optimization of the medication. OBJECTIVE: To ascertain the economic impact of the MRF service provided in community pharmacies to aged polypharmacy patients comparing MRF with usual care, by undertaking a cost analysis and a cost-benefit analysis...
December 2, 2016: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/27913580/responding-to-challenges-for-people-with-psychotic-illness-updated-evidence-from-the-survey-of-high-impact-psychosis
#11
REVIEW
Vera A Morgan, Anna Waterreus, Vaughan Carr, David Castle, Martin Cohen, Carol Harvey, Cherrie Galletly, Andrew Mackinnon, Patrick McGorry, John J McGrath, Amanda L Neil, Suzy Saw, Johanna C Badcock, Debra L Foley, Geoff Waghorn, Sarah Coker, Assen Jablensky
OBJECTIVE: The objective is to summarise recent findings from the 2010 Australian Survey of High Impact Psychosis (SHIP) and examine their implications for future policy and planning to improve mental health, physical health and other circumstances of people with a psychotic disorder. METHODS: Survey of High Impact Psychosis collected nationally representative data on 1825 people with psychotic illness. Over 60 papers have been published covering key challenges reported by participants: financial problems, loneliness and social isolation, unemployment, poor physical health, uncontrolled symptoms of mental illness, and lack of stable, suitable housing...
December 1, 2016: Australian and New Zealand Journal of Psychiatry
https://www.readbyqxmd.com/read/27912904/changes-of-geriatric-syndromes-in-older-adults-survived-from-intensive-care-unit
#12
Hsin-Ju Tang, Hsin-Yi Jean Tang, Fang-Wen Hu, Ching-Huey Chen
Nearly 90% of the older adult patients discharged from hospital with a cluster of geriatric syndromes. The patterns of geriatric syndromes in older adult ICU survivors are to be further explored. The aim of this study was to examine the risk factors and patterns of geriatric syndromes among older adult patients before admitting to ICU and throughout their hospitalization. A total of 137 older adult patients (age 76.9 ± 6.6; 52.6% male) participated in the study. The results showed significant increase in the occurrence of geriatric syndromes from T0 (upon ICU admission) to T1 (transition to inpatient care unit), with improvement at T2 (hospital discharge), but did not return to the baseline...
November 29, 2016: Geriatric Nursing
https://www.readbyqxmd.com/read/27911302/association-between-cognitive-status-before-surgery-and-outcomes-in-elderly-patients-with-hip-fracture-in-a-dedicated-orthogeriatric-care-pathway
#13
Lorene Zerah, Judith Cohen-Bittan, Mathieu Raux, Anthony Meziere, Cendrine Tourette, Christian Neri, Marc Verny, Bruno Riou, Frederic Khiami, Jacques Boddaert
BACKGROUND: Dementia is associated with a worse prognosis of hip fracture, but the impact of a dedicated geriatric care pathway on the prognosis of these patients has not been evaluated. OBJECTIVE: According to the cognitive status before surgery, our main objective was to compare mortality rate at 6 months; secondary outcomes were to compare in-hospital complications, the risk of new institutionalization, and the ability to walk at 6 months. METHODS: Between 2009 and 2015, all patients (>70 years) admitted after hip fracture surgery into a dedicated unit of peri-operative geriatric care were included: patients with dementia (DP), without dementia (NDP), and with cognitive status not determined (CSND)...
November 28, 2016: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/27910294/medication-management-in-the-older-adult-a-narrative-exploration
#14
Johnanna Hernandez
BACKGROUND AND PURPOSE: The purpose of this study was to characterize the meaning nurse practitioners (NPs) ascribed to personal experiences providing care to older adults who take multiple medications to manage complex conditions. The study illuminated the NP experience in caring for the older adult while addressing the complexities of medication management through narrative stories in practice. METHODS: NPs self-identifying as caring for older adults were interviewed (N=15)...
December 2, 2016: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/27908276/changes-in-physical-functioning-among-men-and-women-aged-50-79-years-in-germany-an-analysis-of-national-health-interview-and-examination-surveys-1997-1999-and-2008-2011
#15
A K Buttery, Y Du, M A Busch, J Fuchs, B Gaertner, H Knopf, C Scheidt-Nave
BACKGROUND: This study examines changes in physical functioning among adults aged 50-79 years in Germany based on data from two German National Health Interview and Examination Surveys conducted in 1997-1999 (GNHIES98) and 2008-2011 (DEGS1). METHODS: Using cross-sectional data from the two surveys (GNHIES98, n = 2884 and DEGS1, n = 3732), we examined changes in self-reported physical functioning scores (Short Form-36 physical functioning subscale (SF-36 PF)) by sex and age groups (50-64 and 65-79 years)...
December 1, 2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27907210/assessing-potentially-inappropriate-prescribing-in-community-dwelling-older-patients-using-the-updated-version-of-stopp-start-criteria-a-comparison-of-profiles-and-prevalences-with-respect-to-the-original-version
#16
Encarnación Blanco-Reina, Maria Rosa García-Merino, Ricardo Ocaña-Riola, Lorena Aguilar-Cano, Jennifer Valdellós, Inmaculada Bellido-Estévez, Gabriel Ariza-Zafra
Emerging and changing evidence made it necessary to update STOPP-START criteria, and version 2 was published recently. In this study the objectives were to determine the prevalence of potentially inappropriate medication prescribing (PIM) in primary care using STOPP versions 1 (v1) and 2 (v2), as well as 2012 AGS Beers criteria, and analyze the factors associated with inappropriate prescribing according to STOPP/START v2. A cross-sectional study was carried out including community-dwelling older adults over the age of 65...
2016: PloS One
https://www.readbyqxmd.com/read/27902720/intervention-to-improve-appropriate-prescribing-and-reduce-polypharmacy-in-elderly-patients-admitted-to-an-internal-medicine-unit
#17
Milena Urfer, Luigia Elzi, Salome Dell-Kuster, Stefano Bassetti
BACKGROUND: Polypharmacy and inappropriate medication prescriptions are associated with increased morbidity and mortality. Most interventions proposed to improve appropriate prescribing are time and resource intensive and therefore hardly applicable in daily clinical practice. OBJECTIVE: To test the efficacy of an easy-to-use checklist aimed at supporting the therapeutic reasoning of physicians in order to reduce inappropriate prescribing and polypharmacy. METHODS: We assessed the efficacy and safety of a 5-point checklist to be used by all physicians on the internal medicine wards of a Swiss hospital by comparing outcomes in 450 consecutive patients aged ≥65 years hospitalized after the introduction of the checklist, and in 450 consecutive patients ≥65 years hospitalized before the introduction of the checklist...
2016: PloS One
https://www.readbyqxmd.com/read/27900915/multiple-morbidities-assessment
#18
Erin Dean
Essential facts Multimorbidity, in which a person has two or more long-term health conditions, is associated with reduced quality of life, higher mortality, polypharmacy and high treatment burden, higher rates of adverse drug events, and much greater health services usage, including unplanned or emergency care.
November 30, 2016: Nursing Older People
https://www.readbyqxmd.com/read/27899849/statin-therapy-review-of-safety-and-potential-side-effects
#19
REVIEW
Satish Ramkumar, Ajay Raghunath, Sudhakshini Raghunath
BACKGROUND: Hydroxymethyl glutaryl coenzyme A reductase inhibitors, commonly called statins, are some of the most commonly prescribed medications worldwide. Evidence suggests that statin therapy has significant mortality and morbidity benefit for both primary and secondary prevention from cardiovascular disease. Nonetheless, concern has been expressed regarding the adverse effects of long term statin use. The purpose of this article was to review the current medical literature regarding the safety of statins...
November 2016: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/27899737/cognitive-training-in-parkinson-s-disease-a-theoretical-perspective
#20
REVIEW
Courtney C Walton, Sharon L Naismith, Amit Lampit, Loren Mowszowski, Simon J G Lewis
Cognitive impairment is now widely accepted as a fundamental aspect of Parkinson's disease (PD). Given the prevalence of cognitive impairment and the associated impact on well-being, evidence-based interventions are needed. However, while research is continually accumulating in order to better understand the pathology and trajectory of cognitive changes, treatment options lag behind. Nonpharmacological approaches are of particular interest in this group, given the typical polypharmacy already present in PD patients...
November 28, 2016: Neurorehabilitation and Neural Repair
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