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Francesco Paciullo, Marco Proietti, Vanessa Bianconi, Alessandro Nobili, Matteo Pirro, Pier Mannuccio Mannucci, Gregory Y H Lip, Graziana Lupattelli
BACKGROUND: Among rate-control or rhythm-control strategies, there is conflicting evidence as to which is the best management approach for non-valvular atrial fibrillation (AF) in elderly patients. DESIGN: We performed an ancillary analysis from the 'Registro Politerapie SIMI' study, enrolling elderly inpatients from internal medicine and geriatric wards. METHODS: We considered patients enrolled from 2008 to 2014 with an AF diagnosis at admission, treated with a rate-control-only or rhythm-control-only strategy...
March 21, 2018: Drugs & Aging
H-J Assion, A Schweppe, H Reinbold, U Frommberger
BACKGROUND: Bipolar disorder and schizophrenia are severe mental illnesses, each with a prevalence of approximately 1-2% in the general population. There is considerable controversy about differentiating schizophrenia from schizoaffective or bipolar disorder owing to many similarities in psychopathology, progression, and biological factors. The aim of this study was to identify similarities and differences in the pharmacological treatment of these disorders by comparing the prescription patterns...
March 21, 2018: Der Nervenarzt
Murugan Venkatesan, Amol R Dongre, Kalaiselvan Ganapathy
Context: A module-based training program for medical interns using World Health Organization guide for good prescription along with the individual feedback on their prescription was developed and implemented. Objective: The objective of the study was to obtain the medical interns' reactions to newly developed skill-based training program on rational treatment. Study Setting: This study was conducted at the Department of Community Medicine...
October 2017: Journal of Family Medicine and Primary Care
Cyrille Patrice Launay, Hélène Rivière, Julia Chabot, Olivier Beauchet
BACKGROUND: The 6-item Brief Geriatric Assessment (BGA) is a screening tool to identify frail inpatients who are at risk of adverse health events. Its predictive value for in-hospital mortality has not been examined yet. OBJECTIVE: This study examined whether the BGA is able to predict in-hospital mortality in older patients. METHODS: A total of 1082 participants were included in this observational prospective cohort study. At their admission to the medical wards of Angers University Hospital (France), all inpatients aged ≥65 years were screened with the BGA...
April 2018: Maturitas
Julie A Pasco, Kara L Holloway, Amanda L Stuart, Lana J Williams, Sharon L Brennan-Olsen, Michael Berk
OBJECTIVES: Pretirees are a demographic interposed between the latter stages of working life and old age. We aimed to characterise subjective wellbeing and lifestyle behaviours for individuals aged in their late-fifties and sixties. STUDY DESIGN: Cross-sectional study of 233 men and 229 women aged 55-69 yr from the Geelong Osteoporosis Study. MAIN OUTCOME MEASURES: Subjective wellbeing assessed using the World Health Organization Quality of Life questionnaire (WHOQOL-BREF, Australia)...
April 2018: Maturitas
Sungchul Huh, Tae Wan Kim, Jung Hyun Yang, Myung Hoon Moon, Soo-Yeon Kim, Hyun-Yoon Ko
Objective: To investigate the current status of pharmacotherapy prescribed by physiatrists in Korea for cognitive-behavioral disorder. Methods: A cross-sectional study was performed by mailing questionnaires to 289 physiatrists working at teaching hospitals. Items on the questionnaire evaluated prescribing patterns of 16 drugs related to cognitive-behavioral therapy, the status of combination pharmacotherapy, and tools for assessing target symptoms. Results: Fifty physiatrists (17...
February 2018: Annals of Rehabilitation Medicine
Lucas Morin, Kristina Johnell, Marie-Laure Laroche, Johan Fastbom, Jonas W Wastesson
Objective: Polypharmacy is the concomitant use of several drugs by a single person, and it increases the risk of adverse drug-related events in older adults. Little is known about the epidemiology of polypharmacy at the population level. We aimed to measure the prevalence and incidence of polypharmacy and to investigate the associated factors. Methods: A prospective cohort study was conducted using register data with national coverage in Sweden. A total of 1,742,336 individuals aged ≥65 years at baseline (November 1, 2010) were included and followed until death or the end of the study (December 20, 2013)...
2018: Clinical Epidemiology
Nazanin Abolhassani, Julien Castioni, Valérie Santschi, Gérard Waeber, Pedro Marques-Vidal
BACKGROUND: Polypharmacy (PP) and excessive polypharmacy (EPP) are increasingly common and associated with risk of drug-drug interactions (DDIs). We aimed to measure the trends and determinants of PP and DDIs among patients discharged from the Department of Internal Medicine of the Lausanne University Hospital. METHODS: The retrospective study included 17,742 adult patients discharged between 2009 and 2015. Polypharmacy and EPP were defined as the concomitant prescription of five or more and ten or more drugs, respectively...
March 19, 2018: Journal of Patient Safety
Joachim Zeeh
No abstract text is available yet for this article.
March 2018: MMW Fortschritte der Medizin
Fiona M Baumer, Brenda E Porter
BACKGROUND: Sunflower Syndrome describes reflex seizures - typically eyelid myoclonia with or without absence seizures - triggered when patients wave their hands in front of the sun. While valproate has been recognized as the best treatment for photosensitive epilepsy, many clinicians now initially treat with newer medications; the efficacy of these medications in Sunflower Syndrome has not been investigated. We reviewed all cases of Sunflower Syndrome seen at our institution over 15 years to describe the clinical course, electroencephalogram (EEG), and treatment response in these patients...
March 3, 2018: Epilepsy Research
Pamela S Roberts, Manoj Goud, Harriet Udin Aronow, Richard V Riggs
Frailty is a complex and growing phenomenon facing healthcare providers throughout the continuum of care. Frailty is not well understood in post-acute care (PAC) settings. The purpose of this scoping review was to summarize current evidence of frailty impact on outcomes and frailty mitigation initiatives in PAC. Three major publication databases were searched from January 2000-June 2017 that identified 18 articles specifically addressing frailty in PAC. Three themes were identified: scales used to measure frailty; factors that led to an adverse outcome or diagnosis of frailty; and interventions to address frailty in PAC...
March 14, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Mitsuhiro Akiyama, Tsutomu Takeuchi
IgG4-related disease is a heterogeneous immune-mediated fibroinflammatory condition that can affect every single organ. This disease is more prevalent in the elderly (the mean age of patients is above 60 years) and the prevalence rate is estimated to be over 4.6 per 100,000 population. Before making a diagnosis, the exclusion of malignancies, lymphoma, anti-neutrophil cytoplasmic antibody-associated vasculitis, multicentric Castleman disease, and other mimickers is crucial for appropriate treatment. Broad management guidelines have been published emphasizing the need for prompt treatment and the use of glucocorticoids as first-line drug therapy for induction of remission...
March 15, 2018: Drugs & Aging
Amy C Justice, Kirsha S Gordon, Melissa Skanderson, Eva Jennifer Edelman, Kathleen M Akgün, Cynthia L Gibert, Vincent Lo Re, David Rimland, Julie A Womack, Christina M Wyatt, Janet P Tate
BACKGROUND: HIV-positive individuals (HIV+) on antiretrovirals commonly take enough other medications to cross a threshold for polypharmacy but little is known about associated outcomes. We asked whether non-antiretroviral polypharmacy is associated with hospitalization and mortality and whether associations differ by HIV status. METHODS: Data on HIV+ and uninfected individuals in the US Veterans Affairs Healthcare System were analyzed. Eligible HIV+ were on antiretrovirals with suppressed HIV-1 RNA and uninfected individuals received at least one medication...
March 27, 2018: AIDS
Janani Thillainadesan, Danijela Gnjidic, Sarah Green, Sarah N Hilmer
BACKGROUND: Polypharmacy and potentially inappropriate medications (PIMs) are prevalent in older adults in hospital, and are associated with negative outcomes including adverse drug reactions, falls, confusion, hospitalisation and death. Deprescribing may reduce inappropriate polypharmacy and use of inappropriate medications. OBJECTIVE: The aim of this systematic review was to investigate the efficacy of deprescribing interventions in older inpatients to reduce PIMs and impact on clinical outcomes...
March 14, 2018: Drugs & Aging
Natasha Slater, Simon White, Rebecca Venables, Martin Frisher
OBJECTIVES: While older age and ill health are known to be associated with polypharmacy, this paper aims to identify whether wealth, body mass index (BMI), smoking and alcohol consumption are also associated with polypharmacy (5-9 prescribed medications) and hyperpolypharmacy prevalence (≥10 prescribed medications), among older people living in England. DESIGN: Cross-sectional study. SETTING: The English Longitudinal Study of Ageing Wave 6 (2012-2013)...
March 14, 2018: BMJ Open
Benjamin Wu, Eric J Bruns, Ming-Hui Tai, Bethany R Lee, Ramesh Raghavan, Susan dosReis
OBJECTIVE: The study examined differences in psychotropic polypharmacy among youths with serious emotional and behavioral disorders who received coordinated care services (CCS) that used a wraparound model and a matched sample of youths who received traditional services. METHODS: A quasi-experimental design compared psychotropic polypharmacy one year before and one year after discharge from CCS. The cohort was youths with serious emotional and behavioral disorders who were enrolled in CCS from December 2009 through May 2014...
March 15, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
Markus Kneihsl, Christian Enzinger, Kurt Niederkorn, Gerit Wünsch, Lisa Müller, Valeriu Culea, Andreas Lueger, Franz Fazekas, Thomas Gattringer
BACKGROUND: Stroke has become a treatable condition with increasing evidence of treatment benefits in older people. However, stroke mimics in geriatric patients are especially prevalent, causing incorrect suspicion and consecutive burden to patients and emergency room resources. We therefore examined the dimension of this problem by investigating emergency room admissions from nursing homes for suspected stroke. METHODS: We performed a retrospective cohort study of all nursing home residents who were admitted to the neurological emergency room of our primary and tertiary care university hospital between 2013 and 2015...
March 14, 2018: Cerebrovascular Diseases
Ann E Vandenberg, Katharina V Echt, Lawanda Kemp, Gerald McGwin, Molly M Perkins, Anna K Mirk
Suboptimal prescribing persists as a driver of poor quality care of older veterans and is associated with risk of hospitalization and emergency department visits. We adapted a successful medication management model, Integrated Management and Polypharmacy Review of Vulnerable Elders (IMPROVE), from an urban geriatric specialty clinic to rural community-based clinics that deliver primary care. The goals were to promote prescribing quality and safety for older adults, including reduced prescribing of potentially inappropriate medications (PIMs)...
March 2018: Journal of the American Geriatrics Society
M Fernández, C Valbuena, C Natal
OBJECTIVES: To describe the risk factors and the effect of medication use on the risk of falls in a population of 65 years or older. MATERIAL AND METHODS: Descriptive study of falls in the elderly population. The risk factors and consequences of the fall were recorded. Hypnotic and sedative risk drugs, opioids, and the simultaneous consumption of six or more drugs were considered. Diuretics were also included. The cumulative incidence for each group and the corresponding relative risks of falls were analysed from the cases registered between June and November 2016...
March 9, 2018: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
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