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Polypharmacy

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https://www.readbyqxmd.com/read/28737101/intervention-to-prevent-falls-community-based-clinics
#1
Dorothy I Baker, Linda Leo-Summers, Terrence E Murphy, Barbara Katz, Beth A Capobianco
PURPOSE: The purpose of this study was to document results of State funded fall prevention clinics on rates of self-reported falls and fall-related use of health services. METHODS: Older adults participated in community-based fall prevention clinics providing individual assessments, interventions, and referrals to collaborating community providers. A pre-post design compares self-reported 6-month fall history and fall-related use of health care before and after clinic attendance...
July 1, 2017: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/28735690/polypharmacy-in-youth-treated-with-antipsychotics-do-antidepressants-or-stimulants-add-to-the-risk-for-type-2-diabetes
#2
EDITORIAL
Christoph U Correll, Britta Galling
No abstract text is available yet for this article.
August 2017: Journal of the American Academy of Child and Adolescent Psychiatry
https://www.readbyqxmd.com/read/28734784/drug-delivery-innovations-to-address-global-health-challenges-for-pediatric-and-geriatric-populations-through-improvements-in-patient-compliance
#3
Joshua Boateng
Despite significant advances in pharmaceutical and biotechnological drug discovery, the global population is plagued with many challenging diseases. These are further compounded by anticipated explosion in an ageing population, which presents several problems such as polypharmacy, dysphagia and neurological conditions, resulting in non-compliance and disease complications. For antibiotics, poor compliance, can result in development of drug resistant infections which can be fatal. Further, children, especially, in developing countries die unnecessarily from easily treatable diseases (e...
July 19, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28733905/glp-1-glucagon-receptor-co-agonism-for-treatment-of-obesity
#4
REVIEW
Miguel A Sánchez-Garrido, Sara J Brandt, Christoffer Clemmensen, Timo D Müller, Richard D DiMarchi, Matthias H Tschöp
Over a relatively short period, obesity and type 2 diabetes have come to represent a large medical and economic burden to global societies. The epidemic rise in the prevalence of obesity has metabolic consequences and is paralleled by an increased occurrence of other diseases, such as diabetes, cancer and cardiovascular complications. Together, obesity and type 2 diabetes constitute one of the more preventable causes of premature death and the identification of novel, safe and effective anti-obesity drugs is of utmost importance...
July 21, 2017: Diabetologia
https://www.readbyqxmd.com/read/28733184/medication-use-and-its-potential-impact-on-the-oral-health-status-of%C3%A2-nursing-home-residents-in-flanders-belgium
#5
Barbara Janssens, Mirko Petrovic, Wolfgang Jacquet, Jos M G A Schols, Jacques Vanobbergen, Luc De Visschere
BACKGROUND: Polypharmacy is considered the most important etiologic factor of hyposalivation, which in turn can initiate oral health problems. OBJECTIVES: To describe the medication use of nursing home residents, to identify the medications related to hyposalivation and to find possible associations between the different classes of medication, the number of medications, and the oral health status of the residents. DESIGN: A cross-sectional study...
July 18, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28732818/adherence-to-copd-treatment-myth-and-reality
#6
REVIEW
Paola Rogliani, Josuel Ora, Ermanno Puxeddu, Maria Gabriella Matera, Mario Cazzola
COPD is a chronic disease in which effective management requires long-term adherence to pharmacotherapies but the level of adhesion to the prescribed medications is very low and this has a negative influence on outcomes. There are several approaches to detect non-adherence, such as pharmacy refill methods, electronic monitoring, and self-report measures, but they are all burdened with important limitations. Medication adherence in COPD is multifactorial and is affected by patients (health beliefs, cognitive abilities, self-efficacy, comorbidities, psychological profile, conscientiousness), physicians (method of administration, dosing regimen, polypharmacy, side effects), and society (patient-prescriber relationship, social support, access to medication, device training, follow-up)...
August 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28731948/managing-cancer-pain-in-older-adults
#7
Emily J Guerard, James F Cleary
Managing cancer pain in older adults can be complex and challenging. Understanding the unique needs of older patients with cancer is important to safe and effective pain management. The goals of this review are to discuss the assessment of older adults with cancer-related pain, treatment of cancer pain, and adverse effects or potential risks from treatment that are unique to older patients. A detailed pain assessment and when possible utilizing the geriatric assessment are vital to developing a cancer pain management plan...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28731943/the-impact-of-polypharmacy-on-patient-outcomes-in-older-adults-with-cancer
#8
Ginah Nightingale, Emily Skonecki, Manpreet K Boparai
Polypharmacy is prevalent in older adults with cancer and may be advantageous for the management of certain chronic disease states, but uncertainty exists regarding potential hazards and consequences. Cancer-related therapy adds to the prevalence of polypharmacy, which can lead to compromised cancer management plans (i.e., postoperative complications, treatment delays, and/or premature treatment discontinuation). Polypharmacy has been identified as one of the domains commonly included in the Comprehensive Geriatric Assessment likely because of the potential influence on health outcomes...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28728199/-polypharmacy-solutions-for-enhanced-drug-safety
#9
Olaf Krause, Gesine Picksak, Ulrike Junius-Walker
Polypharmacy (≥ 5 drugs) is common among older people and may lead to falls, ADEs and delirium. Adherence is an important part in the medication management. Simple questions (i. e. for OTC, handling and omission of drugs) are effective. As most old people are treated by general practitioners (GP), they play a key role for drug safety and reducing polypharmacy. The involvement of pharmacists in analyzing one patient's drugs can enhance solutions for drug problems ("two-man rule"). An IT-based medication plan acts as an important communication tool for an enhanced team work between doctors, pharmacists and nursing care...
July 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28728095/lifetime-use-of-psychiatric-medications-and-cognition-at-43years-of-age-in-schizophrenia-in-the-northern-finland-birth-cohort-1966
#10
A P Hulkko, G K Murray, J Moilanen, M Haapea, I Rannikko, P B Jones, J H Barnett, S Huhtaniska, M K Isohanni, H Koponen, E Jääskeläinen, J Miettunen
BACKGROUND: Higher lifetime antipsychotic exposure has been associated with poorer cognition in schizophrenia. The cognitive effects of adjunctive psychiatric medications and lifetime trends of antipsychotic use remain largely unclear. We aimed to study how lifetime and current benzodiazepine and antidepressant medications, lifetime trends of antipsychotic use and antipsychotic polypharmacy are associated with cognitive performance in midlife schizophrenia. METHODS: Sixty participants with DSM-IV schizophrenia from the Northern Finland Birth Cohort 1966 were examined at 43years of age with an extensive cognitive test battery...
June 27, 2017: European Psychiatry: the Journal of the Association of European Psychiatrists
https://www.readbyqxmd.com/read/28725921/-parkinson-s-disease-in-the-elderly
#11
Rüdiger Lange, Frank Erbguth
Due to the increasing life expectancy and a higher incidence in the elderly, the number of elderly patients with idiopathic Parkinson's disease will increase in the coming years. Since the burden of comorbidities is higher and medication side effects are more likely in the elderly, particularly in the light of frequently occurring polypharmacy, increased awareness and therapeutic knowledge is necessary. Besides the therapy of motor symptoms, non-motor symptoms, e. g. neuropsychiatric and autonomic disorders, also need to be addressed as they can also greatly impair the quality of life...
July 19, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28724310/non-guideline-recommended-prescribing-of-proton-pump-inhibitors-implications-for-the-future-and-reducing-over-usage
#12
Brian Godman, Joseph Fadare
Drs Godman and Fadare review the paper by Mares-Garcia and colleagues in Spain regarding the extent of non-guideline recommended prescribing (NGRP) of proton pump inhibitors (PPIs) in ambulatory care. NGRP of PPIs is an increasing public health concern given the implications of overuse of PPIs on infection rates, osteoporosis and chronic kidney disease as well as increasing polypharmacy rates. Costs are less of an issue especially where there are low prices for generic PPIs; the main focus is on improving the quality of PPI prescribing...
July 20, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28722795/influence-of-renal-function-on-anticoagulation-control-in-patients-with-non-valvular-atrial-fibrillation-taking-vitamin-k-antagonists
#13
José M Lobos-Bejarano, Angel Castellanos Rodríguez, Vivencio Barrios, Carlos Escobar, José Polo-García, José Carlos Del Castillo-Rodríguez, Diego Vargas-Ortega, Adriana Lopez-Pineda, Luis Prieto-Valiente, Gregory Y H Lip
BACKGROUND AND PURPOSE: Chronic kidney disease (CKD) has been related to poor anticoagulation control and an increased risk of bleeding. This study aims to evaluate the association between impaired renal function (eGFR <60 mL/min/1.73 m(2) ) and anticoagulation control in patients with non-valvular atrial fibrillation (AF) on vitamin K antagonists (VKA) therapy. We also assessed whether the predictive value of the SAMe-TT2 R2 score prevailed for subgroups both with and without CKD...
July 19, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28721543/-decision-aids-in-complex-polypharmacy-medication-data-bases-and-counselling-by-clinical-pharmacists
#14
REVIEW
W Weinrebe, R Preda, S Bischoff, D Nussbickel, M Humm, K Jeckelmann, S Goetz
The number of older people with polypharmacy (more than six drugs taken simultaneously) is increasing. The greatest proportion consists of guideline drugs, analgesics and psychopharmaceuticals because in many cases of geriatric multimorbidity several underlying main diseases are present which must be treated according to the guidelines. Polypharmacy is a complex and difficult situation for all treating physicians because substantial side effects and intoxication can be induced but it can also be very difficult to recognize which drug was at fault and how a reduction can be safely made...
July 18, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28720634/physician-factors-associated-with-polypharmacy-and-potentially-inappropriate-medication-use
#15
Kenya Ie, Maria Felton, Sydney Springer, Stephen A Wilson, Steven M Albert
BACKGROUND: Despite accumulating evidence about the harm of polypharmacy in family medicine, few studies have investigated factors related to polypharmacy. The objective of this study was to explore factors related to physicians' prescribing behavior. METHODS: We conducted a survey of physicians at 5 family medicine residency practices and a linked health record review of their patients ≥65 years old. The determinants of physicians' mean number of prescriptions and potentially inappropriate medications (PIMs) were examined using a generalized linear model...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28719564/the-new-apgar-score-a-checklist-to-enhance-quality-of-life-in-geriatric-patients-with-hip-fracture
#16
Joseph Bernstein, Sara Weintraub, Eric Hume, Mark D Neuman, Stephen L Kates, Jaimo Ahn
For geriatric patients with hip fractures, the broken bone is the reason for admission, but only part of the overall disease. Indeed, it may be more helpful to consider the patient having geriatric hip fracture syndrome or sustaining a hip attack, as there are many associated medical, social, psychological, and other problems to which attention must be paid. To that end, we have identified a series of 10 steps, collected into a checklist, that can be undertaken for all patients with geriatric hip fracture. In homage to the maxim "we come into the world under the brim of the pelvis and go out through the neck of the femur," we defined our checklist by the acronym APGAR SCORE, named after the classic checklist of the same name used to assess a newborn child...
July 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28718324/physical-health-and-drug-safety-in-individuals-with-schizophrenia
#17
Tamara Pringsheim, Martina Kelly, Doug Urness, Michael Teehan, Zahinoor Ismail, David Gardner
BACKGROUND: While antipsychotic medications are the mainstay of therapy for individuals with schizophrenia and psychotic disorders, their use is associated with adverse effects on physical health that require the attention and care of prescribers. METHODS: We used the ADAPTE process to adapt existing guideline recommendations from the National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN) guidelines on the dosing of antipsychotics and antipsychotic polypharmacy, screening for adverse effects of antipsychotics, and management of metabolic and extrapyramidal side effects to the Canadian context...
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28717862/practical-considerations-for-the-use-of-subcutaneous-treatment-in-the-management-of-dyslipidaemia
#18
REVIEW
Franck Boccara, Ricardo Dent, Luis Ruilope, Paul Valensi
Suboptimal drug adherence represents a major challenge to effective primary and secondary prevention of cardiovascular disease. While adherence is influenced by multiple considerations, polypharmacy and dosing frequency appear to be rate-limiting factors in patient satisfaction and subsequent adherence. The cardiovascular and metabolic therapeutic areas have recently benefited from a number of advances in drug therapy, in particular protease proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors and incretin-based therapies, respectively...
July 17, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28702888/cushing-s-syndrome-a-model-for-sarcopenic-obesity
#19
Michael Drey, Christina M Berr, Martin Reincke, Julia Fazel, Jochen Seissler, Jochen Schopohl, Martin Bidlingmaier, Stefanie Zopp, Nicole Reisch, Felix Beuschlein, Andrea Osswald, Ralf Schmidmaier
PURPOSE: Obesity and its metabolic impairments are discussed as major risk factors for sarcopenia leading to sarcopenic obesity. Cushing's syndrome is known to be associated with obesity and muscle atrophy. We compared Cushing's syndrome with matched obese controls regarding body composition, physical performance, and biochemical markers to test the hypothesis that Cushing's syndrome could be a model for sarcopenic obesity. METHODS: By propensity score matching, 47 controls were selected by body mass index and gender as obese controls...
July 12, 2017: Endocrine
https://www.readbyqxmd.com/read/28700758/deprescribing-a-simple-method-for-reducing-polypharmacy
#20
Kathryn McGrath, Emily R Hajjar, Chandrika Kumar, Christopher Hwang, Brooke Salzman
Polypharmacy brings with it increased risks for adverse drug events and reduced functional capacity. This 4-step plan will help you safely deprescribe in older adults.
July 2017: Journal of Family Practice
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