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polypharmacy and elderly

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https://www.readbyqxmd.com/read/28422415/impact-of-hospitalization-in-an-acute-geriatric-unit-on-polypharmacy-and-potentially-inappropriate-prescriptions-a-retrospective-study
#1
Marta Gutiérrez-Valencia, Mikel Izquierdo, Vincenzo Malafarina, Javier Alonso-Renedo, Belén González-Glaría, Beatriz Larrayoz-Sola, María Pilar Monforte-Gasque, Pello Latasa-Zamalloa, Nicolás Martínez-Velilla
AIM: Polypharmacy is a highly prevalent geriatric syndrome, and hospitalizations can worsen it. The aim of the present study was to analyze the influence of hospitalization on polypharmacy and indicators of quality of prescribing, and their possible association with health outcomes. METHODS: A retrospective study of 200 patients discharged from an acute geriatric unit was carried out. Indicators of quality of prescription were registered at admission and discharge: polypharmacy defined as ≥5 medications, hyperpolypharmacy (≥10), potentially inappropriate prescribing by Beers and Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria, potentially prescribing omissions by Screening Tool to Alert doctors to the Right Treatment (START) criteria, drug interactions and anticholinergic burden measured with the Anticholinergic Risk Scale...
April 19, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28414538/part-3-impact-of-systemic-conditions-and-medications-on-oral-health
#2
Diana Critchlow
The people who are treated in the community setting will often have multiple comorbidities. Systemic medical conditions can have a negative impact on oral health. In addition, the medications used to treat systemic conditions may also themselves cause oral symptoms. As a large proportion of patients treated by the community nursing team will be elderly, this paper will focus on common geriatric conditions that can display oral or dental symptoms. The effects of medications will be discussed and linked to oral complaints patients may express...
April 2, 2017: British Journal of Community Nursing
https://www.readbyqxmd.com/read/28405956/the-impact-of-polypharmacy-and-drug-interactions-among-the-elderly-population-in-western-sicily-italy
#3
Giulia Scondotto, Fanny Pojero, Sebastiano Pollina Addario, Mauro Ferrante, Maurizio Pastorello, Michele Visconti, Salvatore Scondotto, Alessandra Casuccio
AIM: Primary endpoint was to report polypharmacy distribution in the general population vs ≥65 years old people and to examine the frequency of drug-drug interactions (DDIs) in the Health Local Unit of Palermo, Italy, in relationship with patients' age. METHODS: Drug prescription data for the year 2014 were extracted from the database of the Local Health Unit of Palermo Province, Italy. Patients were divided into five age groups (0-13, 14-64, 65-69, 70-74, and ≥75 year old)...
April 12, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28377541/depression-and-associated-factors-in-hospitalized-elderly-a-cross-sectional-study-in-a-saudi-teaching-hospital
#4
Sultan Hassan Alamri, Abdulaziz Ihsan Bari, Abdulrahman Talal Ali
BACKGROUND: Depression in the elderly is a serious and often underdiagnosed psychiatric disorder that has been linked to adverse outcomes in the hospital setting. OBJECTIVES: To determine the prevalence of depression and possible associated factors among hospitalized elderly. DESIGN: An analytical cross-sectional study. SETTINGS: Medical and surgical wards of King Abdulaziz University Hospital, Jeddah, Saudi Arabia. PATIENTS AND METHODS: The study included 200 consecutively hospitalized patients aged 60 years and older...
March 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/28375036/new-developments-in-the-pharmacotherapeutic-management-of-heart-failure-in-elderly-patients-concerns-and-considerations
#5
Elles M Screever, Wouter C Meijers, Dirk J van Veldhuisen, Rudolf A de Boer
Heart failure (HF) remains a major public health problem worldwide, affecting approximately 23 million patients, and is predominantly a disease of the elderly population. Elderly patients mostly suffer from HF with preserved ejection fraction (HFpEF), which often presents with multiple co-morbidities and they require multiple medical treatments. This, together with the heterogeneous phenotype of HFpEF, makes it a difficult syndrome to diagnose and treat. Areas covered: Although HF is most abundant in the elderly, this group is still underrepresented in clinical trials, which results in the lack of evidence-based medical regimens...
April 17, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28373468/analysis-of-factors-affecting-short-term-results-in-elderly-patients-undergoing-elective-surgical-resection-for-stage-i-ii-colon-cancer
#6
Stefano M M Basso, Franco Lumachi, Patrizio Pianon, Giovanni Fanti, Federica Maffeis, Paolo Ubiali
AIM: The aim of this study was to analyze the influence of comorbidities and to compare the short-term results of elective surgical resection of stage I-II colon adenocarcinoma in elderly (≥65 years) versus younger patients. PATIENTS AND METHODS: Two groups of sex-matched younger and older patients were compared: Group A: N=36, median age 58 (range=43-65) years; and group B: N=67, median age 73 (range=66-86) years. RESULTS: Overall, 71 out of 103 (68...
April 2017: Anticancer Research
https://www.readbyqxmd.com/read/28373115/polypharmacy-in-elderly-patients-the-march-goes-on-and-on
#7
EDITORIAL
Joseph S Alpert
No abstract text is available yet for this article.
March 31, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28372591/cooperation-between-geriatricians-and-general-practitioners-for-improved-pharmacotherapy-in-home-dwelling-elderly-people-receiving-polypharmacy-the-coop-study-study-protocol-for-a-cluster-randomised-controlled-trial
#8
Rita Romskaug, Espen Molden, Jørund Straand, Hege Kersten, Eva Skovlund, Kaisu H Pitkala, Torgeir Bruun Wyller
BACKGROUND: Polypharmacy and inappropriate drug use is associated with negative health outcomes among older people. Various interventions for improving drug treatment have been evaluated, but the majority of studies are limited by the use of surrogate outcomes or suboptimal design. Thus, the potential for clinically significant improvements from different interventions is still unclear. The main objective of this study is therefore to evaluate the effect upon patient-relevant endpoints of a cooperation between geriatricians and general practitioners on complex drug regimens in home-dwelling elderly people...
April 4, 2017: Trials
https://www.readbyqxmd.com/read/28371121/clinical-medication-review-tool-for-polypharmacy-mapping-approach-for-pharmacotherapeutic-classifications
#9
Fumihiro Mizokami, Tomohiro Mizuno, Tomoyo Mori, Tadashi Nagamatsu, Hideharu Endo, Tomoyuki Hirashita, Takanobu Ichino, Masahiro Akishita, Katsunori Furuta
AIM: Polypharmacy is an extremely important problem, because it increases the risk of adverse drug reactions. The aim of the current study was to create a clinical medication review tool to detect inappropriate medication use, and assess this new method with elderly Japanese patients. METHODS: The new method involves optimizing prescription drugs from indications, based on the chronic disease-anatomical therapeutic class code list. The present study investigated the prevalence of potentially inappropriate medications in 5667 Japanese patients aged ≥65 years with polypharmacy (≥5 drugs) in comparison with the Beers criteria 2012...
March 30, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28352631/guidance-on-opioids-prescribing-for-the-management-of-persistent-non-cancer-pain-in-older-adults
#10
REVIEW
Fabio Guerriero
Many older adults suffer from persistent pain but prevalence studies consistently showed high levels of untreated or under-treated pain in old population. Both persistent pain and pain under-treatment adversely affect independence and quality of life in geriatric patients. Pain management is challenging in this age-group because of the declining organ function, the presence of concurrent diseases and polypharmacy. For all the above reasons, persistent pain in the elderly should be considered a geriatric syndrome per se and effective approaches are warranted...
March 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28350792/association-between-delirium-superimposed-on-dementia-and-mortality-in-hospitalized-older-adults-a-prospective-cohort-study
#11
Thiago J Avelino-Silva, Flavia Campora, Jose A E Curiati, Wilson Jacob-Filho
BACKGROUND: Hospitalized older adults with preexisting dementia have increased risk of having delirium, but little is known regarding the effect of delirium superimposed on dementia (DSD) on the outcomes of these patients. Our aim was to investigate the association between DSD and hospital mortality and 12-mo mortality in hospitalized older adults. METHODS AND FINDINGS: This was a prospective cohort study completed in the geriatric ward of a university hospital in São Paulo, Brazil...
March 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28332012/-frequency-of-falls-among-clients-of-home-care-services-the-importance-of-care-related-and-social-risk-factors
#12
A Rommel, J Kottner, R Suhr, N Lahmann
BACKGROUND: Among the elderly falls frequently result in injuries, increase the need for long-term care and pose a challenge for the quality assurance in nursing care. We describe the frequency and risk factors of falls among care-dependent persons using home care services in Germany. METHODS: The participants of the study "Nursing-related health problems in home care" (n = 880) were recruited based on a list of the officially accredited nursing services. Data collection followed a standardized study protocol...
March 22, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28326532/common-drug-side-effects-and-drug-drug-interactions-in-elderly-adults-in-primary-care
#13
Susan E Merel, Douglas S Paauw
Prescribing medications, recognizing and managing medication side effects and drug interactions, and avoiding polypharmacy are all essential skills in the care of older adults in primary care. Important side effects of medications commonly prescribed in older adults (statins, proton pump inhibitors, trimethoprim-sulfamethoxazole and fluoroquinolone antibiotics, zolpidem, nonsteroidal antiinflammatory drugs, selective serotonin reuptake inhibitors, dipeptidyl peptidase 4 inhibitors) were reviewed. Important drug interactions with four agents or classes (statins, warfarin, factor Xa inhibitors, and calcium channel blockers) are discussed...
March 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28303369/clinical-aspects-of-changes-in-water-and-sodium-homeostasis-in-the-elderly
#14
REVIEW
Christian A Koch, Tibor Fulop
The population of elderly individuals is increasing worldwide. With aging, various hormonal and kidney changes occur, both affecting water homeostasis. Aging is a risk factor for chronic kidney disease (CKD) and many features of CKD are reproduced in the aging kidney. Dehydration and hyperosmolarity can be triggered by diminished thirst perception in this population. Elderly with dementia are especially susceptible to abnormalities of their electrolyte and body water homeostasis and should be (re-)assessed for polypharmacy...
March 2017: Reviews in Endocrine & Metabolic Disorders
https://www.readbyqxmd.com/read/28288711/marginal-zone-lymphoma-in-elderly-and-geriatric-patients
#15
REVIEW
Valentin Goede
Approximately 50% of patients with newly diagnosed marginal zone lymphoma (MZL) are of advanced age. For the three subtypes of MZL (extranodal MZL of mucosa-associated lymphoid tissue, splenic MZL, nodal MZL), the median age at diagnosis is around 65-70 years. Due to the lack of larger studies in MZL, little is known of the prevalence of comorbidity, polypharmacy, or geriatric syndromes in older patients with MZL. The impact of these concurrent conditions on the tolerability and feasibility of diagnostic or therapeutic procedures used in MZL has not been specifically investigated...
March 2017: Best Practice & Research. Clinical Haematology
https://www.readbyqxmd.com/read/28284382/medication-induced-interstitial-nephritis-in-the-21st-century
#16
REVIEW
Cynthia C Nast
Interstitial nephritis is an immune mediated form of tubulointerstitial kidney injury that may occur secondary to drugs, autoimmune disease, infections, and hematologic disorders or as a reactive process. Drug-induced acute interstitial nephritis (DI-AIN) occurs in 0.5%-3% of all kidney biopsies and in 5%-27% of biopsies performed for acute kidney injury. Drugs are implicated in 70%-90% of biopsy-proved IN with a prevalence of 50% in less developed to 78% in more developed countries. DI-AIN typically is idiosyncratic because of a delayed hypersensitivity reaction, although some chemotherapeutic agents are permissive for immune upregulation and injure the kidney in a dose-related manner...
March 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28284002/non-persistence-with-antiplatelet-therapy-in-elderly-patients-after-a-transient-ischemic-attack
#17
Martin Wawruch, Dusan Zatko, Gejza Wimmer, Jan Luha, Sona Wimmerova, Peter Kukumberg, Jan Murin, Adam Hloska, Tomas Tesar, Rashmi Shah
BACKGROUND: Antiplatelet therapy following a transient ischemic attack (TIA) constitutes an important secondary prevention measure. AIMS: The study was aimed at evaluating the development of non-persistence with antiplatelet therapy in elderly patients after a TIA and identifying patient-related characteristics associated with the probability of non-persistence during the follow-up period. METHODS: The study cohort (n = 854) was selected from the database of the largest health insurance provider of the Slovak Republic...
March 11, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28273128/prevalence-risk-factors-and-health-outcomes-associated-with-polypharmacy-among-urban-community-dwelling-older-adults-in-multi-ethnic-malaysia
#18
Li Min Lim, Megan McStea, Wen Wei Chung, Nuruljannah Nor Azmi, Siti Azdiah Abdul Aziz, Syireen Alwi, Adeeba Kamarulzaman, Shahrul Bahyah Kamaruzzaman, Siew Siang Chua, Reena Rajasuriar
BACKGROUND: Polypharmacy has been associated with increased morbidity and mortality in the older population. OBJECTIVES: The aim of this study was to determine the prevalence, risk factors and health outcomes associated with polypharmacy in a cohort of urban community-dwelling older adults receiving chronic medications in Malaysia. METHODS: This was a baseline study in the Malaysian Elders Longitudinal Research cohort. The inclusion criteria were individuals aged ≥55years and taking at least one medication chronically (≥3 months)...
2017: PloS One
https://www.readbyqxmd.com/read/28271916/prevalence-of-inappropriate-medication-use-in-residential-long-term-care-facilities-for-the-elderly-a-systematic-review
#19
Hannelore Storms, Kristel Marquet, Bert Aertgeerts, Neree Claes
BACKGROUND: Multi-morbidity and polypharmacy of the elderly population enhances the probability of elderly in residential long-term care facilities experiencing inappropriate medication use. OBJECTIVES: The aim is to systematically review literature to assess the prevalence of inappropriate medication use in residential long-term care facilities for the elderly. METHODS: Databases (MEDLINE, EMBASE) were searched for literature from 2004 to 2016 to identify studies examining inappropriate medication use in residential long-term care facilities for the elderly...
December 2017: European Journal of General Practice
https://www.readbyqxmd.com/read/28260692/individualizing-treatment-targets-for-elderly-patients-with-type-2-diabetes-factors-influencing-clinical-decision-making-in-the-24-week-randomized-interval-study
#20
W David Strain, Abhijit S Agarwal, Päivi M Paldánius
We tested the feasibility of setting individualized glycemic goals and factors influencing targets set in a clinical trial in elderly patients with type 2 diabetes.A 24-week, randomized, double-blind, placebo-controlled study was conducted in 45 outpatient centers in seven European countries. 278 drug-naïve or inadequately controlled (mean HbA1c 7.9%) patients with type 2 diabetes aged ≥70 years with HbA1c levels ≥7.0% and ≤10.0% were enrolled. Investigator-defined individualized HbA1c targets and the impact of baseline characteristics on individualized treatment targets was evaluated...
March 5, 2017: Aging
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