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polypharmacy and elderly

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https://www.readbyqxmd.com/read/29334745/-citalopram-and-qt-prolongation
#1
Štefan Alušík, Zoltán Paluch
In 2011/2012, the US Food and Drug Administration issued a warning about the effect of citalopram on the QT interval and decreased its dosing. Further studies addressing this issue have been published since then. The authors were interested to know whether or not the studies have furnished new information that could modify or further specify the FDA-issued recommendations. After analyzing the most relevant studies, the authors concluded that even papers published within the last 5 years confirmed that, of the SSRI class of drugs, citalopram prolongs the QT interval most significantly...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29330585/potentially-inappropriate-medications-in-community-dwelling-older-adults-undertaken-as-a-comprehensive-geriatric-risk-assessment
#2
Sharmin S Bala, Sujita W Narayan, Prasad S Nishtala
PURPOSE: The prescription of potentially inappropriate medications (PIMs) is associated with an increase in adverse events, prescribing cascades, high health-care costs, morbidity, and mortality in the elderly. The overarching objective of this study is to examine the prevalence of PIMs in the elderly, applying the 2012 American Geriatrics Society Beers criteria for the study period 2012-2014, and the updated 2015 Beers criteria for 2015. METHODS: The study population (N = 70,479) included a continuously recruited national cohort of community-dwelling older (aged ≥ 65 years) New Zealanders who had undertaken the International Resident Assessment Instrument-Home Care (interRAI-HC) assessments between September 2012 and October 2015...
January 12, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29304725/patient-perceived-barriers-and-facilitators-to-the-implementation-of-a-medication-review-in-primary-care-a-qualitative-thematic-analysis
#3
Mirella Carolin Uhl, Christiane Muth, Ferdinand Michael Gerlach, Goentje-Gesine Schoch, Beate Sigrid Müller
BACKGROUND: Although polypharmacy can cause adverse health outcomes, patients often know little about their medication. A regularly conducted medication review (MR) can help provide an overview of a patient's medication, and benefit patients by enhancing their knowledge of their drugs. As little is known about patient attitudes towards MRs in primary care, the objective of this study was to gain insight into patient-perceived barriers and facilitators to the implementation of an MR. METHODS: We conducted a qualitative study with a convenience sample of 31 patients (age ≥ 60 years, ≥3 chronic diseases, taking ≥5 drugs/d); in Hesse, Germany, in February 2016...
January 5, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29277160/elderly-patients-and-gps-perspectives-of-patient-gp-communication-concerning-polypharmacy-a-qualitative-interview-study
#4
Andrea C Schöpf, Maike von Hirschhausen, Erik Farin, Andy Maun
Aim The aim of this study was to explore elderly patients' and general practitioners' (GPs') perceptions of communication about polypharmacy, medication safety and approaches for empowerment. BACKGROUND: To manage polypharmacy, GPs need to know patients' real medication consumption. However, previous research has shown that patients do not always volunteer all information about their medication regimen, for example, such as the intake of over-the-counter medication or the alteration or discontinuation of prescribed medication...
December 26, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/29249687/male-incontinence-the-etiology-or-basis-of-treatment
#5
REVIEW
Austin G Hester, Alexander Kretschmer, Gopal Badlani
CONTEXT: Elderly men are an increasing proportion of the aging population in the 21st century. Urinary incontinence reduces the quality of life and increases the burden of care for the aging population. OBJECTIVE: The primary objective of this review is to explore the etiopathology of common causes of incontinence in aging male patients. The focus is on the algorithm of the initial evaluation of these patients from both a primary care and a urologic standpoint. EVIDENCE ACQUISITION: A nonsystematic review of the literature was performed in September 2017...
December 14, 2017: European Urology Focus
https://www.readbyqxmd.com/read/29248859/impact-of-age-comorbidity-and-polypharmacy-on-the-efficacy-and-safety-of-edoxaban-for-the-treatment-of-venous-thromboembolism-an-analysis-of-the-randomized-double-blind-hokusai-vte-trial
#6
Thomas Vanassche, Peter Verhamme, Philip S Wells, Annelise Segers, Walter Ageno, Marjolein P A Brekelmans, Cathy Z Chen, Alexander T Cohen, Michael A Grosso, Andria P Medina, Michele F Mercuri, Shannon M Winters, George Zhang, Jeffrey I Weitz, Gary E Raskob, Harry R Büller
BACKGROUND: Many patients with venous thromboembolism (VTE) are elderly, have multiple comorbidities and take several concomitant medications. Physicians may prefer warfarin over direct oral anticoagulants (DOACs) in such patients because comparative data are lacking. This analysis was designed to determine the effects of advanced age, comorbidities, and polypharmacy on the efficacy and safety of edoxaban and warfarin in patients with VTE. METHODS: Using data from the Hokusai-VTE study, we report rates of recurrent VTE and of clinically relevant bleeding by age category (<65, 65-75, and ≥75; <80 versus ≥80years), and by number of comorbidities (0, 1-2, >2) and concomitant medications (<3, 3-5, >5)...
December 13, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29246247/intervention-to-improve-the-appropriate-use-of-polypharmacy-for-older-patients-with-hip-fractures-an-observational-study
#7
Junpei Komagamine, Kazuhiko Hagane
BACKGROUND: Polypharmacy is frequently observed in hip fracture patients. Although it is associated with an increased risk of hip fracture, polypharmacy often continues after hip fracture recovery. This study aimed to evaluate the effectiveness of an intervention to improve appropriate polypharmacy for elderly patients admitted to the hospital for hip fractures. METHODS: We conducted a retrospective observational study to compare the outcomes of patients receiving the intervention (n = 32) with those of patients who received usual care (n = 132)...
December 16, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29222712/categorization-and-association-analysis-of-risk-factors-for-adverse-drug-events
#8
REVIEW
Lina Zhou, Anamika Paul Rupa
PURPOSE: Adverse drug events (ADE) are among the leading causes of morbidity and hospitalization. This review analyzes risk factors for ADE, particularly their categorizations and association patterns, the prevalence, severity, and preventability of ADE, and method characteristics of reviewed studies. METHODS: Literature search was conducted via PubMed, Science Direct, CINAHL, and MEDLINE. A review was conducted of research articles that reported original data about specific risk factors for ADE since 2000...
December 8, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29214511/managing-gout-flares-in-the-elderly-practical-considerations
#9
Abhishek Abhishek
Gout is common in the elderly, affecting an estimated 4.7 million people aged > 60 years in the USA alone. The incidence and prevalence of gout increases, and male predisposition to gout reduces, with increasing age. The elderly have more comorbidities, and gout manifests differently, with more frequent involvement of knees, ankles, and wrists at disease onset, systemic upset, and tophi. Comorbidities and polypharmacy make the management of gout flares challenging in this population. Intra-articular corticosteroid injection remains the treatment of choice for accessible joints, oral prednisolone is preferred over low-dose colchicine, and non-steroidal anti-inflammatory drugs (NSAIDs) are best avoided...
December 6, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29212497/adverse-events-recording-in-electronic-health-record-systems-in-primary-care
#10
Sabine E M de Hoon, Karin Hek, Liset van Dijk, Robert A Verheij
BACKGROUND: Adequate record keeping of medication adverse events in electronic health records systems is important for patient safety. Events that remain unrecorded cannot be communicated from one health professional to another. In the absence of a gold standard, we investigate the variation between Dutch general practices in the extent to which they record medication adverse events. METHODS: Data were derived from electronic health records (EHR) of Dutch general practices participating in NIVEL Primary Care Database (NIVEL-PCD) in 2014, including 308 general practices with a total practice population of 1,256,049 listed patients...
December 6, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29210840/conoscere-e-curare-il-cuore-1986-2016-how-the-heart-has-changed
#11
Alessandro Boccanelli
: The demographic transition, with longer life expectancy, is mainly due to prevention and care of atherosclerotic vascular and heart disease. The cardiovascular patient is now much older and often presents with coexisting geriatric syndromes that affect healthcare goals, outcomes, and the process of care. Numerous mechanisms at cellular level are responsible for cardiovascular aging such as replicative senescence, apoptosis, proteins misfolding, and inflammation. Aging-related modifications are increase in left-ventricular mass, increased left atrial size, myocardial collagen deposition, and calcium deposition in valvular structures and the coronary arteries...
November 27, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29201368/medication-use-and-falls-applying-beers-criteria-to-medication-review-in-parkinson-s-disease
#12
Eleanor Yusupov, Davina Chen, Bhuma Krishnamachari
Objectives: Our goal was to assess the association between potentially inappropriate medication use and risk of falls in the Parkinson's disease population. Methods: This was a retrospective cohort study conducted at an outpatient Parkinson's Disease Treatment Center. Individuals 65 years of age or older, diagnosed with Parkinson's disease who attended at least three visits in 2015 for physical, occupational therapy, or physician's visits were included in the study...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/29194226/success-rate-of-tympanic-membrane-closure-in-the-elderly-compared-to-younger-adults
#13
Casper Jolink, Max R Zwemstra, Maarten J F de Wolf, Fenna A Ebbens, Erik van Spronsen
OBJECTIVE: To assess the effectiveness and safety of tympanoplasty in elderly patients and the effect of frailty on the results. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary referral center. PATIENTS: Thirty-one ears in 30 patients aged 65 years and older were included and matched with 31 controls, based on the type of surgery, of a pool of 133 patients aged 35 to 55 years. INTERVENTION: Therapeutic...
November 30, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/29191263/persistent-and-severe-hypoglycemia-associated-with-trimethoprim-sulfamethoxazole-in-a-frail-diabetic-man-on-polypharmacy-a-case-report-and-literature-review%C3%A2
#14
Raffaella Rossio, Sara Arcudi, Flora Peyvandi, Stefania Piconi
OBJECTIVE: Trimethoprim-sulfamethoxazole (co-trimoxazole) is a commonly used broad-spectrum antibiotic, but it can be associated with potentially serious adverse effects, often not recognized by clinicians. This is a relevant problem in elderly patients, who are particularly susceptible to adverse drug reactions. Moreover, multiple medications taken by older people increase the risk for adverse drug reactions and drug-drug interactions. CASE REPORT: We report the case of an 85-year-old man with diabetes mellitus who attended the emergency room with severe hypoglycemia that persisted despite multiple intravenous bolus doses and continuous infusion of glucose...
November 30, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29189921/lithium-toxicity-in-older-adults-a-systematic-review-of-case-reports
#15
REVIEW
Meng Sun, Nathan Herrmann, Kenneth I Shulman
BACKGROUND AND OBJECTIVES: Despite concerns regarding the vulnerability of older adults to lithium toxicity, this has not been well studied. This literature review aims to characterize the nature of lithium toxicity in older adults, the doses and serum lithium levels associated with toxicity, as well as its clinical and laboratory manifestations, precipitating factors, management and outcome. METHODS: A systematic 10-year search of English articles was conducted using Ovid Medline, Embase Classic + Embase, Cochrane Central Register of Controlled Trials and PsycINFO...
November 30, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29188894/vitamin-d-and-the-mechanisms-circumstances-and-consequences-of-falls-in-older-adults-a-case-control-study
#16
G T Duval, P-Y Paré, J Gautier, S Walrand, M Dinomais, C Annweiler
OBJECTIVES: To determine i) whether cases of elderly fallers had lower serum 25-hydroxyvitamin D (25OHD) concentration than controls without history of falls; and ii) whether serum 25OHD concentration was associated with specific mechanisms, circumstances and consequences of falls. DESIGN: Case-control study with a 1:2 ratio. SETTING: Geriatric ward of the University Hospital of Angers, France, between February 2012 and March 2014. PARTICIPANTS: 216 inpatients (72 cases and 144 age- and gender-matched controls)...
2017: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/29188881/malnutrition-in-acutely-unwell-hospitalized-elderly-the-skeletons-are-still-rattling-in-the-hospital-closet
#17
Y Sharma, C Thompson, R Shari, P Hakendorf, M Miller
INTRODUCTION: Malnutrition is common in hospitalized patients with prevalence rates of up to 30% in Australian hospitals with adverse consequences for both the patients and health care services. Despite formulation of nutritional screening protocols, not all hospitalized patients get nutritional screening. Real life screening rates of hospitalized elderly patients are unknown. AIM: The present study explored nutrition screening rate in acutely unwell elderly patients admitted in a large tertiary hospital and how these patients fared depending upon their nutrition status...
2017: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/29175562/utilisation-and-polypharmacy-aspects-of-antiepileptic-drugs-in-elderly-versus-younger-patients-with-epilepsy-a-pharmacoepidemiological-study-of-cns-active-drugs-in-norway-2004-2015
#18
Arton Baftiu, Silje Andrea Feet, Pål Gunnar Larsson, Margrete Larsen Burns, Oliver Henning, Erik Sætre, Espen Molden, Anne Gerd Granas, Svein I Johannessen, Cecilie Johannessen Landmark
BACKGROUND AND PURPOSE: Many patients with epilepsy use antiepileptic drugs (AEDs) in combination. The elderly is a vulnerable group regarding polypharmacy. The purpose of this study was to investigate changes in utilisation of AEDs, and the extent of polypharmacy with other CNS-active drugs in elderly versus younger patients in Norway. METHODS: This pharmacoepidemiological study included all prescriptions of antiepileptic, antidepressant and antipsychotic drugs from Norwegian pharmacies in the Norwegian Prescription Database (NorPD) (2004-2015)...
November 11, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/29171774/advances-in-treating-psoriasis-in-the-elderly-with-small-molecule-inhibitors
#19
Abigail Cline, Leah A Cardwell, Steven R Feldman
Due to the chronic nature of psoriasis, the population of elderly psoriasis patients is increasing. However, many elderly psoriatic patients are not adequately treated because management is challenging as a result of comorbidities, polypharmacy, and progressive impairment of organ systems. Physicians may hesitate to use systemic or biologic agents in elderly psoriasis patients because of an increased risk of adverse events in this patient population. Small molecule medications are emerging as promising options for elderly patients with psoriasis and other inflammatory conditions...
November 24, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29150094/-geriatric-assessment-and-prognostic-scores-in-older-cancer-patient-additional-support-to-the-therapeutic-decision
#20
REVIEW
Frédéric Pamoukdjian, Evelyne Liuu, Philippe Caillet, Mathilde Gisselbrecht, Stéphane Herbaud, Pascaline Boudou-Rouquette, Laurent Zelek, Elena Paillaud
Cancer is a disease of the elderly as demonstrated by the epidemiological evolution of Western countries. Indeed, two third of cancers newly diagnosed occur over 65 years. However, older cancer patients have been often excluded from clinical trials in oncology and the extrapolation of cancer treatments in this population remains difficult in practice. Scientific societies recommend that a comprehensive geriatric assessment (CGA) be performed in patients aged 70 and over and selected using screening tools for frailty such as the G8 index...
November 14, 2017: Bulletin du Cancer
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