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polypharmacy and elderly

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https://www.readbyqxmd.com/read/28923660/factors-influencing-short-term-outcomes-for-older-patients-accessing-emergency-departments-after-a-fall-the-role-of-fall-dynamics
#1
Caterina Trevisan, Patrizia Di Gregorio, Eugenio Debiasi, Martina Pedrotti, Mario La Guardia, Enzo Manzato, Giuseppe Sergi, Albert March
BACKGROUND: While the relevance of falls in raising the risk of fractures, hospitalization and disability in older age is well recognized, the factors influencing the onset of fractures and the need for ward admission after a fall have yet to be fully elucidated. We investigated which factors and fall dynamics were mainly associated with fall-related injuries and hospitalization among elderly persons accessing the Emergency Department (ED) following a fall. METHODS: The study involved 2144 older subjects who accessed the ED after a fall...
September 13, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28919724/development-of-a-core-outcome-set-for-medication-review-in-older-patients-with-multimorbidity-and-polypharmacy-a-study-protocol
#2
Jean-Baptiste Beuscart, Olivia Dalleur, Benoit Boland, Stefanie Thevelin, Wilma Knol, Shane Cullinan, Claudio Schneider, Denis O'Mahony, Nicolas Rodondi, Anne Spinewine
BACKGROUND: Medication review has been advocated to address the challenge of polypharmacy in older patients, yet there is no consensus on how best to evaluate its efficacy. Heterogeneity of outcomes reported in clinical trials can hinder the comparison of clinical trial findings in systematic reviews. Moreover, the outcomes that matter most to older patients might be under-reported or disregarded altogether. A core outcome set can address this issue as it defines a minimum set of outcomes that should be reported in all clinical trials in any particular field of research...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28918484/drug-herb-interactions-in-the-elderly-patient-with-ibd-a-growing-concern
#3
REVIEW
Haider Rahman, Marina Kim, Galen Leung, Jesse A Green, Seymour Katz
Inflammatory bowel disease (IBD), which includes conditions such as Crohn's disease and ulcerative colitis, is becoming more prevalent with the elderly being the fastest growing group. Parallel to this, there is an increasing interest in the use of complementary and alternative medicine (CAM). Nearly half of patients with IBD have used CAM at one time. The elderly patients, however, are burdened by comorbid conditions, polypharmacy, and altered functional status. With increasing use of complementary and alternative medicine in our elderly patients with IBD, it is vital for the provider to provide counsel on drug-herb potential interactions...
September 16, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28917330/-oral-administration-of-medicines-in-elderly-patients-and-adaptation-of-galenic-forms
#4
Éric Pautas, Lasamy Bui, Alexandra Monti, Sébastien Krypciak, Anastasia Obraztsova, Eléna Paillaud
Physiological ageing and pathologies can have an influence on the pharmacology of numerous medicines, leading to serious iatrogenic accidents, polypharmacy and incorrect use of a medicine in elderly people. An observational study carried out in a short-stay geriatric unit focused on the issues surrounding the difficulties the elderly may encounter when taking medicines and the prevalence of the manipulation of galenic forms.
September 2017: Soins. Gérontologie
https://www.readbyqxmd.com/read/28917110/prevalence-and-predictors-of-potentially-inappropriate-prescribing-of-central-nervous-system-and-psychotropic-drugs-among-elderly-patients-a-national-population-study-in-korea
#5
Hyeonseok Cho, Junjeong Choi, Young-Sang Kim, Sang Joon Son, Kang Soo Lee, Hee-Jin Hwang, Hye-Young Kang
OBJECTIVES: To investigate the prevalence of potentially inappropriate prescribing (PIP) of central nervous system and psychotropic (CNS-PS) drugs to the Korean elderly population, and to identify PIP-associated factors. METHODS: Ambulatory care visits were identified from the 2013 National Aged Patient Sample (HIRA-APS-2013) data, composed of 20% random samples of all enrollees in the universal health security program aged ≥65 years. The CNS-PS section of Screening Tool of Older Person's potentially inappropriate Prescriptions (STOPP) criteria version 2 was used to identify PIP at these visits...
September 6, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28894183/gut-microbiota-composition-is-associated-with-polypharmacy-in-elderly-hospitalized-patients
#6
Andrea Ticinesi, Christian Milani, Fulvio Lauretani, Antonio Nouvenne, Leonardo Mancabelli, Gabriele Andrea Lugli, Francesca Turroni, Sabrina Duranti, Marta Mangifesta, Alice Viappiani, Chiara Ferrario, Marcello Maggio, Marco Ventura, Tiziana Meschi
Reduced biodiversity and increased representation of opportunistic pathogens are typical features of gut microbiota composition in aging. Few studies have investigated their correlation with polypharmacy, multimorbidity and frailty. To assess it, we analyzed the fecal microbiota from 76 inpatients, aged 83 ± 8. Microbiome biodiversity (Chao1 index) and relative abundance of individual bacterial taxa were determined by next-generation 16S rRNA microbial profiling. Their correlation with number of drugs, and indexes of multimorbidity and frailty were verified using multivariate linear regression models...
September 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28892805/an-evaluation-of-the-central-nervous-system-medication-use-and-frailty-among-residents-of-aged-care-homes-in-malaysia
#7
Syed Shahzad Hasan, Chia Siang Kow, Kaeshaelya Thiruchelvam, David Weng Kwai Chong, Syed Imran Ahmed
BACKGROUND/AIMS: Old age and institutionalization in care homes are associated with increased use of risk medications affecting the central nervous system (CNS). This study evaluated medication utilization and appropriateness; and assessed frailty among residents of Malaysian aged care homes. METHODS: The subjects of this study included 202 elderly (≥65 years) residents of 17 aged care homes in suburban peninsular Malaysia. Frailty was measured using the Groningen Frailty Indicator (GFI) score and independence in daily living was measured as KATZ activity of daily living score...
September 12, 2017: Neuroepidemiology
https://www.readbyqxmd.com/read/28892271/potential-drug-drug-interactions-and-polypharmacy-in-institutionalized-elderly-patients-in-a-public-hospital-in-brazil
#8
Ellen Carolina Dias Castilho, Adriano Max Moreira Reis, Tatiana Longo Borges, Lilian Dias Castilho Siqueira, Adriana Inocenti Miasso
INTRODUCTION: Despite the impact on patient safety and the fact that prevalence is higher in older patients, previous research did not analyse drug-drug interactions (DDIs) in view of nursing care of elderly psychiatric patients. AIM: To identify potential drug-drug interactions and polypharmacy in prescriptions of aged inpatients with psychiatric disorders and analyse associated factors. METHODS: In this retrospective cross-sectional study, we analysed the medical records of institutionalized patients diagnosed with psychiatric disorders (n = 94), aged >60 years, and prescribed multiple medications...
September 11, 2017: Journal of Psychiatric and Mental Health Nursing
https://www.readbyqxmd.com/read/28889761/safety-issues-associated-with-using-medication-to-treat-overactive-bladder
#9
George Araklitis, Linda Cardozo
The mainstay of overactive bladder treatment is the use of anticholinergic medication with its common side effects well known. This review focused on three less well-known safety issues when treating OAB. Areas covered: Patients with increased anticholinergic load are at risk of cognitive decline, dementia or even death. The elderly are particularly at risk due to polypharmacy. Botulinum toxin carries the risk of high urinary residuals, urinary tract infection and need to self catheterise. The use of vaginal oestrogens may improve OAB symptoms, but there is concern in those with a history of breast cancer...
September 10, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28868891/anticholinergic-burden-in-older-inpatients-on-psychotropic-medication-do-we-care
#10
Mei Shiang Lee, Steve Kisely, Boris Zolotarev, Andrew Warren, Jack Henderson, Manoj George
OBJECTIVES: This quality activity explored the prescribing patterns in an Older Persons Mental Health Inpatient Unit in order to establish whether the Anticholinergic Cognitive Burden Scale (ACB Scale) score on admission was reviewed to minimise anticholinergic cognitive burden (ACB) while maintaining therapeutic effects. METHODS: A retrospective electronic chart review of 50 discharged patients for any documented ACB review by the treating team, as well as the ACB Scale scores on admission and discharge...
September 1, 2017: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/28858118/an-evaluation-of-medication-appropriateness-and-frailty-among-residents-of-aged-care-homes-in-malaysia-a-cross-sectional-study
#11
Syed Shahzad Hasan, Chia Siang Kow, Rohit Kumar Verma, Syed Imran Ahmed, Piyush Mittal, David W K Chong
Aging is significantly associated with the development of comorbid chronic conditions. These conditions indicate the use of multiple medications, and are often warranted by clinical guidelines. The aim of the present study was to evaluate medication appropriateness and frailty among Malaysian aged care home residents with chronic disease. The participants were 202 elderly (≥65 years) individuals, a cross-sectional sample from 17 aged care homes. After ethics approval, each participant was interviewed to collect data on sociodemographics, frailty status (Groningen Frailty Indicator [GFI]), medication appropriateness (Medication Appropriateness Index (MAI), the 2015 Beers' criteria (Potentially Inappropriate Medication [PIM]), and 2014 STOPP criteria (Potentially Inappropriate Prescribing [PIP])...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28851511/polypharmacy-potentially-inappropriate-medications-and-drug-drug-interactions-in-geriatric-patients-with-hematologic-malignancy-observational-single-center-study-of-122-patients
#12
David Y Leger, Stephane Moreau, Nicolas Signol, Jean-Baptiste Fargeas, Marie-Agnès Picat, Amélie Penot, Julie Abraham, Marie-Laure Laroche, Dominique Bordessoule
OBJECTIVES: Geriatric patients with hematologic malignancies (HMs) are prescribed targeted and supportive care treatments that add to the preexisting polypharmacy (PP). PP is associated with an increased risk of potentially inappropriate medications (PIM) and drug-drug interactions (DDI) resulting in increased hospitalization and mortality in the elderly. As very few data exist on these medication issues in the context of HMs, the objective of this study was to evaluate prevalence of PP, DDI and PIM use at baseline and 3months among elderly patients with HMs who received baseline geriatric assessment...
August 26, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28832855/polypharmacy-among-the-elderly-a-population-based-study
#13
Karine Gonçalves Pereira, Marco Aurélio Peres, Débora Iop, Alexandra Crispim Boing, Antonio Fernando Boing, Marina Aziz, Eleonora d'Orsi
Objective: To investigate polypharmacy among the elderly living in the urban area of Florianopolis, in the state of Santa Catarina, Brazil, estimating the prevalence and associated factors. Methods: This is a cross-sectional population-based study with a sample of 1,705 individuals aged 60 years old or older, between 2009 and 2010. The dependent variable was polypharmacy (defined as "use of five or more medications"). The following exploratory variables were utilized: sociodemographic data, use of health services and self-rated health status...
April 2017: Revista Brasileira de Epidemiologia, Brazilian Journal of Epidemiology
https://www.readbyqxmd.com/read/28830291/pay-for-performance-associated-with-increased-volume-of-medication-reviews-but-not-with-less-inappropriate-use-of-medications-among-the-elderly-an-observational-study
#14
H Ödesjö, A Anell, A Boman, J Fastbom, S Franzén, J Thorn, S Björck
OBJECTIVE: A pay for performance programme was introduced in 2009 by a Swedish county with 1.6 million inhabitants. A process measure with payment linked to coding for medication reviews among the elderly was adopted. We assessed the association with inappropriate medication for five years after baseline. DESIGN AND SETTING: Observational study that compared medication for elderly patients enrolled at primary care units that coded for a high or low volume of medication reviews...
September 2017: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/28805478/production-of-platelet-rich-plasma-gel-from-elderly-patients-under-antithrombotic-drugs-perspectives-in-chronic-wounds-care
#15
M Velier, J Magalon, A Daumas, M Cassar, P Francois, A Ghazouane, C Philandrianos, B Bertrand, C Frere, D Bernot, P Villani, F Dignat George, F Sabatier
Platelet-Rich Plasma (PRP) is an autologous biological therapy obtained by centrifuging the patient's own blood to concentrate platelets. The addition of autologous thrombin and calcium chloride to PRP allows the production of a semi-solid form called PRP gel. PRP gel is increasingly used in a variety of tissue defects and predominantly in the management of non-healing chronic wounds. The topical application of PRP gel seems promising due to the capability of platelets to store and secrete growth factors (GF), fibrin and cytokines, which are essentials for wound healing...
August 14, 2017: Platelets
https://www.readbyqxmd.com/read/28801825/intractable-constipation-in-the-elderly
#16
REVIEW
Noemi Baffy, Amy E Foxx-Orenstein, Lucinda A Harris, Susan Sterler
Chronic constipation is a common gastrointestinal disorder disproportionately affecting the elderly. Immobility, polypharmacy, and physiologic changes contribute to its increased prevalence in this population. Unidentified and undertreated constipation leads to a significant negative impact on quality of life and an increase in healthcare spending. Careful physical examination and exploration of the clinical history can unmask primary and secondary forms of constipation, guiding diagnostic and therapeutic considerations...
August 11, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28791591/age-related-differences-in-non-persistence-with-statin-treatment-in-patients-after-a-transient-ischaemic-attack
#17
Martin Wawruch, Dusan Zatko, Gejza Wimmer, Jan Luha, Sona Wimmerova, Petra Matalova, Peter Kukumberg, Jan Murin, Tomas Tesar, Beata Havelkova, Rashmi Shah
BACKGROUND AND OBJECTIVE: Non-persistence with secondary preventive measures, including medications such as statins, adversely affects the prospects of successful outcomes. This study was aimed at evaluating non-persistence with statin therapy in cohorts of young and elderly patients after a transient ischaemic attack (TIA) and identifying patient-associated characteristics that influence the risk for non-persistence. METHODS: The study cohorts included 797 adult patients who were initiated on statin therapy following a TIA diagnosis between 1 January 2010 and 31 December 2010...
August 8, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28776873/the-systematic-tool-to-reduce-inappropriate-prescribing-strip-combining-implicit-and-explicit-prescribing-tools-to-improve-appropriate-prescribing
#18
A Clara Drenth-van Maanen, Anne J Leendertse, Paul A F Jansen, Wilma Knol, Carolina J P W Keijsers, Michiel C Meulendijk, Rob J van Marum
Inappropriate prescribing is a major health care issue, especially regarding older patients on polypharmacy. Multiple implicit and explicit prescribing tools have been developed to improve prescribing, but these have hardly ever been used in combination. The Systematic Tool to Reduce Inappropriate Prescribing (STRIP) combines implicit prescribing tools with the explicit Screening Tool to Alert physicians to the Right Treatment and Screening Tool of Older People's potentially inappropriate Prescriptions criteria and has shared decision-making with the patient as a critical step...
August 4, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28763310/elderly-patients-with-multiple-myeloma-towards-a-frailty-approach
#19
REVIEW
Sonja Zweegman, Monika Engelhardt, Alessandra Larocca
PURPOSE OF REVIEW: To describe how to better identify frail multiple myeloma patients and to treat them appropriately. RECENT FINDINGS: Proteasome inhibitors, such as bortezomib, carfilzomib, and ixazomib, and immunomodulatory agents (IMiDs), such as thalidomide, lenalidomide, and pomalidomide, have significantly improved the outcome of multiple myeloma patients in the last decade. However, both in clinical trials and in daily clinical practice, elderly multiple myeloma patients have shown lesser benefit...
September 2017: Current Opinion in Oncology
https://www.readbyqxmd.com/read/28757769/the-borderland-between-normal-aging-and-dementia
#20
REVIEW
Raymond Y Lo
Alzheimer's disease (AD) has become a global health issue as the population ages. There is no effective treatment to protect against its occurrence or progression. Some argue that the lack of treatment response is due to delays in diagnosis. By the time a diagnosis of AD is made, neurodegenerative changes are at the stage where very few neurons can be salvaged by medication. The AD research community has developed the idea of mild cognitive impairment (MCI) in an attempt to find predementia patients who might benefit from potentially therapeutic drugs that have proven ineffective in the past...
April 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
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