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Drug use in the elderly

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https://www.readbyqxmd.com/read/28734882/opioid-prescribing-among-cancer-and-non-cancer-patients-time-trend-analysis-in-the-elderly-using-administrative-data
#1
Lisa Barbera, Rinku Sutradhar, Anna Chu, Hsien Seow, Doris Howell, Craig C Earle, Mary Ann O'Brien, Deb Dudgeon, Clare Atzema, Amna Husain, Ying Liu, Carlo DeAngelis
BACKGROUND: In 2007, Cancer Care Ontario introduced a provincial symptom screening program, which included pain, for cancer patients. Over this same time, opioid prescribing has been increasingly scrutinized among non-cancer patients. The study purpose was to see if opioid prescribing changed among older adults after 2007 in the context of changing opioid regulations, and whether effects were different among patients with a cancer history. METHODS: Ontario residents aged ≥65 were identified from 2004 to 2013...
July 19, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28733846/implementation-of-a-standardized-protocol-to-manage-elderly-patients-with-low-energy-pelvic-fractures-can-service-improvement-be-expected
#2
Nikolaos K Kanakaris, Tess Greven, Robert M West, Arie B Van Vugt, Peter V Giannoudis
PURPOSE: The incidence of low energy pelvic fractures (FPFs) in the elderly is increasing. Comorbidities, decreased bone-quality, problematic fracture fixation and poor compliance represent some of their specific difficulties. In the absence of uniform management, a standard operating procedure (SOP) was introduced to our unit, aiming to improve the quality of services provided to these patients. METHODS: A cohort study was contacted to test the impact of (1) using a specific clinical algorithm and (2) using different antiosteoporotic drugs...
July 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28733071/long-term-stroke-and-bleeding-risk-in-patients-with-atrial-fibrillation-treated-with-oral-anticoagulants-in-contemporary-practice-providing-evidence-for-shared-decision-making
#3
Peter A Noseworthy, Xiaoxi Yao, Bernard J Gersh, Ian Hargraves, Nilay D Shah, Victor M Montori
BACKGROUND: Oral anticoagulation is recommended as a lifelong therapy for most patients with atrial fibrillation (AF). However, data on long-term outcomes in clinical practice on these drugs are scarce, particularly for the recently approved agents. We aimed to describe differences in characteristics between patients in everyday practice and those enrolled in the pivotal trials, and to report long-term outcomes on oral anticoagulation in practice. METHODS: We performed a retrospective cohort analysis using a large U...
July 14, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28732235/medication-takeovers-covert-druggings-and-behavioral-control-in-alzheimer-s
#4
Brandon Berry, Ester Carolina Apesoa-Varano
Older adults consume the most prescription medication in the U.S. For those who develop Alzheimer's disease, risk of medication misuse increases with the progression of the disease. Family members commonly intervene to lessen risks by taking over the management and administering of a medication regimen. Despite the potential for grave harm around the misuse of powerful drugs, few studies provide insight into the household social context of medication use for this disease. Drawing on 60 in-depth interviews conducted in four waves over 2...
July 6, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28722540/association-between-serum-uric-acid-level-and-hypertension-in-a-chinese-elderly-rural-population
#5
Lei Wu, Yao He, Bin Jiang, Miao Liu, Jianhua Wang, Di Zhang, Yiyan Wang, Jing Zeng
Previous studies have examined the association between elevated serum uric acid (SUA) level and hypertension; however, the association in the Chinese elderly is still uncertain. A cross-sectional study was performed in a rural district of Beijing. A total of 2,397 participants (967 men and 1,430 women) completed the survey. The SUA levels of participants were categorized into four levels using the quartiles (P25, P50, and P75) as cutoff values. Participant was diagnosed as hyperuricemia if the SUA level was ≥417 μmol/L (male) or ≥357 μmol/L (female)...
July 19, 2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/28720319/safety-and-efficacy-of-anti-influenza-drugs-intravenous-peramivir-against-influenza-virus-infection-in-elderly-patients-with-underlying-disease
#6
Kazufumi Takamatsu, Satoshi Marumo, Motonari Fukui, Atsuko Hata
We retrospectively analyzed data of 38 elderly patients, each with an underlying disease, to evaluate peramivir safety and efficacy. Six patients (15.8%) experienced adverse events, all tolerated. Median time from administration until the return to normal temperatures was 31.5 h (95% CI: 22.4-40.6). Results confirm intravenous peramivir's usefulness.
June 26, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28718394/multiple-possible-inaccuracies-cast-doubt-on-a-recent-report-suggesting-selective-serotonin-reuptake-inhibitors-to-be-toxic-and-ineffective
#7
Fredrik Hieronymus, Alexander Lisinski, Jakob Näslund, Elias Eriksson
According to a systematic review on the use of selective serotonin reuptake inhibitors (SSRIs) in adult depression that was recently published in BMC Psychiatry, the results of which have been widely disseminated in lay media, these drugs increase the risk for serious adverse events (SAEs) while exerting poor antidepressant efficacy. A cursory analysis, however, suggests the analysis of SAEs conducted by the authors to be marred by both methodological inaccuracies and blatant errors. After having corrected for these apparent mistakes, we conducted a sensitivity analysis in which we also accounted for a possible moderating effect of age; while this suggests SSRIs to be safe drugs in the non-elderly, they do confirm what is already known, that is, that they may enhance the risk for SAEs in the old...
July 18, 2017: Acta Neuropsychiatrica
https://www.readbyqxmd.com/read/28717929/reduction-in-targeted-potentially-inappropriate-medication-use-in-elderly-inpatients-a-pragmatic-randomized-controlled-trial
#8
Benoit Cossette, Jean-François Éthier, Thomas Joly-Mischlich, Josée Bergeron, Geneviève Ricard, Serge Brazeau, Mathieu Caron, Olivier Germain, Hélène Payette, Janusz Kaczorowski, Mitchell Levine
PURPOSE: The use of potentially inappropriate medications (PIMs) in hospitalized older adults is a complex problem, but the use of computerized alert systems (CAS) has shown some potential. The study's objective is to assess the change in PIM use with a CAS-based pharmacist-physician intervention model compared to usual clinical care. METHODS: Pragmatic single-site randomized controlled trial was conducted at a university teaching hospital. Hospitalizations identified with selected Beers or STOPP criteria were randomized to usual clinical care or to the CAS-based pharmacist-physician intervention...
July 17, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28716467/clinically-relevant-potential-drug-drug-interactions-among-outpatients-a-nationwide-database-study
#9
Janja Jazbar, Igor Locatelli, Nejc Horvat, Mitja Kos
BACKGROUND: Adverse drug events due to drug-drug interactions (DDIs) represent a considerable public health burden, also in Slovenia. A better understanding of the most frequently occurring potential DDIs may enable safer pharmacotherapy and minimize drug-related problems. OBJECTIVES: The aim of this study was to evaluate the prevalence and predictors of potential DDIs among outpatients in Slovenia. METHODS: An analysis of potential DDIs was performed using health claims data on prescription drugs from a nationwide database...
July 11, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28716141/the-german-day-care-study-multicomponent-non-drug-therapy-for-people-with-cognitive-impairment-in-day-care-centres-supplemented-with-caregiver-counselling-detamaks-study-protocol-of-a-cluster-randomised-controlled-trial
#10
Elisa-Marie Behrndt, Melanie Straubmeier, Hildegard Seidl, Stephanie Book, Elmar Graessel, Katharina Luttenberger
BACKGROUND: It is the wish of both people with cognitive impairment and their informal caregivers for the impaired person to live at home for as long as possible. This is also in line with economic arguments about health. The existing structure of day-care services for the elderly can be used to achieve this. Due to the current lack of empirical evidence in this field, most day-care centres do not offer a scientifically evaluated, structured intervention, but instead offer a mixture of individual activities whose efficacy has not yet been established...
July 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28714551/influence-of-the-mode-of-administration-on-the-results-of-medication-adherence-questionnaires
#11
Ana C Cabral, Mariana Moura-Ramos, Margarida Castel-Branco, Margarida Caramona, Fernando Fernandez-Llimos, Isabel V Figueiredo
INTRODUCTION AND OBJECTIVES: Adherence to medication regimen is commonly assessed through questionnaires, some of which are validated via self-administration. The inadequate health literacy of elderly people pushes researchers to the use of interviews as a method of administration. The aims of this study were to compare the results obtained with an interviewer-administered and a self-administered medication adherence questionnaire and to evaluate the consequences of the adherence status classification of individuals...
July 17, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28714419/design-of-multi-target-agents-for-the-treatment-of-alzheimer-s-disease-based-on-tacrine
#12
Hongzhi Lin, Qi Li, Kai Gu, Jie Zhu, Xueyang Jiang, Yao Chen, Haopeng Sun
Alzheimer's disease (AD) is one of the most common forms of dementia in elderly people. To date, efficacious therapeutic agent for the treatment of AD is still very limited, so it has long been a challenging and attractive task to discover new anti-AD drugs. Considering the multifactorial nature of AD, recently, the concept of multi-target-directed ligands (MTDLs) has emerged as a new strategy for designing therapeutic agents on AD. MTDLs are believed to exert their effects through simultaneously affecting multiple targets which contribute to etiology of AD...
July 17, 2017: Current Topics in Medicinal Chemistry
https://www.readbyqxmd.com/read/28709880/low-intensity-transcranial-electric-stimulation-safety-ethical-legal-regulatory-and-application-guidelines
#13
REVIEW
A Antal, I Alekseichuk, M Bikson, J Brockmöller, A R Brunoni, R Chen, L G Cohen, G Dowthwaite, J Ellrich, A Flöel, F Fregni, M S George, R Hamilton, J Haueisen, C S Herrmann, F C Hummel, J P Lefaucheur, D Liebetanz, C K Loo, C D McCaig, C Miniussi, P C Miranda, V Moliadze, M A Nitsche, R Nowak, F Padberg, A Pascual-Leone, W Poppendieck, A Priori, S Rossi, P M Rossini, J Rothwell, M A Rueger, G Ruffini, K Schellhorn, H R Siebner, Y Ugawa, A Wexler, U Ziemann, M Hallett, W Paulus
Low intensity transcranial electrical stimulation (TES) in humans, encompassing transcranial direct current (tDCS), transcutaneous spinal Direct Current Stimulation (tsDCS), transcranial alternating current (tACS), and transcranial random noise (tRNS) stimulation or their combinations, appears to be safe. No serious adverse events (SAEs) have been reported so far in over 18,000 sessions administered to healthy subjects, neurological and psychiatric patients, as summarized here. Moderate adverse events (AEs), as defined by the necessity to intervene, are rare, and include skin burns with tDCS due to suboptimal electrode-skin contact...
June 19, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28707274/cancer-immunotherapies-are-they-as-effective-in-the-elderly
#14
Kate Poropatich, Joel Fontanarosa, Sandeep Samant, Jeffrey A Sosman, Bin Zhang
Almost two-thirds of all new cancer diagnoses are made in persons over the age of 65 years, yet it is unclear if age affects patient responsiveness to immunotherapy, which is increasingly becoming first-line therapy in advanced stages of different tumor types. Preclinical animal studies may be difficult to translate into humans since they frequently use young mice (2-3 months of age) equivalent to adolescent human subjects. Nevertheless, ex vivo studies from humans are concordant with mice tissue findings-older patients have an increased density of circulating regulatory immune cells and a decreased ratio of naïve-to-memory T cells...
July 13, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28707259/rhabdomyolysis-and-aki-with-atorvastatin-and-sitagliptin-use-in-the-setting-of-low-25-hydroxyvitamin-d-levels
#15
Rupinder Singh Buttar, Jasveen Batra, Jacqueline Kreimerman, Melissa Aleta, Michal L Melamed
We report a case of an 86-year-old woman admitted to the hospital with rhabdomyolysis and acute kidney injury 3 weeks after starting sitagliptin while on long-term atorvastatin therapy. She also had low levels of 25-hydroxyvitamin D and mild chronic kidney disease, which may have contributed to the development of rhabdomyolysis. A review of the literature reveals four previous reports of this drug interaction in elderly patients, some with underlying kidney disease.
July 13, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28700610/perioperative-hemodynamics-and-risk-for-delirium-and-new-onset-dementia-in-hip-fracture-patients-a-prospective-follow-up-study
#16
Bjørn Erik Neerland, Maria Krogseth, Vibeke Juliebø, Anette Hylen Ranhoff, Knut Engedal, Frede Frihagen, Johan Ræder, Torgeir Bruun Wyller, Leiv Otto Watne
BACKGROUND: Delirium is common in hip fracture patients and many risk factors have been identified. Controversy exists regarding the possible impact of intraoperative control of blood pressure upon acute (delirium) and long term (dementia) cognitive decline. We explored possible associations between perioperative hemodynamic changes, use of vasopressor drugs, risk of delirium and risk of new-onset dementia. METHODS: Prospective follow-up study of 696 hip fracture patients, assessed for delirium pre- and postoperatively, using the Confusion Assessment Method...
2017: PloS One
https://www.readbyqxmd.com/read/28699798/durability-of-response-to-dapagliflozin-a-review-of-long-term-efficacy-and-safety
#17
Serge Jabbour
BACKGROUND: Due to the chronic nature of type 2 diabetes (T2D), it is essential for an antidiabetic drug to have durable efficacy and a good long-term safety profile. Dapagliflozin is a member of a unique class of antidiabetic drugs that inhibit the sodium-glucose cotransporter 2 (SGLT-2) in the renal tubules and have an insulin-independent mechanism of action. In short-term studies (≤24 weeks), dapagliflozin reduced glycated hemoglobin (A1c), weight, and systolic blood pressure, and had a good safety profile...
July 12, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28696784/the-role-of-tramadol-in-pain-management-in-latin-america-a-report-by-the-change-pain-latin-america-advisory-panel
#18
Joäo Batista Santos Garcia, Osvandré Lech, Durval Campos Kraychete, María Antonieta Rico, John Jairo Hernández-Castro, Frantz Colimon, Carlos Guerrero, Manuel Sempértegui Gallegos, Argelia Lara-Solares, José Alberto Flores Cantisani, César Amescua-Garcia, María Del Rocío Guillén Núñez, María Del Rosario Berenguel Cook, Aziza Jreige Iskandar, Patricia Bonilla Sierra
OBJECTIVE: Change Pain Latin America (CPLA) was created to enhance chronic pain understanding and develop pain management improving strategies in this region. During its 7(th) meeting (August 2016), the main objective was to discuss tramadol's role in treating pain in Latin America. Furthermore, potential pain management consequences were considered, if tramadol was to become more stringently controlled. METHODS: Key topics discussed were: main indications for prescribing tramadol, its pharmacological characteristics, safety and tolerability, effects of restrictions on its availability and use, and consequent impact on the pain care quality...
July 11, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28695564/iron-supplementation-in-switzerland-a-bi-national-descriptive-and-observational-study
#19
Fabienne A Biétry, Balthasar Hug, Oliver Reich, Jick S Susan, Christoph Rudolf Meier
BACKGROUND: Iron deficiency is the most common nutritional disorder in the world, and it is the only common nutrient deficiency in industrialised nations. It is thought to be the most common cause of anaemia. Use of iron supplementation in Switzerland has not been previously quantified in detail. OBJECTIVES: We quantified use of iron supplementation from Swiss data and compared it with data from the UK. We assessed the frequency of serum ferritin and haemoglobin tests prior to newly started iron therapy to see whether use was based on documented low iron levels or blood parameters, especially in the case of parenteral iron supplementation...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28695313/elderly-patients-with-chronic-kidney-disease-have-higher-risk-of-hyperparathyroidism
#20
Rosilene M Elias, Rosa M A Moysés
PURPOSE: As the world's population ages, the incidence of chronic kidney disease (CKD) is growing. There is ongoing debate regarding whether high levels of parathyroid hormone (PTH) would be more common in elderly than young patients, and which factors are driven the risk of secondary hyperparathyroidism (SHPT), independent of renal function. METHODS: Elderly patients (age ≥ 65 years, N = 518) were compared to a 1:1 sex- and estimated glomerular filtration rate (eGFR)-matched sample of young patients (age < 65 years), in a cross-sectional analysis...
July 10, 2017: International Urology and Nephrology
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