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https://www.readbyqxmd.com/read/29113635/proton-pump-inhibitors-and-risk-of-dementia
#1
Rebekah Lynn Ford, Keith A Swanson
Chronic use of a proton-pump inhibitor (PPI) has been associated with a number of unexpected negative outcomes. The most recent revision of the American Geriatrics Society Beers criteria recommends avoiding using longer than eight weeks unless the patient is at high risk. However, this recommendation is often overlooked in the long-term care setting. Recent literature suggests a link between chronic PPI use and increased risk of dementia. A hypothesized mechanism for the relationship between PPI use and dementia has been supported by cellular and animal models...
November 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28992823/impact-of-music-therapy-on-dementia-behaviors-a-literature-review
#2
Nora Fakhoury, Nathaniel Wilhelm, Kristen F Sobota, Kelly R Kroustos
Worldwide, dementia is the most important contributor to disability in elderly patients. Treating patients with dementia can be challenging for clinicians because of the numerous behavioral and psychological symptoms of dementia (BPSD). The Dementia Action Alliance and American Geriatrics Society Beers criteria promote nonpharmacological and behavioral treatments as first-line therapy to manage BPSD to avoid adverse events associated with antipsychotic medications. Some of the nonpharmacologic therapies proposed for BPSD include: music therapy (MT), light therapy, acupressure, aromatherapy, massage, and animal-assisted therapy...
October 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28571163/utilization-pattern-of-potentially-inappropriate-medications-in-geriatric-patients-in-a-tertiary-care-hospital-a-retrospective-observational-study
#3
Rajal Sudhir Narvekar, Nikhil Narayan Bhandare, Jonathan Joaquim Gouveia, Padma Narayan Bhandare
INTRODUCTION: Geriatric population is on the rise throughout the world, hence the quality and the safety of prescribing in the elderly is a global healthcare concern. It is important for the healthcare providers to be aware of the limitations in prescribing certain drugs to the elderly. This study was an attempt to shed light on the utilization pattern of Potentially Inappropriate Medications (PIMs) in elderly patients admitted in the medicine wards in a tertiary care hospital in Goa...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28490560/nursing-home-team-care-deprescribing-study-a-stepped-wedge-randomised-controlled-trial-protocol
#4
Chong-Han Kua, Cindy Ying Ying Yeo, Cheryl Wai Teng Char, Cheryl Wei Yan Tan, Poh Ching Tan, Vivienne Sl Mak, Shaun Wen Huey Lee, Ian Yi-Onn Leong
INTRODUCTION: An ageing population has become an urgent concern for Asia in recent times. In nursing homes, polypharmacy has also become a compounding issue. Deprescribing practice is an evidence-based strategy to provide a better outcome in this group of patients; however, its implementation in nursing homes is often challenging, and prospective outcome data on deprescribing practice in the elderly is lacking. Our study assesses the implementation of team-care deprescribing to understand the benefits of this practice in geriatric setting and to explore the factors affecting deprescribing practice...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28458417/evaluation-of-polypharmacy-and-appropriateness-of-prescription-in-geriatric-patients-a-cross-sectional-study-at-a-tertiary-care-hospital
#5
K B Rakesh, Mukta N Chowta, Ashok K Shenoy, Rajeshwari Shastry, Sunil B Pai
OBJECTIVES: To assess the polypharmacy and appropriateness of prescriptions in geriatric patients in a tertiary care hospital. METHODS: An observational study was done in geriatric patients (>60 years) of either gender. The data collected from patients included: Socio-demographic data such as age, gender, marital status, educational status, socioeconomic status, occupation, nutritional status, history of alcohol/smoking, exercise history, details of comorbid diseases, medication history, findings of clinical examination etc...
January 2017: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/28364990/polypharmacy-reduction-strategies-tips-on-incorporating-american-geriatrics-society-beers-and-screening-tool-of-older-people-s-prescriptions-criteria
#6
REVIEW
Hedva Barenholtz Levy
There is no single definition of polypharmacy. Use of 5 or more medications commonly is used. An alternative, quantitative definition, such as use of more medications than clinically indicated or use of unnecessary or harmful prescribing, has been proposed. Protocols or algorithms to improve polypharmacy and prescribing in older adults have been developed. The American Geriatrics Society (AGS) Beers Criteria and Screening Tool of Older People's Prescriptions (STOPP) explicit criteria reflect elements that are common across protocols and algorithms...
May 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28322487/methodology-for-senior-proof-guidelines-a-practice-example-from-the-netherlands
#7
Barbara C van Munster, Johanna E A Portielje, Andrea B Maier, Arend J Arends, Johannes J A de Beer
RATIONALE, AIMS AND OBJECTIVES: Evidence-based guidelines constitute a foundation for medical decision making. It is often unclear whether recommendations in general guidelines also apply to older people. This study aimed to develop a methodology to increase the focus on older people in the development of guidelines. METHODS: The methodology distinguishes 4 groups of older people: (1) relatively healthy older people; (2) older people with 1 additional specific (interfering) comorbid condition; (3) older people with multimorbidity; and (4) vulnerable older people...
March 21, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27852639/improving-geriatric-prescribing-in-the-ed-a-qualitative-study-of-facilitators-and-barriers-to-clinical-decision-support-tool-use
#8
Ann E Vandenberg, Camille P Vaughan, Melissa Stevens, Susan N Hastings, James Powers, Alayne Markland, Ula Hwang, William Hung, Katharina V Echt
Quality problem or issue: Clinical decision support (CDS) may improve prescribing for older adults in the Emergency Department (ED) if adopted by providers. Initial assessment: Existing prescribing order entry processes were mapped at an initial Veterans Administration Medical Center site, demonstrating cognitive burden, effort and safety concerns. Choice of solution: Geriatric order sets incorporating 2012 Beers guidelines and including geriatric prescribing advice and prepopulated order options were developed...
February 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/27835991/do-photographs-older-adults-narratives-and-collaborative-dialogue-foster-anticipatory-reflection-preflection-in-medical-students
#9
Gabrielle Brand, Ashlee Osborne, Mark Carroll, Sandra E Carr, Christopher Etherton-Beer
BACKGROUND: In changing higher education environments, medical educators are increasingly challenged to prepare new doctors to care for ageing populations. The Depth of Field: Exploring Ageing resource (DOF) uses photographs, reflective questioning prompts, older adults' narratives and collaborative dialogue to foster anticipatory reflection or 'preflection' in medical students prior to their first geriatric medicine clinical placement. The aim of this research is to explore whether photographs, narratives and small group collaborative dialogue fosters reflective learning, enhances reflective capacity and has the potential to shift medical students' attitudes towards caring for older adults...
November 11, 2016: BMC Medical Education
https://www.readbyqxmd.com/read/27633589/-potentially-inappropriate-medications-in-geriatrics-which-tools-to-detect-them
#10
REVIEW
Aude Desnoyer, Bertrand Guignard, Pierre-Olivier Lang, Jules Desmeules, Nicole Vogt-Ferrier, Pascal Bonnabry
BACKGROUND: Potentially inappropriate prescriptions include over-prescription, which refers to prescription of more drugs than clinically needed, mis-prescription which refers to incorrect prescription of a drug that is needed (as per drug, dose, drug interactions, duration of therapy, duplication, follow-up, etc.) and under-prescription which stands for failure to prescribe drugs that are needed. They are associated with adverse drug events, increased use of health-care services, morbimortality and health-care costs, and poorer quality of life...
November 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27228966/the-association-of-change-in-medication-regimen-and-use-of-inappropriate-medication-based-on-beers-criteria-with-adverse-outcomes-in-japanese-long-term-care-facilities
#11
Shinya Ishii, Taro Kojima, Kazuhiko Ezawa, Kentaro Higashi, Yukihiko Ikebata, Yozo Takehisa, Masahiro Akishita
AIM: To describe medication use including potentially inappropriate medication (PIM) and examine the association between adverse outcomes and patient factors including PIM use in Japanese elderly patients in long-term care facilities. METHODS: This was a retrospective cohort study of 470 patients in 53 Geriatric Health Service Facilities and 44 Sanatorium Type Medical Care Facilities for the Elderly Requiring Long Term Care. Standardized forms were used to collect information including oral and parenteral medication use on admission, and 1 month and 3 months after admission...
May 26, 2016: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/27130965/drug-utilization-and-inappropriate-prescribing-in-centenarians
#12
Nisha C Hazra, Alex Dregan, Stephen Jackson, Martin C Gulliford
OBJECTIVES: To use primary care electronic health records (EHRs) to evaluate prescriptions and inappropriate prescribing in men and women at age 100. DESIGN: Population-based cohort study. SETTING: Primary care database in the United Kingdom, 1990 to 2013. PARTICIPANTS: Individuals reaching the age of 100 between 1990 and 2013 (N = 11,084; n = 8,982 women, n = 2,102 men). MEASUREMENTS: Main drug classes prescribed and potentially inappropriate prescribing according to the 2012 American Geriatrics Society Beers Criteria...
May 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27083921/potentially-inappropriate-medications-in-older-adults-why-the-revised-criteria-matter
#13
Hedva Barenholtz Levy, Esther-Lee Marcus
The 2 most widely used explicit criteria regarding inappropriate medication use in older adults are the American Geriatrics Society's Beers Criteria and the Screening Tool of Older People's Prescriptions/Screening Tool to Alert to Right Treatment (STOPP/START). Both documents were updated recently. They are important educational tools that highlight medications for which risks of use may often exceed benefits in older adults and situations in which potentially appropriate medications should be considered for use...
July 2016: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/27059714/effect-of-potentially-inappropriate-use-of-antimuscarinic-medications-on-healthcare-use-and-cost-in-individuals-with-overactive-bladder
#14
Brandon T Suehs, Cralen Davis, Billy Franks, Thomas E Yuran, Daniel Ng, Jason Bradt, John Knispel, Maria Vassilakis, Todd Berner
OBJECTIVES: To examine potentially inappropriate medication (PIM) use in older adults initiating an antimuscarinic medication for the treatment of overactive bladder (OAB). DESIGN: Retrospective database analysis. SETTING: Medical and pharmacy claims data. PARTICIPANTS: Medicare Advantage Prescription Drug Plan members aged 65 and older newly initiated on an antimuscarinic OAB treatment were identified and assigned to PIM and non-PIM comparison groups based on 2012 American Geriatrics Society Beers Criteria and/or the presence of an anticholinergic medication interaction at the time of initiation of treatment (N = 66,275)...
April 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27015054/impact-of-clinical-pharmacy-specialists-on-the-design-and-implementation-of-a-quality-improvement-initiative-to-decrease-inappropriate-medications-in-a-veterans-affairs-emergency-department
#15
Jason M Moss, William E Bryan, Loren M Wilkerson, George L Jackson, Ryan K Owenby, Courtney Van Houtven, Melissa B Stevens, James S Powers, Camille P Vaughan, William W Hung, Ula Hwang, Alayne D Markland, Gerald McGwin, Susan Nicole Hastings
BACKGROUND: As the proportion of older adult patients who interface with the health care system grows, clinical pharmacy specialists (CPS) have a pivotal role in reducing potentially inappropriate medication (PIM) use in this population. OBJECTIVES: To (a) describe CPS involvement in the design and implementation of a quality improvement (QI) initiative to decrease PIM prescribing in a Veterans Affairs (VA) emergency department (ED) and (b) report on changes in PIM prescribing before and after the initiative...
January 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/26869776/physicians-use-of-computerized-clinical-decision-supports-to-improve-medication-management-in-the-elderly-the-seniors-medication-alert-and-review-technology-intervention
#16
Kannayiram Alagiakrishnan, Patricia Wilson, Cheryl A Sadowski, Darryl Rolfson, Mark Ballermann, Allen Ausford, Karla Vermeer, Kunal Mohindra, Jacques Romney, Robert S Hayward
BACKGROUND: Elderly people (aged 65 years or more) are at increased risk of polypharmacy (five or more medications), inappropriate medication use, and associated increased health care costs. The use of clinical decision support (CDS) within an electronic medical record (EMR) could improve medication safety. METHODS: Participatory action research methods were applied to preproduction design and development and postproduction optimization of an EMR-embedded CDS implementation of the Beers' Criteria for medication management and the Cockcroft-Gault formula for estimating glomerular filtration rates (GFR)...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/26782849/predictive-validity-of-the-beers-and-screening-tool-of-older-persons-potentially-inappropriate-prescriptions-stopp-criteria-to-detect-adverse-drug-events-hospitalizations-and-emergency-department-visits-in-the-united-states
#17
MULTICENTER STUDY
Joshua D Brown, Lisa C Hutchison, Chenghui Li, Jacob T Painter, Bradley C Martin
OBJECTIVES: To compare the predictive validity of the 2003 Beers, 2012 American Geriatrics Society (AGS) Beers, and Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria. DESIGN: Retrospective cohort. SETTING: Managed care administrative claims data from 2006 to 2009. PARTICIPANTS: Commercially insured persons aged 65 and older in the United States (N=174,275). MEASUREMENTS: Association between adverse drug events (ADEs), emergency department (ED) visits, and hospitalization outcomes and inappropriate medication use using time-varying Cox proportional hazard models...
January 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/26749340/demystifying-aged-care-for-medical-students
#18
Rosemary Saunders, Karen Miller, Helen Dugmore, Christopher Etherton-Beer
BACKGROUND: Residential aged care environments can provide valuable learning opportunities for health professional education. An aged care community-university partnership developed the Beyond the Teaching Nursing Home: Community Partnership of Learning and Care (BTTNH: CPLC) programme, where older adults volunteer in learning activities with health professional students. This article describes medical students' experience of participating in a clinical learning activity as part of the broader programme...
April 2017: Clinical Teacher
https://www.readbyqxmd.com/read/26712428/patients-aged-80-years-or-older-are-encountered-more-potentially-inappropriate-medication-use
#19
Li Mo, Ding Ding, Shi-Yun Pu, Qin-Hui Liu, Hong Li, Bi-Rong Dong, Xiao-Yan Yang, Jin-Han He
BACKGROUND: Polypharmacy and potentially inappropriate medications (PIMs) are prominent prescribing issues in elderly patients. This study was to investigate the different prevalence of PIM use in elderly inpatients between 65-79 years of age and 80 years or older, who were discharged from Geriatric Department in West China Hospital. METHODS: A large-scale cohort of 1796 inpatients aged 65 years or over was recruited. Respectively, 618 patients were 65-79 years and 1178 patients were 80 years or older...
January 5, 2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/26702910/medication-in-the-elderly-considerations-and-therapy-prescription-guidelines
#20
REVIEW
Davorka Vrdoljak, Josip Anđelo Borovac
UNLABELLED: The aim of this study was to integrate and present pertinent findings from the literature dealing with the treatment of the elderly within a primary care setting. Medical care for the elderly is an integral part of a general practitioner's (GPs) everyday work and is challenging for many reasons. Older people often experience multiple chronic diseases concurrently (comorbidity, multimorbidity) and they often have deteriorated organ function and decreased physiological reserves due to the natural aging process...
2015: Acta Medica Academica
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