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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Mario Iannaccone, Fabrizio D Ascenzo, Ovidio De Filippo, Marco Gagliardi, Danielle A Southern, Sergio Raposeiras-Roubín, Emad Abu-Assi, Jose Paulo Simao Henriques, Jorge Saucedo, José Ramón González-Juanatey, Stephen B Wilton, Wouter J Kikkert, Iván Nuñez-Gil, Albert Ariza-Sole, Xiantao Song, Dimitrios Alexopoulos, Christoph Liebetrau, Tetsuma Kawaji, Zenon Huczek, Shao-Ping Nie, Toshiharu Fujii, Luis Correia, Masa-Aki Kawashiri, José María García-Acuña, Emilio Alfonso, Belén Terol, Alberto Garay, Dongfeng Zhang, Yalei Chen, Ioanna Xanthopoulou, Neriman Osman, Helge Möllmann, Hiroki Shiomi, Michal Kowara, Krzysztof Filipiak, Xiao Wang, Yan Yan, Jing-Yao Fan, Yuji Ikari, Takuya Nakahashi, Kenji Sakata, Masakazu Yamagishi, Claudio Moretti, Fiorenzo Gaita, Oliver Kalpak, Sasko Kedev
OBJECTIVE: Our objective was to define the most appropriate treatment for acute coronary syndrome (ACS) in patients with malignancy. METHODS AND RESULTS: The BleeMACS project is a worldwide multicenter observational prospective registry in 16 hospitals enrolling patients with ACS undergoing percutaneous coronary intervention. Primary endpoints were death, re-infarction, and major adverse cardiac events (MACE; composite of death and re-infarction) after 1 year of follow-up...
October 13, 2016: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
Sourav Chakraborty, Saugata Ghosh, Avishek Banerjea, Radha Raman De, Avijit Hazra, Swapan Kumar Mandal
OBJECTIVES: To study medicine prescribing pattern for chronic kidney disease (CKD) patients on maintenance hemodialysis. MATERIALS AND METHODS: This prospective observational study was conducted in hemodialysis unit of a teaching hospital with adult CKD patients on maintenance hemodialysis. Patients' clinical profile, drug-use pattern, and medication-related problem data were captured in a structured case report form and the data were analyzed descriptively. Adherence level was assessed by Morisky Medication-Taking Adherence Scale 4-item...
September 2016: Indian Journal of Pharmacology
Sarah D Berry, Douglas P Kiel
No abstract text is available yet for this article.
October 1, 2016: JAMA Internal Medicine
Inés Cruz-Esteve, Josep Ramón Marsal-Mora, Gisela Galindo-Ortego, Leonardo Galván-Santiago, Marcos Serrano-Godoy, Esther Ribes-Murillo, Jordi Real-Gatius
OBJECTIVE: Rational prescribing in older people is a priority for health care organizations. The STOPP/START screening tool has been developed to identify potentially inappropriate prescribing (PIP) in individuals. In a primary care setting, STOPP/START can estimate PIP prevalence and related factors at population level. The aim of this study is to measure the prevalence rates of PPI in elderly population using clinical and prescription claim databases. DESIGN: Cross-sectional population study...
September 29, 2016: Atencion Primaria
Jordan D Haag, Amanda Z Davis, Robert W Hoel, Jeffrey J Armon, Laura J Odell, Ross A Dierkhising, Paul Y Takahashi
BACKGROUND: The optimization of medication use during care transitions represents an opportunity to improve overall health-related outcomes. The utilization of clinical pharmacists during care transitions has demonstrated benefit, although the optimal method of integration during the care transition process remains unclear. OBJECTIVE: To evaluate the impact of pharmacist-provided telephonic medication therapy management (MTM) on care quality in a care transitions program (CTP) for high-risk older adults...
July 2016: American Health & Drug Benefits
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...
September 12, 2016: La Presse Médicale
Elodie Cartet-Farnier, Laetitia Goutelle-Audibert, Pascal Maire, Blandine De la Gastine, Sylvain Goutelle
The objectives of this study were to compare the estimations of renal function obtained with six equations, including the Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations and to evaluate the implication of using other equations for drug dosing in elderly patients in place of CG. An observational prospective study was conducted over 6 months in two geriatric hospitals with inclusions of all hospitalized inpatients. A list of 36 drugs for which recommendations of dosage adjustment for renal function were mentioned in the manufacturer dosing guidelines was used to compare the implications of using the various equations for drug dosing...
September 7, 2016: Fundamental & Clinical Pharmacology
Yvonne Morrissey, Michael Bedford, Jean Irving, Chris K T Farmer
BACKGROUND: the use of antihypertensive medication in older people in order to prevent cardiovascular events is well established. The use of such agents has been encouraged by incentive schemes in the United Kingdom including the Quality and Outcomes Framework. In addition, many guidelines recommend good blood pressure (BP) control in the elderly. However, in older people antihypertensives can cause adverse effects related to hypotension. AIM: the aim of this study was to assess the prevalence of low BP and impact on outcomes, particularly in the presence of antihypertensive treatment, in a primary care population of older people...
June 30, 2016: Age and Ageing
Daniela Petruta Primejdie, Marius Traian Bojita, Adina Popa
BACKGROUND: The elderly are frequently exposed to drug related problems causing hospitalizations and increased costs of care. Information about Romanian prescribing practices among the elderly and potential medication associated- risks is lacking. The objective of this study was to identify and compare the most frequent potentially inappropriate medications (PIM) recommended to ambulatory and institutionalized Romanian elderly, through an observational retrospective design. METHODS: All reimbursed medications prescribed to a sample of ambulatory elderly accessing two community pharmacies and all medications recommended to a group of institutionalized elderly (urban facilities, Romania, same month) were analyzed...
2016: BMC Pharmacology & Toxicology
Simon D S Fraser, Maarten W Taal
PURPOSE OF REVIEW: With ageing populations, the prevalence of multimorbidity is increasing. This review discusses recent developments in the understanding of multimorbidity in the context of chronic kidney disease (CKD). It explores the associated treatment burden and the implications for key outcomes and patient care. RECENT FINDINGS: Comorbidity and polypharmacy are common in CKD, even at early stages, and are associated with significant treatment burden. Both 'concordant' and 'discordant' comorbidities have a negative impact on mortality, cardiovascular disease, hospitalisation and length of stay...
November 2016: Current Opinion in Nephrology and Hypertension
Chien-Han Tsao, Chin-Feng Tsai, Yuan-Ti Lee, Mao-Chung Weng, Huei-Chao Lee, Ding-Bang Lin, Chun-Chieh Chen, Meng-Chih Lee, Shiuan-Chih Chen
BACKGROUND: To compare the prevalence of potentially inappropriate medications (PIMs) using the 2012 and 2003 Beers Criteria in frail older patients receiving home health care services (HHS), and to explore the correlates of PIMs based on the 2012 Beers criteria. MATERIALS AND METHODS: A total of 145 older patients (mean age, 80.9 ± 7.6 years) with Barthel scale ≤ 60 receiving regular HHS from a university hospital between January 2013 and June 2013 were retrospectively enrolled...
August 2016: American Journal of the Medical Sciences
Pauline Anrys, Benoît Boland, Jean-Marie Degryse, Jan De Lepeleire, Mirko Petrovic, Sophie Marien, Olivia Dalleur, Goedele Strauven, Veerle Foulon, Anne Spinewine
Explicit criteria, such as the STOPP/START criteria, are increasingly used both in clinical practice and in research to identify potentially inappropriate prescribing in older people. In an article on the STOPP/START criteria version 2, O'Mahony et al have pointed out the advantages of developing computerised criteria. Both clinical decision support systems to support healthcare professionals and software applications to automatically detect inappropriate prescribing in research studies can be developed. In the process of developing such tools, difficulties may occur...
September 2016: Age and Ageing
Radica Z Alicic, Robert A Short, Cynthia L Corbett, Joshua J Neumiller, Brian J Gates, Kenn B Daratha, Celestina Barbosa-Leiker, Sterling McPherson, Naomi S Chaytor, Brad P Dieter, Stephen M Setter, Katherine R Tuttle
BACKGROUND: The hospital readmission rate in the population with chronic kidney disease (CKD) is high and strategies to reduce this risk are urgently needed. METHODS: The CKD-Medication Intervention Trial (CKD-MIT;; NCTO1459770) is a single-blind (investigators), randomized, clinical trial conducted at Providence Health Care in Spokane, Washington. Study participants are hospitalized patients with CKD stages 3-5 (not treated with kidney replacement therapy) and acute illness...
2016: American Journal of Nephrology
Paula Carlota Rivas-Cobas, Nieves Ramírez-Duque, Mercedes Gómez Hernández, Juana García, Antonia Agustí, Xavier Vidal, Francesc Formiga, Alfonso López-Soto, Olga H Torres, Antonio San-José
OBJECTIVE: To analyse potentially inappropriate prescribing (PIP) in elderly polypathological patients (PP). METHOD: Multicentre observational, prospective study of 672 patients aged 75 years and older hospitalised in Internal Medicine between April 2011 and March 2012. The Beers, STOPP-START and ACOVE criteria were used to detect potentially inappropriate prescribing and the results of PP and non-PP patients were compared. RESULTS: Of the 672 patients included, 419 (62%) were polypathological, of which 89...
July 30, 2016: Gaceta Sanitaria
Mary Lynn Davis-Ajami, Jeffery C Fink, Jun Wu
BACKGROUND: Nephrotoxic medication exposure increases risks for acute kidney injury, permanent renal function loss, and costly preventable adverse drug events. Exposure to medications associated with inducing acute tubular nephritis or tubular toxicity versus nonexposure among those with predialysis renal disease-a population vulnerable to increased risk of kidney injury-may affect health services utilization and cost outcomes. Few studies quantify nephrotoxic medication exposure in chronic kidney disease (CKD) and associated costs...
August 2016: Journal of Managed Care & Specialty Pharmacy
Gordon D Schiff, Enrique Seoane-Vazquez, Adam Wright
An 1833 article in the Boston Medical and Surgical Journal (forerunner of the New England Journal of Medicine) explained why prescriptions should be written in Latin to protect patients from knowledge of the names of and indications for the prescribed drugs: "The question is often asked, why..
July 28, 2016: New England Journal of Medicine
David Niedrig, Regina Krattinger, Annika Jödicke, Carmen Gött, Guido Bucklar, Stefan Russmann
PURPOSE: Overdosing of the oral antidiabetic metformin in impaired renal function is an important contributory cause to life-threatening lactic acidosis. The presented project aimed to quantify and prevent this avoidable medication error in clinical practice. METHODS: We developed and implemented an algorithm into a hospital's clinical information system that prospectively identifies metformin prescriptions if the estimated glomerular filtration rate is below 60 mL/min...
July 14, 2016: Pharmacoepidemiology and Drug Safety
A Rösler, P Mißbach, F Kaatz, D Kopf
BACKGROUND: Older patients suffer more often from drug-induced complications. OBJECTIVE: What are the precise recommendations pharmacists can give to geriatricians? MATERIAL AND METHODS: Two pharmacists conducted clinical rounds on 2 geriatric wards over a period of 54 weeks. Protocols of conspicuous medications for geriatric patients were analyzed and suggestions were made. RESULTS: Particularly frequent were the questionable medical indications for proton pump inhibitors, allopurinol, pregabalin and gabapentin...
July 15, 2016: Zeitschrift Für Gerontologie und Geriatrie
Maarten Wauters, Monique Elseviers, Bert Vaes, Jan Degryse, Olivia Dalleur, Robert Vander Stichele, Thierry Christiaens, Majda Azermai
AIMS: Little is known about the impact of Inappropriate Prescribing (IP) in community-dwelling adults, aged 80 and older. The prevalence at baseline (November 2008 - September 2009) and impact of IP (misuse, and underuse) after 18 months on mortality, and hospitalisation in a cohort of community-dwelling adults, aged 80 and older (n = 503) was studied. METHODS: Screening Tool of Older People's Prescriptions (STOPP, misuse) and Screening Tool to Alert to Right Treatment (START, underuse) criteria were cross-referenced and linked to the medication use (in Anatomical Therapeutic Chemical-coding) and clinical problems...
July 18, 2016: British Journal of Clinical Pharmacology
Henok Getachew, Akshaya Srikanth Bhagavathula, Tamrat Befekadu Abebe, Sewunet Admasu Belachew
BACKGROUND: Inappropriate use of antiplatelets and anticoagulants among elderly patients increases the risk of adverse outcomes. The aim of this study was to assess the prevalence of inappropriate prescribing of antithrombotic therapy in hospitalized elderly patients. METHODS: A retrospective cross-sectional, single-center study was conducted at the Gondar University Hospital. A total of 156 hospitalized elderly patients fulfilling the inclusion/exclusion criteria were included in the study...
2016: Clinical Interventions in Aging
2016-07-08 12:20:25
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