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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Aline Cristina Luz, Márcio Galvão de Oliveira, Lúcia Noblat
Background Potentially inappropriate prescribing for older people has become a global concern, although few researchers have analyzed potential prescribing omissions for this population. Objective This study aimed to compare the frequency of potential prescribing omissions for elderly patients at their admission to and discharge from a university hospital in northeast Brazil, using the validated and adapted Brazilian START criteria. Setting A university hospital in northeast Brazil. Methods This cross-sectional study examined data from patients who were ≥ 60 years old when they were admitted for > 24 h to a northeastern Brazil teaching hospital during June-December 2016...
September 22, 2018: International Journal of Clinical Pharmacy
Suresh Basnet, Meng Zhang, Martin Lesser, Gisele Wolf-Klein, Guang Qiu, Myia Williams, Renee Pekmezaris, Paola DiMarzio
AIM: We sought to explore the relationship between the number of medications at hospital discharge and 30-day rehospitalization in older adults aged >65 years. METHODS: This was a multicenter cohort study to determine whether an increased number of medications was associated with 30-day rehospitalization in patients aged >65 years. We explored the relationship between rehospitalization and other risk factors. Data were collected from a large health system in the New York metropolitan area from September 2011 to January 2013...
September 17, 2018: Geriatrics & Gerontology International
Marco Formica, Paolo Politano, Federico Marazzi, Michela Tamagnone, Ilaria Serra, Marita Marengo, Daniela Falconi, Maurizio Gherzi, Fabio Tattoli, Chiara Bottaro, Danilo Giuliano, Vittoria Tibaldi, Giovanni Carlo Isaia
BACKGROUND: Acute kidney injury (AKI) incidence is reported to be 10 times higher in aged people. Related to their higher prevalence of chronic kidney disease (CKD), older patients are at high risk of toxic effects driven by drugs. METHODS: The demographics, hospitalizations, visits to the Emergency Department, pharmacological therapy, and lab tests were analyzed in 71,588 individuals. RESULTS: Data showed a higher prevalence of AKI as well as CKD in the elderly as compared to the younger group, with an associated very high mortality...
September 3, 2018: Blood Purification
Monica Danial, Mohamed Azmi Hassali, Loke Meng Ong, Amer Hayat Khan
BACKGROUND: Accurate identification and routine preventive practices are crucial steps in lessening the incidence of medications and patients related adverse drug reactions (ADRs). METHODS: Three years retrospective study was conducted among chronic kidney disease (CKD) patients at multi-wards in a tertiary healthcare center. Data collected included demographic characteristics, physical examination results, comorbid conditions, laboratory tests and medications taken...
August 29, 2018: BMC Pharmacology & Toxicology
Solène M Laville, Marie Metzger, Bénédicte Stengel, Christian Jacquelinet, Christian Combe, Denis Fouque, Maurice Laville, Luc Frimat, Carole Ayav, Elodie Speyer, Bruce M Robinson, Ziad A Massy, Sophie Liabeuf
AIMS: Drug prescription is difficult to manage in patients with chronic kidney disease (CKD). We assessed the prevalence and determinants of inappropriate drug prescriptions (whether contraindications or inappropriately high doses) with regard to kidney function in patients with CKD under nephrology care. We also assessed the impact of the equation used to estimate GFR on the prevalence estimates. METHODS: The CKD-REIN cohort includes 3033 outpatients with CKD (eGFR between 15-60 ml/min per 1...
August 15, 2018: British Journal of Clinical Pharmacology
Jamil Ibrahim, Azzour D Hazzan, Anna T Mathew, Vipul Sakhiya, Meng Zhang, Candice Halinski, Steven Fishbane
Background: Late-stage chronic kidney disease (LS-CKD) can be defined by glomerular filtration rate (GFR) 0-30 mL/min. It is a period of risk for medication discrepancies because of frequent hospitalizations, fragmented medical care, inadequate communication and polypharmacy. In this study, we sought to characterize medication discrepancies in LS-CKD. Methods: We analyzed all patients enrolled in Northwell Health's Healthy Transitions in LS-CKD program. All patients had estimated GFR 0-30 mL/min, not on dialysis...
August 2018: Clinical Kidney Journal
Ignazio Grattagliano, Tecla Mastronuzzi, Gaetano D'Ambrosio
INTRODUCTION The aim of this study is to determine the prevalence of hyponatremia, its association with long-term medication use and underlying chronic conditions, the rate of hospitalisation and death within 3 months from its discovery and its management in community-dwelling older people. METHODS One year of data for ~5635 patients aged >65 years was extracted from the databases of 19 general practitioners (GPs); 2569 (45.6%) were checked for hyponatremia. RESULTS Hyponatremia occurred in 205 (8.0%) of 2569 checked individuals: 78...
June 2018: Journal of Primary Health Care
Pauline M S Anrys, Goedele C Strauven, Veerle Foulon, Jean-Marie Degryse, Séverine Henrard, Anne Spinewine
BACKGROUND/OBJECTIVES: Our aim was to describe the prevalence of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) in Belgian nursing homes and to identify characteristics of residents, general practitioners (GPs), and nursing homes (NHs) that are associated with the number of PIMs and PPOs. DESIGN: A cross-sectional study. SETTING: and Participants: Nursing home residents (NHRs), aged ≥65 years, not in palliative care were included in 54 Belgian NHs participating in the COME-ON study...
July 25, 2018: Journal of the American Medical Directors Association
Majed Alshamrani, Abdullah Almalki, Mohamed Qureshi, Oyindamola Yusuf, Sherine Ismail
Polypharmacy is a common problem among hemodialysis patients. It is associated with increased hospital admissions, morbidity, mortality, Medication-Related Problems (MRPs), and expenditures. There is a paucity of data on the prevalence of polypharmacy in our setting. This study aims to determine the prevalence of polypharmacy and MRPs and to assess its predictors. We conducted a cross-sectional study in the outpatient hemodialysis unit. A pharmacy resident assessed electronic prescribing records to identify MRPs and discussed therapeutic interventions to enhance effective therapeutic regimens over a three months period...
July 25, 2018: Pharmacy (Basel, Switzerland)
Alex Secora, G Caleb Alexander, Shoshana H Ballew, Josef Coresh, Morgan E Grams
BACKGROUND: Chronic kidney disease (CKD) afflicts many older adults and increases the risk for medication-related adverse events. OBJECTIVE: The aim of this study was to assess the prevalence and associated morbidity and mortality of polypharmacy (use of several medications concurrently), and potentially inappropriate medication (PIM) use in older adults, looking for differences by CKD status. METHODS: We quantified medication and PIM use (from Beers criteria, the Screening Tool of Older People's Prescriptions, and Micromedex® ) by level of estimated glomerular filtration rate (eGFR) for participants aged 65 years or older attending a baseline study visit in the Atherosclerosis Risk in Communities study (n =6392)...
August 2018: Drugs & Aging
Scott Martin Vouri, Joseph S van Tuyl, Margaret A Olsen, Hong Xian, Mario Schootman
OBJECTIVES: Dihydropyridine calcium channel blockers (DH-CCB) are associated with lower-extremity edema (LEE). Loop diuretics have been used inappropriately to treat DH-CCB-associated LEE, constituting a prescribing cascade (PC). The aim of this work was to identify the prevalence and factors associated with potential DH-CCB-LEE-loop diuretic PC. METHODS: The 2014 National Ambulatory Medical Care Survey was used to identify patient visits in which a DH-CCB was continued...
September 2018: Journal of the American Pharmacists Association: JAPhA
Kaori Nomura, Taro Kojima, Shinya Ishii, Takuto Yonekawa, Masahiro Akishita, Manabu Akazawa
BACKGROUND: In 2015, the Japan Geriatric Society (JGS) updated "the Guidelines for Medical Treatment and its Safety in the elderly," accompanied with the Screening Tool for Older Persons' Appropriate Prescriptions for Japanese (STOPP-J): "drugs to be prescribed with special caution" and "drugs to consider starting." The JGS proposed the STOPP-J to contribute to improving prescribing quality; however, each decision should be carefully based on medical knowledge...
July 3, 2018: BMC Geriatrics
Dominik Stämpfli, Fabienne Boeni, Andy Gerber, Victor A D Bättig, Kurt E Hersberger, Markus L Lampert
BACKGROUND: Inappropriate prescribing is linked to increased risks for adverse drug reactions and hospitalisation. Combining explicit and implicit criteria of inappropriate prescribing with the information obtained in patient interviews seems beneficial with regard to the identification of drug-related problems (DRPs) in hospitalised patients. OBJECTIVE: We aimed to investigate the inclusion of pharmacist interviews as part of medication reviews (including the use of explicit and implicit criteria of inappropriate prescribing) to identify DRPs in older inpatients...
June 19, 2018: Drugs & Aging
Chanel F Whittaker, Margaret A Miklich, Roshni S Patel, Jeffrey C Fink
Ensuring patient safety is a priority of medical care because iatrogenic injury has been a primary concern. Medications are an important source of medical errors, and kidney disease is a thoroughfare of factors threatening safe administration of medicines. Principal among these is reduced kidney function because almost half of all medications used are eliminated via the kidney. Additionally, kidney patients often suffer from multimorbidity, including diabetes, hypertension, and heart failure, with a range of prescribers who often do not coordinate treatments...
June 18, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Esther Salgueiro, Bryana Candelaria Elizarde, Ana Isabel Elola, Beatriz García-Pulido, María Luisa Nicieza-García, Gloria Manso
OBJECTIVE: To analyse STOPP/START criteria found most frequently in the studies carried out in Spain, in order to identify the main areas of potentially inappropriate prescribing. METHODS: A literature review was carried out on the original studies performed in Spain that applied the original version of the STOPP/START criteria and that described the most common STOPP and/or START criteria found. In each study, a weighted analysis was performed on the criteria found, by assigning 5 points to the criterion in first position, 4 points to the criterion in second position, and so on to fifth criterion...
September 2018: Revista Española de Geriatría y Gerontología
Maria Mahner, Christina Raus, Fabian Ludwig, Gesine Weckmann, Sylvia Stracke, Jean-François Chenot
BACKGROUND: Many drugs require dose adjustment or are contraindicated in patients with chronic kidney disease (CKD) to avoid adverse events. The aims of this study were to assess if medication was appropriately dose adjusted in patients with CKD in primary care, to identify medications that were frequently prescribed inappropriately and to identify factors predicting mal-prescription. METHODS: We conducted a cross-sectional observational study in 34 general practioners' offices, assessing the medication of patients with CKD stage ≥ 3 according to the corresponding pharmaceutical product information...
June 2018: Deutsche Medizinische Wochenschrift
Simit Doshi, Jay B Wish
No abstract text is available yet for this article.
2018: American Journal of Nephrology
Lili Chan, Aparna Saha, Priti Poojary, Kinsuk Chauhan, Nidhi Naik, Steven Coca, Pranav S Garimella, Girish N Nadkarni
BACKGROUND: Various medications are cleared by the kidneys, therefore patients with impaired renal function, especially dialysis patients are at risk for adverse drug events (ADEs). There are limited studies on ADEs in maintenance dialysis patients. METHODS: We utilized a nationally representative database, the Nationwide Emergency Department Sample, from 2008 to 2013, to compare emergency department (ED) visits for dialysis and propensity matched non-dialysis patients...
2018: American Journal of Nephrology
Daniel Blum, Christopher T Chan
No abstract text is available yet for this article.
2018: American Journal of Nephrology
Ludovic Argoullon, Marie-Agnès Manciaux, Aude Valance, Amélie Bonneville
In the context of improved medication management in the elderly patient, we were interested in the reevaluation of drug prescription during hospitalization. The aim of this study is to assess the prevalence of inappropriate prescribing in the elderly patient before and after hospitalization. PATIENTS AND METHODS: This is a descriptive and retrospective study of drug prescriptions in a non-geriatric unit. Prescriptions were analyzed using STOPP/START tool. RESULTS: Seventy-two patients over 65 years-old were included...
June 1, 2018: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
2018-06-09 16:40:42
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