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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Janelle Guirguis-Blake, Gina A Keppel, John Holmes, Rex W Force, William Kriegsman, Laura-Mae Baldwin
Background: Patients with chronic kidney disease (CKD) are at high risk for adverse drug events related to medication dosing errors and prescriptions for relatively contraindicated medications, such as non-steroidal anti-inflammatory drugs (NSAIDs). Objectives: To examine the scope of and variation in prescribing relatively contraindicated medications and medications above the recommended dose levels among patients with stage III/IV CKD in primary care practice...
February 26, 2018: Family Practice
Lies De Bock, Eline Tommelein, Hans Baekelandt, Wim Maes, Koen Boussery, Annemie Somers
For the majority of Belgian hospitals, a pharmacist-led full medication review process is not standard care and, therefore, challenging to introduce. With this study, we aimed to evaluate the successes and barriers of the implementation of a pharmacist-led full medication review process in the geriatric ward at a local Belgian hospital. To this end, we carried out an interventional study, performing a full medication review on older patients (≥70 years) with polypharmacy (≥5 drugs) who had an unplanned admission to the geriatric ward...
February 28, 2018: Pharmacy (Basel, Switzerland)
Anne Dufey Teso, Pascale Lefuel, Sophie de Seigneux, Aline Lassere-Moutet, Pierre-Yves Martin, Alain Golay
Chronic kidney disease (CKD) usually goes unrecognized for patients until late symptomatic stages. In preterminal CKD, extrarenal substitution methods are usually presented to patients. This is felt like a breakdown, implying major modifications of everyday life. Acquisition of health literacy is necessary for patients with CKD to become autonomous and increase their empowerment toward the disease. Therapeutic education in nephrology plays a major role in improving the care of CKD patients.
February 21, 2018: Revue Médicale Suisse
Barbara Bień, Katarzyna Bień-Barkowska
INTRODUCTION Multimorbidity in older adults leads to polypharmacy with all its hazardous outcomes and drug related problems. OBJECTIVES We assess the difference in the number of drugs between admission to and discharge from a geriatric ward and identify the patient-related factors associated with changes in the drug regimen. PATIENTS AND METHODS This retrospective cross-sectional study covered 301 geriatric patients who underwent drug optimization in line with the Beers and STOPP/START criteria. The numbers of drugs per individual at hospital admission and discharge were compared using the Wilcoxon signed-rank test...
February 14, 2018: Polish Archives of Internal Medicine
Patricia Quintana-Bárcena, Anne Lord, Annie Lizotte, Djamal Berbiche, Lyne Lalonde
BACKGROUND: Drug-related problems (DRPs) are prevalent among chronic kidney disease (CKD) patients. However, little is known about their severity and management by community pharmacists. OBJECTIVES: To (a) describe the prevalence of DRPs by severity level in CKD patients and (b) assess the effect of a training-and-communication network program in nephrology (ProFiL) on these DRPs. METHODS: This is a secondary analysis of a cluster randomized controlled trial evaluating the effect of the ProFiL-program...
February 2018: Journal of Managed Care & Specialty Pharmacy
Lene Vestergaard Ravn-Nielsen, Marie-Louise Duckert, Mia Lolk Lund, Jolene Pilegaard Henriksen, Michelle Lyndgaard Nielsen, Christina Skovsende Eriksen, Thomas Croft Buck, Anton Pottegård, Morten Rix Hansen, Jesper Hallas
Importance: Hospital readmissions are common among patients receiving multiple medications, with considerable costs to the patients and society. Objective: To determine whether a multifaceted pharmacist intervention based on medication review, patient interview, and follow-up can reduce the number of readmissions and emergency department (ED) visits. Design, Setting, and Participants: This randomized clinical multicenter study (Odense Pharmacist Trial Investigating Medication Interventions at Sector Transfer [OPTIMIST]) enrolled patients from September 1, 2013, through April 23, 2015, with a follow-up of 6 months completed on October 31, 2015...
January 29, 2018: JAMA Internal Medicine
Ana Fajreldines, Eduardo Schnitzler, Jorge T Insua, Mariana Valerio, Laura Davide, Marcelo Pellizzari
Together, potentially inappropriate prescribing of medications (PIP) and appropriate prescribing omission (APO) constitute a problem that requires multiple interventions to reduce its size and the occurrence of adverse drug events (ADE). This study aims to assess PIP, APO, ADE before and after the intervention of a clinical pharmacist over medical prescriptions for elderly hospitalized patients. In a before-after study, a total of 16 542 prescriptions for 1262 patients were analyzed applying the criteria defined in both STOPP- START (screening tool of older people's prescriptions and screening tool to alert to right treatment)...
2018: Medicina
Anne Marie Liles
The kidney plays a major role in pharmacokinetics and pharmacodynamics of drugs; therefore, medication errors can result from failure to properly adjust medications in patients with CKD. It is the responsibility of all health-care providers to work collectively when reviewing medications, initiating new medications, and adjusting doses of current medications. Awareness of appropriate dosing recommendations can significantly decrease medication error-associated morbidity, mortality, and cost.
July 2014: Advances in Chronic Kidney Disease
Stephanie L Harrison, Lisa Kouladjian O'Donnell, Clare E Bradley, Rachel Milte, Suzanne M Dyer, Emmanuel S Gnanamanickam, Enwu Liu, Sarah N Hilmer, Maria Crotty
BACKGROUND: Inappropriate polypharmacy may negatively impact the quality of life of residents in aged care facilities, but it remains unclear which medications may influence this reduced quality of life. OBJECTIVE: The objective of this study was to examine whether the Drug Burden Index and potentially inappropriate medications were associated with quality of life in older adults living in residential care with a high prevalence of cognitive impairment and dementia...
January 2018: Drugs & Aging
Whitney J Kiel, Shaun W Phillips
Older adults are demanding increased healthcare attention with regards to prescription use due in large part to highly complex medication regimens. As patients age, medications often have a more pronounced effect on older adults, negatively impacting patient safety and increasing healthcare costs. Comprehensive medication reviews (CMRs) optimize medications for elderly patients and help to avoid inappropriate medication use. Previous literature has shown that such CMRs can successfully identify and reduce the number of medication-related problems and improve acute healthcare utilization...
December 31, 2017: Pharmacy (Basel, Switzerland)
Amy Barton Pai
No abstract text is available yet for this article.
January 2, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Katherine R Tuttle, Radica Z Alicic, Robert A Short, Joshua J Neumiller, Brian J Gates, Kenn B Daratha, Celestina Barbosa-Leiker, Sterling M McPherson, Naomi S Chaytor, Brad P Dieter, Stephen M Setter, Cynthia F Corbett
BACKGROUND AND OBJECTIVES: CKD is characterized by remarkably high hospitalization and readmission rates. Our study aim was to test a medication therapy management intervention to reduce subsequent acute care utilization. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The CKD Medication Intervention Trial was a single-blind (investigators), randomized clinical trial conducted at Providence Health Care in Spokane, Washington. Patients with CKD stages 3-5 not treated by dialysis who were hospitalized for acute illness were recruited...
February 7, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Matthew Phillips, Jo-Anne Wilson, Amany Aly, Marsha Wood, Penelope Poyah, Sarah Drost, Anne Hiltz, Holly Carver
Background: Accreditation Canada recognizes medication reconciliation as a key required organizational practice (ROP) to enhance patient safety. Patients with chronic kidney disease (CKD) carry a high risk for adverse drug events due to multiple co-morbidities, using many medications, and being cared for by many practitioners. Data evaluating the benefits of ambulatory medication reconciliation (AmbMR) in patients with advanced CKD is limited. Methods: We retrospectively evaluated types and rates of medication discrepancies and their potential index for patient harm using the Cornish classification system in a cohort of consecutive non-dialysis-dependent CKD stage 5 patients who received AmbMR...
April 2017: CANNT Journal, Journal ACITN
Christina Raae Hansen, Stephen Byrne, Shane Cullinan, Denis O'Mahony, Laura J Sahm, Patricia M Kearney
PURPOSE: It is contentious whether potentially inappropriate prescribing (PIP) is predominantly a phenomenon of late life or whether it has its origins in early old age. This study examined the pattern of PIP in an early old-aged population over 5 years. METHODS: Secondary data analysis of a population-based primary care cohort, of patients aged 60-74 years. Medication data were extracted from electronic patient records in addition to information on comorbidities and demographics...
March 2018: European Journal of Clinical Pharmacology
Anne-Laure Sennesael, Olivia Dalleur, Séverine Henrard, Charline Artoisenet, Didier Schoevaerdts, Anne Spinewine
Background The use of STOPP-START criteria during hospitalization reduced inappropriate medications in randomized controlled trials. Objective To evaluate whether the implementation of a screening tool (short version of STOPP-START criteria) in routine geriatric practice reduces potentially inappropriate medications (PIM) and potential prescribing omissions (PPO) at discharge. Methods We conducted a retrospective interrupted time series analysis. Four periods were selected between February and September 2013: (1) baseline situation; (2) screening tool made available to physicians; (3) 3 months later; (4) weekly meetings with junior doctors and a clinical pharmacist to review treatments according to the tool...
November 23, 2017: International Journal of Clinical Pharmacy
Olumuyiwa John Fasipe, Peter Ehizokhale Akhideno, Obiyo Nwaiwu, Alex Adedotun Adelosoye
Introduction: Life expectancy has increased significantly among chronic kidney disease (CKD) patients due to the extensive use of polypharmacy practice for medication prescriptions. This predisposes them to potential drug-drug interactions (DDIs), which can lead to an increase in morbidity, mortality, length of hospital stay, and health care cost. Methods: This was a 30-month retrospective study that reviewed the medical case records of consenting adult CKD patients from January 2014 to June 2016...
2017: Clinical Pharmacology: Advances and Applications
Graziano Onder, Alessandra Marengoni
No abstract text is available yet for this article.
November 7, 2017: JAMA: the Journal of the American Medical Association
Kenya Ie, Eric Chou, Richard D Boyce, Steven M Albert
BACKGROUND: Several scales to quantify the impact of potentially harmful medications (PHMs) have been shown to predict mortality and functional decline; however, the effect of PHMs on quality of life (QoL) has not been well-studied. OBJECTIVE: The aims of this study were to investigate an association between PHM use and change in health-related QoL among community-dwelling older adults, and to compare the predictive capacity of PHM scales. METHODS: We conducted a retrospective cohort study using prescription claims data and survey responses...
December 2017: Drugs—Real World Outcomes
Amura Francesca Fog, Gunnar Kvalvaag, Knut Engedal, Jørund Straand
OBJECTIVE: We describe the drug-related problems (DRPs) identified during medication reviews (MRs) and the changes in drug utilization after MRs at nursing homes in Oslo, Norway. We explored predictors for the observed changes. DESIGN: Observational before-after study. SETTING: Forty-one nursing homes. INTERVENTION: MRs performed by multidisciplinary teams during November 2011 to February 2014. SUBJECTS: In all, 2465 long-term care patients...
December 2017: Scandinavian Journal of Primary Health Care
Gorana Nedin Ranković, Slobodan M Janković, Radmila Veličković Radovanović, Zorica Jović, Gordana Pešić, Svetlana Pavlović, Branislava Ranković, Jasmina Ranković, Dragana Stokanović, Dane Krtinić
PURPOSE: The aim of this study was to determine the prevalence of potentially inappropriate drug prescription (PIP) in older patients who were on chronic hemodialysis treatment and to explore the factors that lead to PIP. MATERIALS AND METHODS: The study was performed at the Department of Nephrology, Clinical Center Niš, Serbia. It included patients who were 65 years old and older who suffered from the end-stage of kidney failure and were treated by hemodialysis...
October 26, 2017: Clinical Nephrology
2017-11-05 00:32:46
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