The relationship between common geriatric syndromes and potentially inappropriate medication use among older adults

Aging Clinical and Experimental Research, Journal Year: 2019, Volume and Issue: 32(4), P. 681 - 687

Published: June 12, 2019

Language: Английский

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Drug related problems in older adults living with dementia

PLoS ONE, Journal Year: 2020, Volume and Issue: 15(7), P. e0236830 - e0236830

Published: July 31, 2020

Background Compared with those without dementia, older patients dementia admitted to acute care settings are at higher risk for triad combination of polypharmacy (PP), potentially inappropriate medication (PIM), and drug-drug interaction (DDI), which may consequently result in detrimental health. The aims this research were assess factors associated PP, PIM DDI among hospitalized prevalence characteristics population. Methods In retrospective cross-sectional study, 416 inpatients diagnosed referred specialist geriatric consultation a tertiary hospital Brisbane, Australia during 2006–2016 enrolled. Patients categorized into two groups according their exposure the DDI: 'triad combination' 'non-triad combination'. Data collected using interRAI Acute Care (AC) assessment instrument. Independent evaluated bivariate multivariate logistic regression analyses. Results Overall, 181 (43.5%) classified as group. majority population took least 1 (56%) or experienced one potential (76%). Over 75% participants exposed polypharmacy. most common prescribed PIMs antipsychotics, followed by benzodiazepines. independent presence atrial fibrillation diagnosis medications use cardiac therapy, psycholeptics psychoanaleptics. Conclusions people vulnerable conditions greater risks adverse events from use. This study identified psychoanaleptics predictors DDI. Therefore, these should be carefully considered closely monitored. Furthermore, comprehensive reviews optimize prescribing initiated continually implemented

Language: Английский

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Prevalence and determinants of potentially inappropriate medications prescribing in elderly patients in Chinese communities

Annals of Palliative Medicine, Journal Year: 2021, Volume and Issue: 10(2), P. 2072 - 2079

Published: Feb. 1, 2021

Background: To assess the prevalence and associated risk of potentially inappropriate medications (PIMs) prescribing in community-dwelling elderly patients China to examine most frequently used PIMs. This will provide a reference for formulation medication manuals further standardize use patients. Methods: We conducted cross-sectional retrospective study from April 1, 2020 30, 2020. Data aged ≥65 years were collected Hengjie (N=2,294), Loujiang (N=3,972), Tongxing communities (N=1,969) Suzhou. The frequency PIMs was detected using 2019 Beers criteria 2017 Chinese criteria. Chi-square (for categorical variables), ANOVA continuous variables as applicable), logistic regression describe identify potential predictors Results: A total 8,235 examined. Using criteria, 37.07%, which slightly higher than that found (32.16%). prescribed estazolam (21.53%) insulin (4.60%) based on Logistic analysis showed advanced age, polypharmacy, comorbid disease with high Furthermore, educational background professional title physicians also Conclusions: Given population, implementation evidence-based interventions promote rational clinical drug could improve their quality life.

Language: Английский

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Polypharmacy in Older Adults with Alzheimer’s Disease

Medicina, Journal Year: 2022, Volume and Issue: 58(10), P. 1445 - 1445

Published: Oct. 13, 2022

The number of patients with Alzheimer’s disease is increasing annually. Most these are older adults comorbid physical illnesses, which means that they often treated a combination medications for the have and those disease. Thus, potentially at risk polypharmacy. In addition, drug interactions between treatment illnesses may reduce their efficacy increase side effects. This article reviews polypharmacy in elderly disease, focus on psychotropic drugs.

Language: Английский

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Potentially Inappropriate Medication Use in Patients with Dementia

International Journal of Environmental Research and Public Health, Journal Year: 2022, Volume and Issue: 19(18), P. 11426 - 11426

Published: Sept. 10, 2022

The objective of this study was to characterize the epidemiology using potentially inappropriate medications associated with dementia exacerbation (DPIMs) in elderly outpatients dementia. Electronic medical records were retrospectively reviewed for geriatric patients who prescribed at least one medication 2016 a tertiary, university-affiliated hospital. 2015 Beers criteria used define DPIMs. Logistic regression performed identify factors prescribing DPIMs Among 2100 included our study, 987 (47.0%) DPIM. Benzodiazepines most frequently DPIM followed by anticholinergics, histamine H2-receptor blockers, and zolpidem. risk significantly increased female (odds ratio (OR) 1.355) polypharmacy (OR 5.146) multiple comorbidities 1.129) (p < 0.05 all). Coexistence Parkinson’s disease 1.799), mood disorder 1.373), or schizophrenia 4.116) further likelihood receiving In conclusion, commonly Korea benzodiazepines anticholinergics. Female should be closely monitored minimize unnecessary use and, ultimately, DPIM-related harms.

Language: Английский

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The inappropriate use of proton pump inhibitors and its associated factors among community-dwelling older adults

Heliyon, Journal Year: 2021, Volume and Issue: 7(7), P. e07595 - e07595

Published: July 1, 2021

Little is known about the inappropriate use of proton pump inhibitors (PPIs) and how mild cognitive impairment (MCI) high comorbid burden relate to prescribing PPIs. Therefore, current study aimed examine these associations among community-dwelling older adults in Jordan.This cross-sectional was conducted on 215 from three local healthcare centers located Irbid, Jordan. Data PPI use, including name medication, dose, frequency, duration, indication, were collected retrospectively a review participating adults' medication cards for November December 2019. The data evaluated based Food Drug Administration (FDA) guidelines. MCI measured using Arabic version Montreal Cognitive Assessment, Cumulative Illness Rating Scale Geriatrics.Forty-seven percent participants found have taken PPI, with 68 % having one longer period than recommended by FDA. Older or be more susceptible other long-term logistic regression revealed that statistically significant predictor (p < 0.001).Inappropriate common Jordan, significantly higher prevalence people normal abilities. Future intervention studies are highly encourage optimal PPIs adults.

Language: Английский

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Effect of collaborative dementia care on potentially inappropriate medication use: Outcomes from the Care Ecosystem randomized clinical trial

Alzheimer s & Dementia, Journal Year: 2022, Volume and Issue: 19(5), P. 1865 - 1875

Published: Nov. 4, 2022

Abstract Introduction Potentially inappropriate medications (PIMs) cause adverse events and death. We evaluate the Care Ecosystem (CE) collaborative dementia care program on medication use among community‐dwelling persons living with (PLWD). Methods Secondary analysis of a randomized clinical trial (RCT) comparing CE to usual (UC) changes in PIMs, over 12 months between March 2015 May 2020. outcomes included change number medications, clinically relevant anti‐dementia medications. Results Of 804 PLWD, N = 490 had complete data. The resulted significantly fewer PIMs compared UC (−0.35; 95% CI, −0.49 −0.20; P < 0.0001). Number needed prevent an increase 1 PIM was 3. Total for or cognitive impairment, CNS‐active anticholinergics, benzodiazepines, opioids were also fewer. Anti‐dementia regimens modified more frequently. Conclusion review intervention embedded optimized PLWD. Highlights Compared (UC), prevented increases potentially (PIMs). Use reduced, trend antipsychotics. adjusted use.

Language: Английский

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Willingness of older people living with dementia and mild cognitive impairment and their caregivers to have medications deprescribed

Age and Ageing, Journal Year: 2023, Volume and Issue: 52(1)

Published: Jan. 1, 2023

Abstract Background people living with cognitive impairment commonly take multiple medications including potentially inappropriate (PIMs), which puts them at risk of medication related harms. Aims to explore willingness have a deprescribed older (dementia or mild impairment) and chronic conditions assess the relationship between willingness, patient characteristics belief about medications. Methods cross-sectional study using results from revised Patients’ Attitudes Towards Deprescribing questionnaire (rPATDcog) collected as baseline data in OPTIMIZE study, pragmatic, cluster-randomised trial educating patients clinicians deprescribing. Eligible participants were 65+, diagnosed dementia impairment, prescribed least five-long-term Results was mailed 1,409 intervention 553 (39%) returned included analysis. Participants had mean age 80.1 (SD 7.4) 52.4% female. About 78.5% (431/549) said that they would be willing one their stopped if doctor it possible. Willingness deprescribe negatively associated getting stressed when changes are made previously having bad experience stopping (P &lt; 0.001 for both). Conclusion most deprescribe. Addressing previous experiences stress may key points discuss during deprescribing conversations.

Language: Английский

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Developing a PRogram to Educate and Sensitize Caregivers to Reduce the Inappropriate Prescription Burden in the Elderly with Alzheimer’s Disease (D-PRESCRIBE-AD): Trial protocol and rationale of an open-label pragmatic, prospective randomized controlled trial

PLoS ONE, Journal Year: 2024, Volume and Issue: 19(2), P. e0297562 - e0297562

Published: Feb. 12, 2024

Context Potentially inappropriate prescribing of medications in older adults, particular those with dementia, can lead to adverse drug events including falls and fractures, worsening cognitive impairment, emergency department visits, hospitalizations. Educational mailings from health plans patients their providers encourage deprescribing conversations may represent an effective, low-cost, “light touch”, approach reducing the burden potentially prescription use adults dementia. Objectives The objective D eveloping a PR ogram E ducate S ensitize C aregivers R educe I nappropriate Prescription B urden lderly A lzheimer’s isease (D-PRESCRIBE-AD) trial is evaluate effect plan based multi-faceted educational outreach intervention community dwelling dementia who are currently prescribed sedative/hypnotics, antipsychotics, or strong anticholinergics. Methods D-PRESCRIBE-AD open-label pragmatic, prospective randomized controlled (RCT) comparing three arms: 1) mailing both patient physician (patient plus arm, n = 4814); 2) only (physician 3) usual care (n 4814) among enrolled two large United States plans. primary outcome absence any dispensing targeted during 6-month study observation period after 3-month black out following mailing. Secondary outcomes include dose-reduction, polypharmacy, healthcare utilization, mortality therapeutic switching within classes. Conclusion This pragmatic RCT will contribute evidence base on promoting If successful, such light touch, inexpensive highly scalable interventions have potential reduce for ClinicalTrials.gov Identifier: NCT05147428 .

Language: Английский

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What is the quantity, quality and type of systematic review evidence available to inform the optimal prescribing of statins and antihypertensives? A systematic umbrella review and evidence and gap map

BMJ Open, Journal Year: 2024, Volume and Issue: 14(2), P. e072502 - e072502

Published: Feb. 1, 2024

Objectives We aimed to map the systematic review evidence available inform optimal prescribing of statins and antihypertensive medication. Design Systematic umbrella gap (EGM). Data sources Eight bibliographic databases (Cochrane Database Reviews, CINAHL, EMBASE, Health Management Information Consortium, MEDLINE ALL, PsycINFO, Conference Proceedings Citation Index—Science Science Index) were searched from 2010 11 August 2020. Update searches conducted in ALL 2 2022. relevant websites backwards citation chasing. Eligibility criteria for selecting studies sought reviews quantitative or qualitative research where adults 16 years+ currently receiving, being considered for, a prescription statin applied title abstract full text each article independently by two reviewers. extraction synthesis Quality appraisal was completed one reviewer checked second. Review characteristics tabulated incorporated into an EGM based on patient care pathway. Patients with lived experience provided feedback our questions EGM. Results Eighty included within The highest quantity focused evaluating interventions promote adherence Key gaps lack synthesising experiences specific improve practice. predominantly low quality, limiting confidence findings individual reviews. Conclusions This provides interactive, accessible format policy developers, service commissioners clinicians view optimising To address paucity high-quality research, future should be reported according existing guidelines identified above.

Language: Английский

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