Polypharmacy and risk of fractures in older adults: A systematic review

Journal of Evidence-Based Medicine, Journal Year: 2024, Volume and Issue: 17(1), P. 145 - 171

Published: March 1, 2024

Abstract Background Fractures have serious health consequences in older adults. While some medications are individually associated with increased risk of falls and fractures, it is not clear if this holds true for the use many (polypharmacy). We aimed to identify what known about association between polypharmacy fractures adults aged ≥65 examine methods used study association. Methods conducted a systematic review narrative synthesis studies published up October 2023 PubMed, Embase, CINAHL, PsychINFO, Cochrane Library, Web Science, grey literature. Two independent reviewers screened titles, abstracts, full texts, then performed data extraction quality assessment. Results Among 31 included, 11 different definitions were based on three medication counting (concurrent 15/31, cumulative over period 6/31, daily average 3/31, indeterminate 7/31). Overall, was frequent higher fracture risk. A dose–response relationship increasing number observed. However, only seven adjusted major confounders (age, sex, chronic disease). The ranged from poor high. Conclusions Polypharmacy appears be relevant modifiable factor individuals that can easily those at diversity calculation highlights importance detailed methodology understand compare results.

Language: Английский

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Impact of an Interprofessional Collaboration Between Physicians and Pharmacists on Fall-Risk-Increasing Drugs in Older Patients with Trauma in the Emergency Department

Geriatrics, Journal Year: 2025, Volume and Issue: 10(2), P. 46 - 46

Published: March 17, 2025

Background/Objectives: In older patients, falls constitute a significant public health concern and major cause of hospital admission. Fall-risk-increasing drugs (FRIDs) represent key risk factor for falls. Therefore, modifying these represents an important strategy preventing recurrent further patient harm. The objective this study was to evaluate structured interprofessional collaboration between physicians pharmacists on managing FRIDs in patients who present the emergency department (ED) after fall. Methods: This performed ED tertiary care hospital. Patients were >65 years old presented fall included. A routine group included 1 March 2020 31 May 2020. pharmaceutical September 2023 30 November 2023. group, clinical pharmacist supported identifying FRIDs. Possible solutions improving FRID prescription discussed interprofessionally. number at admission discharge, as well modifications, evaluated. Results: total 107 enrolled each group. There 85 89 with least prescribed (p = 0.483). At there 68 0.010). seven modifications compared 125 Conclusions: study, led reduced being more discharge. Further research is required ascertain feasibility integrating single intervention into multifactorial prevention program.

Language: Английский

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A Longitudinal Study of the Use and Effects of Fall-Risk-Increasing Drugs in Residential Aged Care

Journal of the American Medical Directors Association, Journal Year: 2024, Volume and Issue: 25(8), P. 105074 - 105074

Published: June 12, 2024

Language: Английский

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Revisiting publish or perish

International Journal of Pharmacy Practice, Journal Year: 2023, Volume and Issue: 31(1), P. 1 - 2

Published: Jan. 1, 2023

The term 'publish or perish' was first used in an academic context a 1928 journal article.[1] Since then it has been widely adopted by institutions as tool to incentivise individual staff members publish scholarly articles enhance both their own reputation and career progression, thereby the of institution itself. With increasing use publications performance indicators for they progress through promotion rounds, themselves compete with each other ranking tables government funding, expression is probably true today ever. However, when discipline immediate relevance policy practice real world, do applied health sciences services research better provision care, phrase takes on alternative arguably more important meaning. Research into safe effective medicines, exploiting expertise wider healthcare team such pharmacy team, often referred research, contributes those portfolios work. Reflecting content published International Journal Pharmacy Practice 2022, focussing particularly papers this issue 2023, clear that publication can fulfil much greater role.

Language: Английский

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The Association between Falls and Fall-Risk-Increasing Drugs among Older Patients in Out-Patient Clinics: A Retrospective Cohort, Single Center Study

Research in Social and Administrative Pharmacy, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 1, 2024

Language: Английский

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Baclofen and the risk of fall and fracture in older adults: A real‐world cohort study

Journal of the American Geriatrics Society, Journal Year: 2023, Volume and Issue: 72(1), P. 91 - 101

Published: Nov. 7, 2023

Abstract Background The growth of oral muscle relaxant prescriptions among older adults in the United States is concerning due to drugs' adverse sedative effects. Baclofen a gamma‐aminobutyric acid agonist that associated with encephalopathy. We characterized risk fall and fracture baclofen against other relaxants (tizanidine or cyclobenzaprine) adults. Methods designed new‐user, active‐comparator study using tertiary health system data from Geisinger Health, Pennsylvania (January 2005 through December 2018). Older (aged ≥65 years) newly treated baclofen, tizanidine, cyclobenzaprine were included. Propensity score‐based inverse probability treatment weighting (IPTW) was used balance groups on 58 baseline characteristics. Fine–Gray competing regression estimate fracture. Results cohort comprised 2205 new users, 1103 tizanidine 9708 users. During median follow‐up 100 days, higher compared (IPTW incidence rate, 108.4 vs. 61.9 per 1000 person‐years; subdistribution hazard ratio [SHR], 1.68 [95% CI, 1.20–2.36]). comparable (SHR, 1.17 0.93–1.47]) 106 days. similar patients versus 0.85 0.63–1.14]) 0.67–1.07]). Conclusions greater than but not users cyclobenzaprine. Our findings may inform risk‐benefit considerations increasingly common clinical encounters where are prescribed.

Language: Английский

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Factors associated with fall risk increasing drug use in older black and white men and women: the Health ABC Study

BMC Geriatrics, Journal Year: 2024, Volume and Issue: 24(1)

Published: Sept. 19, 2024

Language: Английский

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Fall risk-increasing drugs and associated health outcomes among community-dwelling older patients: A cross-sectional study in Croatian cohort of the EuroAgeism H2020 project

Acta Pharmaceutica, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 19, 2024

Abstract Our study aimed to assess the prevalence of fall risk-increasing drugs (FRIDs) in a sample community-residing older patients Croatia and its association with negative health outcomes. An observational, cross-sectional was conducted on (65+) visiting community pharmacies three regionally different sites Croatia. Data were collected using questionnaire developed for that purpose included components comprehensive geriatric assessment. Prevalence FRIDs identified “Screening Tool Older Persons Prescriptions adults high risk” (STOPPFall). In 407 participants (median age 73 (IQR 69–70) years; 63.9 % females), 79.1 used at least one FRID. The most common drug classes diuretics, benzodiazepines, opioids (in 51.1 %, 38.1 17.2 participants, respectively). More prescribed oldest old (85+) from poorer regions (Slavonia) ( p < 0.05). Exposition as significant risk factor associated falls (OR = 1.24 (1.04–1.50); 0.020) higher health-care utilization 1.29 (1.10–1.51); 0.001). highlights need rationalization FRID use. To reduce unnecessary exposure adults, professionals must consider individualization medication schemes regarding selection, dosing, combinations only necessary FRIDs.

Language: Английский

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Unveiling the latest deprescribing research: a new themed collection

International Journal of Pharmacy Practice, Journal Year: 2023, Volume and Issue: 31(3), P. 267 - 268

Published: April 26, 2023

Journal Article Unveiling the latest deprescribing research: a new themed collection Get access Sion Scott University of Leicester, LE1 7RH, UK Correspondence: Scott; Email: [email protected] Search for other works by this author on: Oxford Academic Google Scholar International Pharmacy Practice, Volume 31, Issue 3, June 2023, Pages 267–268, https://doi.org/10.1093/ijpp/riad031 Published: 26 April 2023

Language: Английский

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