Drug stewardship in chronic kidney disease to achieve effective and safe medication use

Nature Reviews Nephrology, Journal Year: 2024, Volume and Issue: 20(6), P. 386 - 401

Published: March 15, 2024

Language: Английский

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Potentially clinically significant drug-drug interactions in older patients admitted to the hospital: A cross-sectional study

Frontiers in Pharmacology, Journal Year: 2023, Volume and Issue: 14

Published: Feb. 2, 2023

Background: An international consensus list of potentially clinically significant drug-drug interactions (DDIs) in older people has been recently validated. Our objective was to describe the prevalence and characteristics drug combinations causing DDIs identified medication history patients admitted hospital manifest DDIs–DDIs involved adverse events present at admission, that contributed ADE-related admissions, drug-related laboratory deviations. Methods: The data were obtained from our previous study examined drug-relatedness admissions University Hospital Hradec Králové via department emergency medicine Czech Republic. Patients ≥ 65 years old included. Drug using people. Results: Of 812 hospital, 46% exposed DDIs. A combination medications affect potassium concentrations accounted for 47% all In 27 cases, associated with admissions. 4 ADEs Manifest most frequently antithrombotic agents central nervous system depressants. Conclusion: results confirm findings European OPERAM trial, which found are very common patients. 4.3% hospital. 3.3%, difference rates potential suggests if a computerized decision support is used alerting patients, it needs be contextualized (e.g., take concomitant medications, doses values, patients’ comorbidities into account).

Language: Английский

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Medication Use Quality and Safety in Older Adults: 2023 Update

Journal of the American Geriatrics Society, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 27, 2025

ABSTRACT Improving the quality of medication use and safety are important priorities for healthcare providers who care older adults. The objective this article was to identify four exemplary articles with focus in 2023. We selected high‐quality studies that advanced field research. chosen cover domains related deprescribing/discontinuation, optimizing use, safety/adverse drug events, other. first study a randomized clinical trial evaluating efficacy patient‐centered Shed‐MEDS deprescribing intervention among adults transitioning from hospital postacute facilities (domain: deprescribing/discontinuation). second study, retrospective cohort Medicare beneficiaries, described phenomenon prescribing cascade relic evaluated continued potassium after discontinuation loop diuretic use). third systematic review meta‐analysis describing prevalence drug–drug interactions community‐dwelling other). Lastly, fourth beneficiaries concurrent gabapentin opioid risk mortality safety). Collectively, succinctly highlights pertinent topics promoting safe medications promotes awareness adults' regimens.

Language: Английский

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Prescribing Cascades of Loop Diuretics and Anti-vertigo Drugs Following Treatment with Gabapentinoids and Benzodiazepines: Prescription Sequence Symmetry Analysis of a Large-Scale Claims Database Including Japanese Older Adults

Drugs - Real World Outcomes, Journal Year: 2024, Volume and Issue: 11(3), P. 529 - 540

Published: Aug. 8, 2024

Gabapentinoids (GBP) and benzodiazepines (BZ) are commonly prescribed in older adults their package inserts list edema vertigo as adverse drug reactions. These reactions may be treated with symptomatic therapies without discontinuing the culprit drugs or decreasing dose, thereby initiating a prescribing cascade often resulting polypharmacy. Whether cascades occur treatment of dizziness among Japanese patients GBP BZ has not been investigated, including mirogabalin, class marketed Japan. We aimed to investigate GBP-induced BZ-induced loop diuretics (LD) anti-vertigo (AVD), respectively, adults. A prescription sequence symmetry analysis design was used detect signals associated induced by (exposure drugs). Loop AVD were outcome identify following initiation exposure drugs. The study population consisted enrollees large-scale health claims database provided DeSC Healthcare, Inc., between April 2014 March 2021. Subjects eligible for aged ≥ 65 years an within 90 days before after initiation. signal detected if secular trend-adjusted ratios statistically significant on comparison frequencies identified 2671 prescriptions GBP-LD combination, 4009 GBP-AVD 8675 BZ-LD 9462 BZ-AVD combination. adjusted significantly larger than one (adjusted ratio [95% confidence interval], 1.69 [1.56–1.83]; 1.35 [1.29–1.41], respectively), indicating positive cascades. No (0.89 [0.83–0.94]; 0.90 [0.87–0.94], respectively). mirogabalin higher that pregabalin (2.23 [1.84–2.71] vs 1.59 [1.46–1.73]). Our provides good evidence LD-prescribing would effect BZ. Edema emerging around 1 month should carefully differentiated from pathological edema, undue LD avoided.

Language: Английский

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Drug-related hospitalizations - insights from the Czech Republic

Česká a slovenská farmacie, Journal Year: 2024, Volume and Issue: 73(2), P. 93 - 102

Published: June 14, 2024

Drug-related hospitalizations - insights from the Czech Republic Background and objective: represent a significant burden on healthcare. The aim of study was to determine prevalence drug-related identify medications clinical manifestations associated with in patients admitted hospital through emergency department. This cross-sectional examined unplanned at University Hospital Hradec Kralove Department Emergency Medicine between August November 2018. Data were obtained electronic health records. methodology for identifying based guideline European project OPERAM. article focuses subgroup problems related medication safety. Of total 1252 analyzed, 145 cases identified as drug-related. 12% (95% confidence interval 10-13). In 62% cases, only contributed cause hospitalization. Antithrombotics, cytostatics, diuretics, systemic corticosteroids most common classes leading hospitalizations. Gastrointestinal bleeding potential preventability 34%. remain relatively common, while some them could be potentially prevented. Pharmacists can contribute enhancing patient safety by detecting proposing measures minimize risks.

Language: Английский

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Prescribing cascades

Journal of Prescribing Practice, Journal Year: 2023, Volume and Issue: 5(12), P. 498 - 499

Published: Dec. 2, 2023

Deborah Robertson provides an overview of recently published articles that may be interest to non-medical prescribers. Should you wish look at any the papers in more detail, a full reference is provided

Language: Английский

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