The impact of age, sex, and gender on polypharmacy and potential prescribing cascades: Lessons from five databases DOI Creative Commons
Paula A. Rochon, Joyce Li, Denis O’Mahony

et al.

Journal of the American Geriatrics Society, Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 19, 2024

Few studies describe how gender-related factors may contribute to polypharmacy and prescribing cascades. Describing these patterns using cross-national comparisons can improve the robustness of findings provide lessons on importance considering age, sex, gender in pharmacological research. The aim study was explore intersection with co-prescribing suggesting a potential cascade.

Language: Английский

Inappropriate Prescription of Loop Diuretics for Calcium Channel Blocker-Related Peripheral Edema: Lessons from Physiology DOI
Jesús D. Meléndez‐Flores,

Mónica Sánchez-Cárdenas

The American Journal of the Medical Sciences, Journal Year: 2025, Volume and Issue: unknown

Published: April 1, 2025

Language: Английский

Citations

0
Identifying and quantifying potentially problematic prescribing cascades in clinical practice: A mixed‐methods study DOI Creative Commons
Atiya K. Mohammad, Jacqueline G. Hugtenburg, Joost W. Vanhommerig

et al.

Journal of the American Geriatrics Society, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 20, 2024

Abstract Background A prescribing cascade occurs when medication causes an adverse drug reaction (ADR) that leads to the prescription of additional medication. Prescribing cascades can cause excess burden, which is particular concern in older adults. This study aims identify and quantify potentially problematic relevant for clinical practice. Methods mixed‐methods was conducted. First, were identified through literature search. An expert panel ( n = 16) pharmacists physicians assessed whether these problematic. Next, a cohort quantified adults using Dutch community pharmacy data period 2015–2020. Additionally, influence multiple medications causing same ADR evaluated. Prescription sequence symmetry analysis used calculate adjusted ratios (aSRs), adjusting temporal trends. aSR >1.0 indicates occurrence cascade. In subgroup analysis, aSRs calculated Results Seventy‐six three provided by experts. Of these, 66 (83.5%) considered significant positive found 41 (62.1%) cascades. The highest amiodarone hypothyroidism treated with thyroid hormones (4.63 [95% confidence interval 4.40–4.85]), based on 565 incident users. biggest population 34,645) angiotensin converting enzyme‐inhibitors urinary tract infections antibiotics. Regarding four potential ADRs, higher people as compared only one those medications. Among remained 37 Conclusion overview generated These results support healthcare providers intervene reduce burden

Language: Английский

Citations

3
Which older adults are at highest risk of prescribing cascades? A national study of the gabapentinoid–loop diuretic cascade DOI
Matthew E. Growdon, Bocheng Jing, Earl J. Morris

et al.

Journal of the American Geriatrics Society, Journal Year: 2024, Volume and Issue: 72(6), P. 1728 - 1740

Published: March 28, 2024

Abstract Background Prescribing cascades are important contributors to polypharmacy. Little is known about which older adults at highest risk of experiencing prescribing cascades. We explored veterans the gabapentinoid (including gabapentin and pregabalin)–loop diuretic (LD) cascade, given dramatic increase in recent years. Methods Using Veterans Affairs Medicare claims data (2010–2019), we performed a prescription sequence symmetry analysis (PSSA) assess loop initiation before after among (≥66 years). To identify calculated adjusted ratio (aSR), assesses temporality LD relative initiation. explore high‐risk groups, used multivariable logistic regression with order modeled as binary dependent variable. odds ratios (aORs), measuring extent factors associated one versus another. Results Of 151,442 who initiated gabapentinoid, there were 1,981 patients within 6 months initiating compared 1,599 gabapentinoid. In gabapentinoid–LD group, mean age was 73 years, 98% male, 13% Black, 5% Hispanic, 80% White. Patients each group similar across patient health utilization (standardized difference <0.10 for all comparisons). The aSR 1.23 (95% CI: 1.13, 1.34), strongly suggesting cascade's presence. People ≥85 years less likely have cascade (compared 66–74 years; aOR 0.74, 95% 0.56–0.96), people taking ≥10 medications more 0–4 drugs; 1.39, 1.07–1.82). Conclusions Among adults, those younger many may be higher contributing worsening polypharmacy potential drug‐related harms. did not strong predictors this that prevention efforts should widespread rather than focused on specific subgroups.

Language: Английский

Citations

2
Side effects of antihypertensive drugs DOI

Talia Wall

Side effects of drugs annual, Journal Year: 2024, Volume and Issue: unknown, P. 237 - 247

Published: Jan. 1, 2024

Language: Английский

Citations

0
The Increasing Problem of Resistant Hypertension: We’ll Manage till Help Comes! DOI Creative Commons
Francesco Natale,

Rosa Franzese,

Ettore Luisi

et al.

Medical Sciences, Journal Year: 2024, Volume and Issue: 12(4), P. 53 - 53

Published: Oct. 4, 2024

Arterial hypertension remains the major cardiovascular risk worldwide. It is estimated that under 50 years of age one in every three adults hypertensive while beyond prevalence almost 50% globally. The latest World Health Organization (WHO) Global Report on Hypertension indicated global number patients doubled last decades, with related increasing deaths, disability, and costs annually. Because this increase, early diagnosis timely treatment great importance. However, based WHO Report, it up to 46% individuals were never diagnosed. Of those diagnosed, less than treatment, nearly half among these at target according current guidelines. also important note an patients, despite use or more drugs, still do not achieve a blood pressure normalization, thus defining clinical scenario resistant (RH). This condition associated higher hypertension-mediated organ damage hospitalization due acute events. Current guidelines recommend triple combination therapy (renin angiotensin system blocking agent + thiazide thiazide-like diuretic dihydropyridinic calcium-channel blocker) all RH. Beta-blockers mineralocorticoid receptor antagonists, alone combination, should be considered concomitant conditions potential contraindications. Finally, renal denervation proposed preserved kidney function remain maximum tolerated medical treatment. failure procedure long term contraindication strong call for new therapeutic approach. In present review, we will discuss pharmacological novelties come management RH next future.

Language: Английский

Citations

0
The impact of age, sex, and gender on polypharmacy and potential prescribing cascades: Lessons from five databases DOI Creative Commons
Paula A. Rochon, Joyce Li, Denis O’Mahony

et al.

Journal of the American Geriatrics Society, Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 19, 2024

Few studies describe how gender-related factors may contribute to polypharmacy and prescribing cascades. Describing these patterns using cross-national comparisons can improve the robustness of findings provide lessons on importance considering age, sex, gender in pharmacological research. The aim study was explore intersection with co-prescribing suggesting a potential cascade.

Language: Английский

Citations

0