Impact of in-hospital medication changes on clinical outcomes in older inpatients: the journey and destination

Age and Ageing, Journal Year: 2025, Volume and Issue: 54(2)

Published: Feb. 1, 2025

Medication review is integral in the pharmacological management of older inpatients. To assess association in-hospital medication changes with 28-day postdischarge clinical outcomes. Retrospective cohort 2000 inpatients aged ≥75 years. included number increases (medications started or dose-increased) and decreases stopped dose-decreased) for (i) all medications, (ii) Drug Burden Index (DBI)-contributing medications (iii) Beers Criteria 2015 (potentially inappropriate PIMs). Changes also differences PIMs DBI score, at discharge versus admission. Associations outcomes (28-day ED visit, readmission mortality) were ascertained using logistic regression, adjusted age, gender principal diagnosis. For mortality, sensitivity analysis excluded end-of-life patients due to higher death risk. Patients stratified into : ≤4, 5-9 ≥10 medications. The mean age was 86 years (SD = 5.8), 59.1% female. reduced visits risk prescribed five nine no associations ≤4 ≥ 10 In group, decreasing risks visit (adjusted odds ratio, aOR 0.55, 95% CI 0.34-0.91, P .02) (aOR 0.62, 0.38-0.99, .04). Decreasing DBI-contributing 0.71, 0.51-0.99, Differences 0.65, 0.43-0.99, There mortality analyses groups. associated

Language: Английский

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Pharmacy-led interventions to reverse and prevent prescribing cascades in primary care: a proof-of-concept study

International Journal of Clinical Pharmacy, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 15, 2025

Prescribing cascades occur in clinical practice when a medication causes an adverse drug reaction (ADR), which is addressed by prescribing additional medication. The aim was to provide proof-of-concept for pharmacy-led interventions reverse or prevent cascades. Two community pharmacies each tested two approaches. To cascades, ten were selected from literature. Dispensing records screened identify patients with these who started medications associated five of telephoned one month after their first dispensing discuss ADRs. Pharmacists assessed the need intervene together prescribers. Primary outcome proportion treatment change initiated. Secondary outcomes time investment, potential cost-savings, and pharmacists' experiences. 24 included. For eight prescriber consulted, resulting reversal three Forty-four included Six them experienced ADR that could lead cascade. conducted this. estimated investment possibly intervention 4.5 h reversing approach 4.8 preventing approach, while follow-up actions required 1.8 0.5 h, respectively. Both approaches be cost-saving. considered both relevant but identified knowledge gap on how some Pharmacy-led may more efficient screening methods tools are needed before further implementation.

Language: Английский

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Building a pan-European network to bridge gaps in geriatric medicine education: the PROGRAMMING COST Action 21,122—a call for endorsement

European Geriatric Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 19, 2025

Abstract Background The growing challenges of population aging create a pressing need for specialized geriatric medicine services to effectively address the complex health needs older adults and influence supportive healthcare policies. Older patients may present clinical complexity with multimorbidity, disability, and/or frailty, necessitating shift from traditional organ-oriented approach holistic, patient-centered care model. Rationale action Despite recommendations World Health Organization scientific professional societies, is not universally recognized as distinct specialty in Europe, education this field remains heterogeneous. A notable discrepancy availability across European countries can be found. Many professionals lack basic training medicine, contributing fragmented poorer outcomes. To these challenges, it essential integrate into undergraduate postgraduate curricula all professionals. Expected outcomes COST Action 21,122 PROGRAMMING (PROmoting GeRiAtric Medicine where still eMergING) initiative aims promote by developing targeted educational goals programs fostering interdisciplinary collaboration. This assess current state identify both global local skills among In addition, seeks establish consensus on core tailored contexts disseminate findings stakeholders, policymakers, public. By uniting diverse aspires sustainable changes Europe. Graphical abstract

Language: Английский

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Quality of prescribing and health-related quality of life in older adults: a narrative review with a special focus on patients with atrial fibrillation and multimorbidity

European Geriatric Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: March 9, 2025

Abstract Purpose To summarise the association between potentially inappropriate prescribing (PIP) and health-related quality of life (HRQOL) in older adults, with a special focus on those atrial fibrillation (AF) multimorbidity, while exploring potential interventions to improve their impact HRQOL. Methods A comprehensive search strategy was conducted MEDLINE using PubMed interface August 16th, 2024, focusing key terms related “potentially prescribing” “quality life”. Additionally, reference lists included studies were screened. Only utilising validated assessment tools for HRQOL or measuring global self-perceived health status considered. Studies involving populations an average age ≥ 65 years included. Results Of 1810 articles screened, 35 The findings indicate that prescribing, independent polypharmacy, may negatively influence review identified range aimed at improving among including pharmacist-driven, general practitioner-driven, multidisciplinary approaches. Interventions assessed distinct population groups specifically residential care homes. While some demonstrated improvements quality, overall evidence regarding remains limited. Conclusion relationship underexplored adults AF despite high prevalence PIP. Effective pharmacotherapy should be coupled patients' clinical functional parameters, considering Adopting multidisciplinary, integrated, patient-centred approach is essential sustainable appropriate practices enhance

Language: Английский

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Effect of a Population Health Management Intervention on Medication Therapy Problems in People With Chronic Kidney Disease: Post-hoc Analysis of the K-CHAMP Cluster Randomized Trial

Kidney Medicine, Journal Year: 2025, Volume and Issue: unknown, P. 100995 - 100995

Published: March 1, 2025

Language: Английский

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Medication Safety in Acute Care Settings

Medical Clinics of North America, Journal Year: 2025, Volume and Issue: unknown

Published: April 1, 2025

Language: Английский

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Potentially inappropriate prescribing in polymedicated older adults with atrial fibrillation and multimorbidity: a Swedish national register-based cohort study

Frontiers in Pharmacology, Journal Year: 2024, Volume and Issue: 15

Published: Sept. 10, 2024

Current research on potentially inappropriate prescribing (PIP) in polymedicated older adults with atrial fibrillation (AF) and multimorbidity is predominantly focused PIP of oral anticoagulants (OAC). Our study aimed to assess (i) the overall prevalence multimorbid AF, (ii) potential associated factors PIP, (iii) association adverse health outcomes a nationwide sample Swedish adults.

Language: Английский

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Deprescribing is associated with reduced readmission to hospital: An updated meta‐analysis of randomized controlled trials

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

Published: Sept. 5, 2024

See the related reply by Fontana et al .

Language: Английский

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Reply to: Deprescribing is associated with reduced readmission to hospital: An updated meta‐analysis of randomized controlled trials

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

Published: Sept. 5, 2024

See the related letter by Lee et al .

Language: Английский

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Hierarchical endpoints analyzed using the win‐ratio method as a practical innovation for deprescribing trials

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

Published: Oct. 17, 2024

Language: Английский

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