Exposure to anticholinergic and sedative medications using the Drug Burden Index and its association with vertigo, dizziness and balance problems in older people – Results from the KORA-FF4 Study

Experimental Gerontology, Journal Year: 2019, Volume and Issue: 124, P. 110644 - 110644

Published: June 28, 2019

Language: Английский

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Characterizing tramadol users with potentially inappropriate co-medications: A latent class analysis among older adults

PLoS ONE, Journal Year: 2021, Volume and Issue: 16(2), P. e0246426 - e0246426

Published: Feb. 19, 2021

Background Although tramadol is an effective weak opioid analgesic, careful monitoring of potential central nervous system adverse reactions in older adults needed, especially when used with concomitant medications which may trigger the effects. We aimed to characterize users potentially inappropriate co-medications using a latent class analysis (LCA). Method Patients aged 65 years or and receiving were included from nationwide healthcare claims database. defined antidepressants, first-generation antihistamines, anxiolytics as co-medications. applied LCA for grouping based on common characteristics medication use utilization, each patient was probabilistically assigned class. Patients’ different classes compared. Potential drug (ADRs) any visits emergency department after occurrence Logistic regression examine association between ADRs. Results identified four distinct representing patterns co-medications: multiple drug-drug interaction (pDDI) combination users, antihistamines-tramadol antidepressants-tramadol anxiolytics-tramadol users. Multiple pDDI showed high proportion regular use, tended visit more medical institutions, had Charlson comorbidity score. The duration longest shortest When compared increased ADR risk observed (adjusted odds ratio (OR), 1.81; 95% confidence interval (CI), 1.75–1.88), (1.24; 1.19–1.29), (1.04; 1.00–1.08). Conclusions Four among Differences these classes. These findings help identify patients at ADRs owing tramadol.

Language: Английский

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Polypharmacy in Australian Veterans with Post-traumatic Stress Disorder upon Admission to a Mental Health Facility: A Retrospective Chart Review

Drugs - Real World Outcomes, Journal Year: 2022, Volume and Issue: 9(3), P. 347 - 357

Published: May 17, 2022

Polypharmacy increases the risk of adverse drug events and drug-drug interactions, contributes to falls, hospital admissions, morbidity mortality. Veterans with post-traumatic stress disorder often have psychological physical comorbidities, increasing likelihood general psychotropic polypharmacy. This study investigates prevalence polypharmacy in inpatient veterans disorder, illustrates potential risks associated this population. Medical records 219 admitted a mental health facility for management were retrospectively reviewed. Medication lists on admission extracted coded according Anatomical Therapeutic Chemical Classification classes. The (five or more total medications), (two N-code sedative medications sedating effects) Drug Burden Index calculated. Class combinations reported, associations between demographic characteristics determined. Mean age was 62.5 (± 14.6) years. In addition 90.9% had diagnosis at least one other psychiatric condition, 96.8% non-psychiatric medical condition. 76.7%, 79.9% 75.3%. scores ranged from 0 8.2, 66.2% participants scoring ≥ 1. cohort high general, polypharmacy, drug-related events. highlights importance awareness potentially inappropriate combinations, need improved medication review by prescribers.

Language: Английский

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Application of a person-centered prescription model improves pharmacotherapeutic indicators and reduces costs associated with pharmacological treatment in hospitalized older patients at the end of life

Frontiers in Public Health, Journal Year: 2022, Volume and Issue: 10

Published: Oct. 3, 2022

This study sought to investigate whether applying an adapted person-centered prescription (PCP) model reduces the total regular medications in older people admitted a subacute hospital at end of life (EOL), improving pharmacotherapeutic indicators and reducing expense associated with pharmacological treatment. Randomized controlled trial. The trial was registered ClinicalTrials.gov (NCT05454644). A Basque Country, Spain. Adults ≥65 years (n = 114) who were geriatric convalescence unit required palliative care. PCP consisted systematic four-step process conducted by geriatricians clinical pharmacists. Relative original model, this entails protocol for tools assessments be on identified as being EOL. After mean change number drugs, STOPPFrail (Screening Tool Older Persons' Prescriptions Frail adults limited expectancy) criteria, drug burden index (DBI), drug-drug interactions, medication regimen complexity (MRCI) 28-days cost chronic prescriptions between admission discharge analyzed. All patients followed 3 months after measure intervention's effectiveness over time variables medical prescriptions. prescribed baseline 9.0 ± 3.2 intervention group 8.2 3.5 control group. -1.74 -0.07 (mean difference 1.67 0.57; p 0.007). Applying reduced all measured criteria compared pre-admission (p < 0.05). At discharge, significantly lower (-34.91€ vs. -0.36€; 0.004). improves costs treatment hospitalized EOL, continuing discharge. Future studies must continuity transition care primary so that these new models are offered transversally not isolation.

Language: Английский

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Long‐term anticholinergic, benzodiazepine and Z‐drug use in community‐dwelling older adults: What is the impact on cognitive and neuropsychological performance?

International Journal of Geriatric Psychiatry, Journal Year: 2021, Volume and Issue: 36(11), P. 1767 - 1777

Published: July 6, 2021

Long-term use of anticholinergics, benzodiazepines and related drugs (or "Z-drugs") have been associated with cognitive impairment dementia. However, the relationship these medications function domain-specific neuropsychological performance in older adults without dementia, is unclear.5135 (74.0 ± 8.3 years; 67.4% female) a diagnosis dementia were recruited Ireland to Trinity-Ulster-Department Agriculture (TUDA) study. Detailed assessment was conducted using Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB) Repeatable for Neuropsychological Status (RBANS).A total 44% (2259 5153) used either potential or definite anticholinergic medication. Overall, 9.7% (n = 500) Regular benzodiazepine reported by 7% 363), whilst 7.5% 387) "Z-drug". Use definite, but not medication poorer on all three assessments (β: -0.09; 95% CI: -0.14, -0.03, p 0.002 MMSE; β: -0.04; -0.06, -0.02; < 0.001 FAB; -4.15; -5.64, -2.66; RBANS) addition domains RBANS. also test performance, especially Immediate Memory -4.98; -6.81, -3.15; 0.001) Attention -6.81; -8.60, -5.03; RBANS domains.Regular benzodiazepines, anticholinergics "Z-drugs", overall adults.

Language: Английский

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