Population-Based Trends in Complexity of Hospital Inpatients

JAMA Internal Medicine, Journal Year: 2024, Volume and Issue: 184(2), P. 183 - 183

Published: Jan. 8, 2024

Clinical experience suggests that hospital inpatients have become more complex over time, but few studies evaluated this impression.

Language: Английский

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Polypharmacy prevalence in older adults seen in United States physician offices from 2009 to 2016

PLoS ONE, Journal Year: 2021, Volume and Issue: 16(8), P. e0255642 - e0255642

Published: Aug. 3, 2021

Background/objectives With an aging population suffering from increased prevalence of chronic conditions in the United States (U.S.), a large portion these patients are on multiple medications. High-risk medications can increase risk for drug-drug interactions and medication nonadherence. This study aims to describe polypharmacy high-risk prescribing U.S. physician offices. Methods was cross-sectional Centers Disease Control Prevention’s National Ambulatory Medical Care Survey 2009 2016. All over 65 years old were included. Polypharmacy categorized as no (< 2 medications), minor (2–3 moderate (4–5 major (>5 medications). Medications further into categories (anticholinergics, cardiovascular agents, central nervous system (CNS) medications, pain other). Comparisons between degrees performed utilizing chi-square or Wilcoxon rank-sum tests with JMP Pro 14 ® (SAS Institute, Cary, NC). Results Over billion patient visits Overall, common (65.1%): (16.2%), (12.1%), (36.8%). Patients older compared those (75 vs. 73 years, respectively) most frequently prescribed (477.3 per 1,000 total visits). NSAIDs prescribed, 232.4 resulting one NSAID prescription, while 21.9 resulted two more NSAIDs. Conclusion Most experienced some degree polypharmacy, many experiencing polypharmacy. indicates need expanded pharmacist roles through therapy management safety monitoring this population.

Language: Английский

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A Proposed Curricular Framework for an Interprofessional Approach to Deprescribing

Medical Science Educator, Journal Year: 2023, Volume and Issue: 33(2), P. 551 - 567

Published: Feb. 23, 2023

Deprescribing involves reducing or stopping medications that are causing more harm than good no longer needed. It is an important approach to managing polypharmacy, yet healthcare professionals identify many barriers. We present a proposed pre-licensure competency framework describes essential knowledge, teaching strategies, and assessment protocols promote interprofessional deprescribing skills. The considers how involve patients care partners in decisions. An action plan example curriculum mapping exercise included help educators assess their curricula, select implement these concepts strategies within programs ensure learners graduate with competencies manage increasingly complex medication regimens as people age.The online version contains supplementary material available at 10.1007/s40670-022-01704-9.

Language: Английский

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Prescription of Potentially Inappropriate Medication in Older Inpatients of an Internal Medicine Ward: Concordance and Overlap Among the EU(7)-PIM List and Beers and STOPP Criteria

Frontiers in Pharmacology, Journal Year: 2021, Volume and Issue: 12

Published: July 30, 2021

Background: Age-related comorbidities prone older adults to polypharmacy and an increased risk of potentially inappropriate medication (PIM) use. This work aims analyze the concordance overlap among EU(7)-PIM list, 2019 Beers criteria, Screening Tool Older Person’s Prescriptions (STOPP) version 2 criteria also prevalence PIM. Methods: A retrospective cohort study was conducted on inpatients internal medicine ward. Demographic, clinical, pharmacological data were collected, during March 2020. After PIM identification by STOPP v2 between analyzed. descriptive analysis performed, all results with a p -value lower than 0.05 considered statistically significant. Results: total 616 patients included in whose median age 85 (Q1–Q3) (78–89) years. Most male (51.6%), number days hospitalization 17 (13–22) days. According 79.7, 92.0, 76.5% adults, respectively, used at least one poor (&lt;63.4%) observed. An association prescribed medicines found applied criteria. Moreover, PIMs diagnoses endocrine, nutritional, metabolic diseases, mental, behavioral, neurodevelopmental disorders, circulatory system diseases observed according that musculoskeletal connective tissue Conclusion: Despite Beers, this highlights need for more studies develop strategies facilitate decrease high hospitalized patients. The new tools adapting existing medical ward inpatients.

Language: Английский

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Polypharmacy in Older Adults Undergoing Major Surgery: Prevalence, Association With Postoperative Cognitive Dysfunction and Potential Associated Anesthetic Agents

Frontiers in Medicine, Journal Year: 2022, Volume and Issue: 9

Published: Feb. 15, 2022

Polypharmacy, which is defined as the use of 5 or more medications, can exert significant adverse impact on older adult patients. The objective this study was to determine prevalence polypharmacy, and investigate its association with postoperative cognitive dysfunction (POCD) in patients who underwent elective major surgery at Siriraj Hospital-Thailand's largest national tertiary referral center.This prospective included aged ≥65 years were scheduled for during December, 2017 2019 period. Patient demographic, sociodemographic, anthropometric, clinical, comorbidity, anesthetic, surgical, medication data collected compared between polypharmacy non-polypharmacy groups. Postoperative diagnosed least a 2-point decrease their Montreal Cognitive Assessment score after surgery. Multivariate logistic regression analysis used identify independent predictors POCD.A total 250 (141 males, 109 females) an average age 72.88 ± 6.93 included. 74%. Preoperative showed group be likely receiving potentially inappropriate cardiovascular thoracic surgery, have comorbidities. There non-significant trend POCD (crude odds ratio (OR): 2.11, 95% confidence interval [CI]: 0.90-4.94; p = 0.08). Benzodiazepine, desflurane, isoflurane administration all significantly associated univariate analysis. revealed intraoperative benzodiazepine (adjusted OR [aOR]: 2.24, CI: 1.10-4.68; 0.026) (aOR: 2.80, 1.35-5.81; 0.006) two variables development POCD. Desflurane found protective factor crude 0.17 (95% 0.03-0.74, 0.019); however, not multivariate analysis.There high study; although close (p 0.08), Benzodiazepine both identified among undergoing especially those classified polypharmacy.

Language: Английский

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Aging and the Prevalence of Polypharmacy and Hyper-Polypharmacy Among Older Adults in South Korea: A National Retrospective Study During 2010–2019

Frontiers in Pharmacology, Journal Year: 2022, Volume and Issue: 13

Published: May 9, 2022

Background: Polypharmacy has become a global health problem and is associated with adverse outcomes in the elderly. This study evaluated prevalence of polypharmacy hyper-polypharmacy elderly patients South Korea during 2010–2019. Methods: We analyzed outpatient care persons aged ≥65 years covered by National Health Insurance (NHI) using NHI claims data from 2010 to 2019. was defined as use ≥5 medications, ≥10 we examined them over periods ≥90 days ≥180 days. The average annual percent change (AAPC) calculated Joinpoint statistical software. Results: among medication decreased 42.5% 41.8% 2019, for increased 10.4% 14.4%. 37.8% 38.1% 6.4% 9.4%. steadily patients, AAPCs 3.7 4.5, respectively. Conclusion: remained stably high, rates about 42 38%, respectively, past 10 Korea. Therefore, strategies address need be implemented. Further research also required identify clinical (including mortality risks) polypharmacy.

Language: Английский

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Sex and gender differences in drug treatment: experiences from the knowledge database Janusmed Sex and Gender

Biology of Sex Differences, Journal Year: 2023, Volume and Issue: 14(1)

Published: May 12, 2023

Evidence from clinical research indicates that men and women can differ in response to drug treatment. The knowledge database Janusmed Sex Gender was developed illuminate potential sex gender differences therapy and, therefore, achieve a better patient safety. contains non-commercial evidence-based information on substances regarding aspects Here, we describe our experiences reflections collecting, analyzing, evaluating the evidence.

Language: Английский

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Use of Phosphodiesterase 5 Inhibitors Is Associated With Lower Risk of Colorectal Cancer in Men With Benign Colorectal Neoplasms

Gastroenterology, Journal Year: 2019, Volume and Issue: 157(3), P. 672 - 681.e4

Published: May 16, 2019

Language: Английский

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AttentionDDI: Siamese attention-based deep learning method for drug–drug interaction predictions

BMC Bioinformatics, Journal Year: 2021, Volume and Issue: 22(1)

Published: Aug. 21, 2021

Abstract Background Drug–drug interactions (DDIs) refer to processes triggered by the administration of two or more drugs leading side effects beyond those observed when are administered themselves. Due massive number possible drug pairs, it is nearly impossible experimentally test all combinations and discover previously unobserved effects. Therefore, machine learning based methods being used address this issue. Methods We propose a Siamese self-attention multi-modal neural network for DDI prediction that integrates multiple similarity measures have been derived from comparison characteristics including targets, pathways gene expression profiles. Results Our proposed model provides advantages: (1) It trained end-to-end, overcoming limitations models composed separate steps, (2) offers explainability via an Attention mechanism identifying salient input features (3) achieves similar better performance (AUPR scores ranging 0.77 0.92) compared state-of-the-art tested on various benchmark datasets. Novel predictions further validated using independent data resources. Conclusions find able accurately predict DDIs mechanism, typically in Natural Language Processing domain, can be beneficially applied aid explainability.

Language: Английский

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Underprescription of medications in older adults: causes, consequences and solutions—a narrative review

European Geriatric Medicine, Journal Year: 2021, Volume and Issue: 12(3), P. 453 - 462

Published: March 11, 2021

Language: Английский

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