Impact of the expert consensus on polypharmacy and potentially inappropriate medication use in elderly lung cancer outpatients with multimorbidity: An interrupted time series analysis, 2016–2021 DOI Creative Commons
Fangyuan Tian, Zhaoyan Chen, Rui Tang

et al.

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

Published: Oct. 5, 2022

Objectives: Elderly lung cancer patients often have chronic diseases other than cancer. Therefore, this kind of population is accompanied by polypharmacy. This situation and the resulting potentially inappropriate medication (PIM) use are an increasing global concern. In context, Chinese Association Geriatric Research issued expert consensus on safety management However, long- short-term effects polypharmacy PIM not clear. Methods: The study was conducted in Chengdu, a city southwestern China, consisting prescriptions for elderly outpatients with multimorbidity (cancer diseases) from January 2016 to December 2021. 2019 Beers criteria were used evaluate use, interrupted time series analysis longitudinal effectiveness measuring prevalence use. We R software version 4.2.0 data analysis. Results: A total 7,238 outpatient included study. After publication consensus, level (β = -10.273, P < 0.001) decreased, but trend 0.158, p 0.855) increased. decreased abruptly -22.828, after intervention, long-term still upward 0.907, 0.916). Conclusion: hospitals Chengdu optimal. Future research interventions rationing needed.

Language: Английский

Prevalence of Use of Potentially Inappropriate Medications Among Older Adults Worldwide DOI Creative Commons
Fangyuan Tian, Zhaoyan Chen, Yachao Zeng

et al.

JAMA Network Open, Journal Year: 2023, Volume and Issue: 6(8), P. e2326910 - e2326910

Published: Aug. 2, 2023

Importance The use of potentially inappropriate medications (PIMs) is widespread yet continues to receive little attention in outpatient services. Objective To estimate the overall prevalence PIM Data Sources PubMed, Embase, and Web Science were searched identify relevant studies published from January 1, 1990, November 21, 2022. Study Selection Observational that reported among older patients services screened. Extraction Synthesis Two reviewers independently selected eligible articles, extracted data, assessed risk bias. A random-effects meta-analysis was conducted pool estimates. Main Outcomes Measures global patterns estimated, temporal trends regional differences investigated. Results total 94 articles with 132 estimates analyzed, including nearly 371.2 million participants 17 countries. Overall, pooled 36.7% (95% CI, 33.4%-40.0%). Africa had highest (47.0%; 95% 34.7%-59.4%), followed by South America (46.9%; 35.1%-58.9%), Asia (37.2%; 32.4%-42.2%), Europe (35.0%; 28.5%-41.8%), North (29.0%; 22.1%-36.3%), Oceania (23.6%; 18.8%-28.8%). In addition, low-income areas. Use PIMs has become increasingly prevalent past 2 decades. Conclusions Relevance This study different groups, such as geographic regions World Bank countries, suggests noticeable environment economic income burden Furthermore, high trend decades indicates be worthy attention.

Language: Английский

Citations

78
Prescription of potentially inappropriate medicines and comparison with lists of essential medicines for treatment of chronic disorders in older patients DOI Creative Commons
Juan Gu, Sijia Li, Anyong Yu

et al.

Archives of Gerontology and Geriatrics, Journal Year: 2023, Volume and Issue: 109, P. 104939 - 104939

Published: Jan. 26, 2023

To examine the current situation of potentially inappropriate medicines (PIM) for treatment chronicity in older patients and whether were included 22nd World Health Organization (WHO) Model List Essential Medicines (EMLs), China National list (China EMLs), or supplementary essential Guizhou Province 2018 (Guizhou EMLs) through real world data, so as to promote development lists suitable provide a reference revision reduce adverse effects, drug-induced diseases even possible death due use existing medicines.A retrospectively study was conducted. Dispensing records aged ≥ 65 admitted convenience clinic tertiary hospital from January 1, 2021 December 31, extracted electronic information system. Then, we merged dispensing same patient on date one record with at least chronic disease included. The American Geriatrics Society(AGS)/Beers Criteria 2019 (Beers 2019) used evaluate PIM status. Thereafter, compared WHO EMLs, EMLs find out percentages drugs PIMs above all PIMs. evaluation conducted using Excel software (version 2019).A total 5314 reports this study. 5.95% (316/5314), 7.88% (419/5314) met Table 2 (medicines that are most adults), 4 should be caution) Beers 2019, respectively. Among which 47.37%, 78.95%, 78.95% respectively 47.06%, 76.47%, 82.35% 2019.PIM is common clinical practice. Patients diabetes, hypertension, arthritis, depression and/or anxiety Parkinson' more frequently prescribed according 2019. Take into consideration formulate special may key way PIM.

Language: Английский

Citations

2
Development and validation of a nomogram to predict the risk of potentially inappropriate medication use in older lung cancer outpatients with multimorbidity DOI
Fangyuan Tian, Zhaoyan Chen, Bin Wu

et al.

Expert Opinion on Drug Safety, Journal Year: 2023, Volume and Issue: 22(8), P. 725 - 732

Published: Feb. 21, 2023

At present, there is no predictive model that can predict the prevalence of potentially inappropriate medication (PIM) use in older lung cancer outpatients.We measured PIM by 2019 Beers criteria. Significant factors were identified to develop nomogram using logistic regression. We validated internally and externally two cohorts. The discrimination, calibration, clinical practicability verified receiver operating characteristic (ROC) curve analysis, Hosmer-Lemeshow test, decision analysis (DCA), respectively.A total 3300 outpatients divided into a training cohort (n = 1718) validation cohorts, including an internal 739) external 843). A for predicting patients was developed six significant factors. ROC showed area under 0.835 0.810 0.826 respectively. Hosmer‒Lemeshow test yielded P 0.180, 0.779 0.069, demonstrated high net benefit DCA.The could be convenient, intuitive, personalized tool assessing risk outpatients.

Language: Английский

Citations

2
Use of potentially inappropriate medications and medications of concern in older adults with multiple myeloma DOI Creative Commons
Paulo Vitor Rozario da Silva, Cristiane Aparecida Menezes de Pádua, Taísa Roberta Lopes Machado

et al.

Geriatrics Gerontology and Aging, Journal Year: 2024, Volume and Issue: 18

Published: Jan. 1, 2024

Objectives: To analyze the use of potentially inappropriate medications (PIMs) and used in supportive therapy that require caution older adults with cancer, addition to determining associated factors agreement between criteria sets identify PIMs. Methods: This cross-sectional study included individuals multiple myeloma aged ≥ 60 years who were undergoing outpatient treatment. PIMs identified according American Geriatric Society Beers 2019, PRISCUS 2.0, Brazilian Consensus on Potentially Inappropriate Medicines criteria. Medications concern defined National Comprehensive Cancer Network Factors using logistic regression. The degree 3 was measured Cohen’s kappa coefficient. Results: frequency PIM 52.29% criteria, 62.74% 65.36% while patients concern. Agreement Beers, PRISCUS, high, it excellent In final regression model, polypharmacy each set, as well Conclusions: high. about Consensus, high or excellent. There an independent association by myeloma.

Language: Английский

Citations

0
Utilização de medicamentos potencialmente inapropriados e medicamentos que requerem cautela em idosos com mieloma múltiplo DOI Creative Commons
Paulo Vitor Rozario da Silva, Cristiane Aparecida Menezes de Pádua, Taísa Roberta Lopes Machado

et al.

Geriatrics Gerontology and Aging, Journal Year: 2024, Volume and Issue: 18

Published: Jan. 1, 2024

Objetivo: Analisar o uso de medicamentos potencialmente inapropriados (MPIs) e usados em terapia suporte que requerem cautela idosos com câncer (MTSRCICs), determinando os fatores associados. Visou-se também determinar a concordância entre critérios explícitos empregados na identificação MPI. Metodologia: Estudo transversal indivíduos mieloma múltiplo (MM), idade ≥ 60 anos tratamento ambulatorial. Os MPI foram identificados acordo AGS Beers 2019, PRISCUS 2.0 Consenso Brasileiro Medicamentos Potencialmente Inapropriados (CBMPI). MTSRCIC definidos National Comprehensive Cancer Network. associados ao por regressão logística múltipla. O grau três no estudo foi mensurado pelo coeficiente kappa Cohen. Resultados: As frequências 52,29% (AGS 2019), 62,74% (CBMPI), 65,36% (PRISCUS 2.0) (MTSRCICs). concordâncias 2019 2,0 CBMPI altas, enquanto excelente. No modelo final polifarmácia associada positivamente para utilizados, além associado à utilização MTSRCICs. Conclusões: A frequência do elevada. relação alta ou apresentou associação independente positiva MPIs MTSRCICs pacientes MM.

Citations

0
Association of potentially inappropriate medications with prognosis among older patients with non-small cell lung cancer DOI Creative Commons
Zhuo Ma, Man Xu,

Mengyuan Fu

et al.

BMC Geriatrics, Journal Year: 2024, Volume and Issue: 24(1)

Published: June 25, 2024

Abstract Background Potentially inappropriate medications (PIMs) are common among older adults with cancer, but their association overall survival (OS) non-small cell lung cancer (NSCLC) patients remains unclear. This study aimed to investigate the between use of PIMs and OS in NSCLC. Methods In this cohort study, we included ≥ 65 years newly diagnosed NSCLC from January 2014 December 2020. medication (PIM) is defined by Beers criteria 2019 at baseline within six months following initiation systemic therapy. Multivariable Cox regression model was built assess (OS). Results We finally 338 a median follow-up for 1777 days. The prevalence receiving least one PIM 39.9% (135/338) 61.2% (71/116) after therapy, respectively. most important factor associated number prescribed ( P < 0.001). Baseline therapy were significantly inferior (476 days vs. 844 days, = 0.044; 633 1600 0.007; respectively). multivariable analysis, both independent predictors poor prognosis (adjusted HR, 1.33; 95% CI, 1.01–1.75; 0.041; adjusted 1.86; 1.11–3.14; 0.020; Conclusions prevalent prognosis. There an urgent need clinicians conduct reconciliation appropriate deprescribing population, especially multiple PIMs.

Language: Английский

Citations

0
Impact of the expert consensus on polypharmacy and potentially inappropriate medication use in elderly lung cancer outpatients with multimorbidity: An interrupted time series analysis, 2016–2021 DOI Creative Commons
Fangyuan Tian, Zhaoyan Chen, Rui Tang

et al.

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

Published: Oct. 5, 2022

Objectives: Elderly lung cancer patients often have chronic diseases other than cancer. Therefore, this kind of population is accompanied by polypharmacy. This situation and the resulting potentially inappropriate medication (PIM) use are an increasing global concern. In context, Chinese Association Geriatric Research issued expert consensus on safety management However, long- short-term effects polypharmacy PIM not clear. Methods: The study was conducted in Chengdu, a city southwestern China, consisting prescriptions for elderly outpatients with multimorbidity (cancer diseases) from January 2016 to December 2021. 2019 Beers criteria were used evaluate use, interrupted time series analysis longitudinal effectiveness measuring prevalence use. We R software version 4.2.0 data analysis. Results: A total 7,238 outpatient included study. After publication consensus, level (β = -10.273, P < 0.001) decreased, but trend 0.158, p 0.855) increased. decreased abruptly -22.828, after intervention, long-term still upward 0.907, 0.916). Conclusion: hospitals Chengdu optimal. Future research interventions rationing needed.

Language: Английский

Citations

1