Attitudes of Older Adult Patients and Caregivers Towards Deprescribing of Medications in Ethiopia

Clinical Interventions in Aging, Journal Year: 2023, Volume and Issue: Volume 18, P. 1129 - 1143

Published: July 1, 2023

Deprescribing is essential for reducing inappropriate medication use and polypharmacy. For a holistic approach, it to know how older adult patients their caregivers perceive deprescribing.To assess the attitude of towards deprescribing at Ambo University Referral Hospital.Institutional-based cross-sectional study was conducted using revised Patients' Attitude Towards tool (rPATD). The data analyzed SPSS-25 software. Backward linear regression logistic were used measure association between outcome determinant variables. two-sided P-value ≤0.05 with 95% confidence interval utilized reporting significant factors.One hundred fifty-six (81.3%) respondents (ie, 85.0% 77.2% caregivers) agreed stop one or more regular medications if physician said possible despite 98 (51.0%) them 49.0% 53.3% being satisfied their/their care recipient's medications. On overall aggregate mean score, had neutral position (2.6-3.59) regarding burden concerns stopping whereas majority disagree (1.0-2.59) inappropriateness they taking (3.6-5.0) need involvement in treatment decision making. Concerns about medicine scores (AOR = 0.440, CI 0.262-0.741, P 0.035) perceived levels 0.653, 0.456-0.936, 0.020) significantly associated willingness discontinue satisfaction regimen respectively.The would like deprescribe physicians recommended it. medicines respectively. Healthcare providers should prompt process by addressing

Language: Английский

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Revisiting systematic reviews on deprescribing trials to better inform future practice and research

British Journal of Clinical Pharmacology, Journal Year: 2023, Volume and Issue: 89(12), P. 3758 - 3764

Published: July 31, 2023

Deprescribing aims to address the problem of medication overuse in older adults. There has been an increasing number systematic reviews 'deprescribing'. We aimed describe categories trials included recent reviews, and make recommendations for future research. categorized 122 eight deprescribing into: discontinuation, implementation, optimisation (including initiation) non-initiation trials. identified heterogeneity inconsistency reviews. For example, 39 (32.0%) involved initiation addition component. It is now time international researchers develop validate terminology used involving discontinuation/deprescribing medications, provide evidence synthesis that will better inform research, translation into practice policy.

Language: Английский

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Multidisciplinary medication review during older patient hospitalization according to STOPP/START criteria reduces potentially inappropriate prescriptions: MoPIM cohort study

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

Published: July 8, 2024

Abstract Purpose Multimorbidity and polypharmacy in older adults converts the detection adequacy of potentially inappropriate drug prescriptions (PIDP) a healthcare priority. The objectives this study are to describe clinical decisions taken after identification PIDP by pharmacists, using STOPP/START criteria, evaluate degree accomplishment these decisions. Methods Multicenter, prospective, non-comparative cohort patients aged 65 older, hospitalized because an exacerbation their chronic conditions. Each possible was manually identified pharmacist at admission initial decision multidisciplinary committee. At discharge, criteria were re-applied final recorded. Results From all (n = 674), 493 (73.1%) presented least one STOPP admission, significantly reduced up 258 (38.3%) discharge. A similar trend observed for START (36.7% vs. 15.7%). Regarding top 10 most prevalent committee initially agreed withdraw 257 (34.2%) modify 93 (12.4%) prescriptions. However, evaluation revealed that 503 (67.0%) those ultimately amended. For associated PIDP, decided initiate 149 (51.7%) prescriptions, while total 198 (68.8%) finally introduced Conclusions committee, through pharmacotherapy review, succeeded identifying reducing prescription inadequacy, both with high multimorbidity polypharmacy. Trial Registration NCT02830425.

Language: Английский

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The effects of applying artificial intelligence to triage in the emergency department: A systematic review of prospective studies

Journal of Nursing Scholarship, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 11, 2024

Abstract Introduction Accurate and rapid triage can reduce undertriage overtriage, which may improve emergency department flow. This study aimed to identify the effects of a prospective applying artificial intelligence‐based in clinical field. Design Systematic review studies. Methods CINAHL, Cochrane, Embase, PubMed, ProQuest, KISS, RISS were searched from March 9 April 18, 2023. All data screened independently by three researchers. The included studies that measured outcomes related AI‐based triage. Three researchers extracted assessed study's quality using Strengthening Reporting Observational Studies Epidemiology (STROBE) protocol. Results Of 1633 studies, seven met inclusion criteria for this review. Most applied machine learning triage, only one was based on fuzzy logic. except one, utilized five‐level classification system. Regarding model performance, feed‐forward neural network achieved precision 33% level 1 classification, whereas clip specificity sensitivity 99%. accuracy model's prediction ranged 80.5% 99.1%. Other time reduction, overtriage checks, mistriage factors, patient care prognosis outcomes. Conclusion Triage nurses use intelligence as supportive means Ultimately, we hope be resource positively affect health. Protocol Registration We have registered our PROSPERO (registration number: CRD 42023415232).

Language: Английский

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The current view of potentially inappropriate medications (PIMs) among older adults in Saudi Arabia: a systematic review

Frontiers in Pharmacology, Journal Year: 2023, Volume and Issue: 14

Published: Dec. 22, 2023

Introduction: Potentially inappropriate medications PIMs are common among elderly population and becoming a global health issue. It has been associated with negative consequences like preventable adverse drug reactions, hospitalization mortality. Objectives: To investigate the most commonly potentially in older adults Saudi Arabia. Additionally, we aim to gain insights into typical healthcare settings where providers offer services related PIMs. Methods: This is systematic review design using Preferred Reporting Items Systematic Reviews Meta-Analysis (PRISMA) statement. PubMed Google Scholar were used search for relevant studies following keywords (older adults, elderly, medications, PMIs, Arabia, Kingdom of Arabia) no restrictions date publications nor study language. Results: Only 8 have met our inclusion exclusion criteria, which was them cross-sectional (n = 6.75%) all conducted hospital-based settings. In addition, prevalence ranged from 19% 80% depends on site administration study. We found that proton pump inhibitors, non-steroidal anti-inflammatory drugs, aspirin, diuretics, gastrointestinal antidepressants reported included studies. Conclusion: The Arabia notably high 80%, underscoring need additional research assess existing practices within this vulnerable demographic across various

Language: Английский

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Identification of Barriers for Active Disease Management and of Medication-Related Problems through Therapeutic Patient Education in Older Home-Care Patients

Healthcare, Journal Year: 2024, Volume and Issue: 12(2), P. 231 - 231

Published: Jan. 17, 2024

Combining therapeutic patient education (TPE) with a medication review service could foster the adoption of appropriate lifestyles by patients and support care-providers in identifying strategies to improve quality prescribed care. This study aimed identify barriers experienced managing their diseases medication-related problems. was monocentric, case series, observational involving home-care from Local Health Authority ASL TO4. Patients were enrolled for TPE intervention where drug therapies habits collected through narrative interviews. Medication performed potentially inappropriate prescriptions (PIPs). Twenty (13 females) mean age 74.7 years enrolled. had an average 4.3 80.0% them treated ≥5 daily medications. The main PIPs involved ibuprofen, furosemide pantoprazole. qualitative analysis interviews identified seven macro-themes relating different aspects management: therapy; diseases; patient; journey; professionals; family caregivers; information. results this revealed some critical related treatment path healthcare professionals. These will be used plan educational interventions polypharmacy adherence understanding management diseases.

Language: Английский

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Person-centred medicine in the care home setting: development of a complex intervention

BMC Primary Care, Journal Year: 2024, Volume and Issue: 25(1)

Published: May 27, 2024

Abstract Background Person-centred medicine is recommended in the care of older patients. Yet, involvement home residents and relatives medication processes remains limited routine care. Therefore, we aimed to develop a complex intervention focusing on resident relative interprofessional communication support person-centred setting. Methods The development took place from October 2021 March 2022 Municipality Aarhus, Denmark. study followed Medical Research Council guidance using combination theoretical, evidence-based, partnership approaches. patient tool, PREparation Patients for Active Involvement Review (PREPAIR), was included preliminary model. Study activities developing programme theory, engaging stakeholders, exploring key uncertainties through interviews, co-producing workshops, testing with end-users an implementation strategy. Consolidated Framework Implementation Interprofessional Shared Decision Making Model were used. Data analysed rapid analysis approach. Results Before six four interviewed. Based their feedback, PREPAIR modified fit population. In total, ten persons participated including health professionals municipal managerial quality improvement staff. developed prototype tested three subsequently refined final intervention, two fixed components (PREPAIR template) delivered flexible three-stage workflow. Additionally, multi-component strategy formed. line supported professionals´ awareness about involvement. It provided structure involvement, empowered speak, brought new insights dialogue, thereby supporting medication-related decisions. perceived be relevant, acceptable, feasible Conclusion Our results indicate that may viable approach facilitate This will further explored planned feasibility study.

Language: Английский

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Prevalence of potentially inappropriate medications and prescription dynamics in elderly hospitalized patients in Spain

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

Published: Sept. 30, 2024

Language: Английский

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Potentially inappropriate prescription of medications to older adults who access a community pharmacy in Peru

Pharmacia, Journal Year: 2024, Volume and Issue: 71, P. 1 - 11

Published: Oct. 11, 2024

Polypharmacy in older adults is associated with a higher incidence of medication-related problems, such as pharmacological interactions, adverse reactions, and medication errors. This study aimed to identify evaluate potentially inappropriate prescription medications (PIP) using the screening tool persons’ prescriptions/screening alert doctors right treatment (STOPP/START) criteria representative community pharmacy Trujillo, Peru. The population sample consisted 158 subjects, 66.5% between 65 69 years old, 53.8% male, 77.9% receiving 3 4 medications. Medical prescriptions were analyzed explicit STOPP/START version 2 criteria, revealing that 93.7% patients presented STOPP (to stop medication) START start medication). most frequently identified criterion was gradual withdrawal benzodiazepines, while initiation antihypertensive systolic blood pressure > 160 mmHg diastolic 90 mmHg. Principal component analysis showed high prevalence PIP significantly (p < 0.05) number prescribed age decreases, medical diagnoses also decreases. It concluded there studied population, posing greater challenge adults, highlighting importance addressing prescribing practices involvement pharmacists.

Language: Английский

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Exploring virtual delivery of academic detailing to general practitioners compared with in-person delivery: a qualitative study

BMJ Open Quality, Journal Year: 2024, Volume and Issue: 13(4), P. e002444 - e002444

Published: Oct. 1, 2024

Background Inappropriate prescribing may have detrimental consequences for the patient and increase healthcare utilisation costs. Academic detailing (AD) is an interactive outreach method to deliver non-commercial evidence-based medical information professionals, aiming improve care. Performing AD virtually has recently become more relevant, especially with COVID-19 pandemic. Objectives The aim of this study was explore general practitioners’ (GP’s) experiences perceptions delivered AD. Methods We invited practicing GPs that had received virtual in Norway during autumn 2020. Semistructured individual interviews were audio video recorded February–May 2021. Interviews transcribed analysed applying thematic analysis according Braun Clarke. Results From nine GPs, we identified five themes concerning (1) informants’ satisfaction their opinions about detailers characteristics, (2) factors are important participation AD, campaign topic being most important, (3) a paradox between desire time discussion constraint they facing, (4) many benefits compared in-person (5) perceived learning outcomes unaffected by mode delivery. Conclusion Virtual worked very well terms scheduling visit, using technology facilitate visit achieving same outcomes. should be offered as alternative traditional remote geographical areas or circumstances when physical challenging.

Language: Английский

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