European Journal of Clinical Pharmacology,
Год журнала:
2024,
Номер
80(4), С. 603 - 612
Опубликована: Фев. 6, 2024
Abstract
Purpose
This
study
aims
to
identify
PIM
prevalence
in
older
adults
according
the
2019
Beers
criteria,
Screening
Tool
of
Older
Person’s
Prescriptions
version
2
(STOPP
v2)
and
Portuguese
EU(7)-PIM
list
also
analyze
concordance
between
these
criteria.
Methods
A
retrospective
was
conducted
among
1200
(≥
65
years
old),
users
primary
health
care.
Demographic,
clinical,
pharmacological
data
were
collected
concerning
period
April
2021
August
2022.
comparative
analysis
performed
three
identification
determined
Lin
correlation
coefficient.
Results
The
mean
age
76.3
(SD
7.7)
old
57.6%
females.
Our
findings
indicate
varying
rates
criteria
with
63.8%
(95%
CI
61.0–66.6%),
66.8%
64.1–69.5%),
50.1%
47.2–53.0%)
take
at
least
one
list,
2019,
STOPP
v2
respectively.
highest
observed
for
proton
pump
inhibitors
(30.1%,
95%
27.6–32.9)
alprazolam
(10.1%,
8.4–11.9%).
poor
(<
0.834).
coefficient
found
(0.833),
lowest
(0.735).
Conclusion
reveals
adults,
as
assessed
by
different
highlights
need
targeted
interventions
improved
prescribing
practices.
In
future,
studies
should
focus
on
occurrence
negative
outcomes
associated
consumption.
Journal of the American Geriatrics Society,
Год журнала:
2024,
Номер
72(10), С. 3219 - 3238
Опубликована: Июнь 1, 2024
Polypharmacy
is
a
primary
risk
factor
for
the
prescription
of
potentially
inappropriate
medications
(PIMs),
drug-drug
interactions
(DDIs),
and
ultimately,
adverse
drug
reactions
(ADRs).
Medication
review
deprescribing
represent
effective
strategies
to
simplify
therapeutic
regimens,
minimize
risks,
reduce
PIM
prescriptions.
This
systematic
meta-analysis
experimental
observational
studies
aimed
evaluate
impact
different
medication
interventions
in
hospitalized
older
patients.
BMJ Quality & Safety,
Год журнала:
2024,
Номер
unknown, С. bmjqs - 017101
Опубликована: Май 24, 2024
Introduction
Deprescribing
(
medication
dose
reduction
or
cessation
)
is
an
integral
component
of
appropriate
prescribing.
The
extent
to
which
deprescribing
recommendations
are
included
in
clinical
practice
guidelines
unclear.
This
scoping
review
aimed
identify
that
contain
recommendations,
qualitatively
explore
the
content
and
format
estimate
proportion
recommendations.
Methods
Bibliographic
databases
Google
were
searched
for
published
English
from
January
2012
November
2022.
Guideline
registries
2017
February
2023.
Two
reviewers
independently
screened
records
containing
one
more
A
10%
sample
guideline
was
eligible
a
recommendation.
recommendation
characteristics
extracted
language
features
including
content,
form,
complexity
readability
examined
using
conventional
analysis
SHeLL
Health
Literacy
Editor
tool.
Results
80
316
included.
had
substantial
variability
their
terminology.
Most
contained
regarding
who
(75%,
n=60)
,
what
(99%,
n=89)
when
why
(91%,
n=73)
deprescribe,
however,
fewer
(58%,
n=46)
detailed
guidance
on
how
deprescribe.
Approximately
29%
identified
(n=14/49)
Conclusions
increasingly
being
incorporated
into
guidelines,
many
do
not
clear
actionable
deprescribe
may
limit
effective
implementation
practice.
co-designed
template
best
guide,
information
aspects
essential
preferred
by
end-users
should
be
developed
employed.
Trial
registration
number
osf.io/fbex4.
Journal of Global Health,
Год журнала:
2025,
Номер
15
Опубликована: Фев. 6, 2025
In
2018,
China
issued
a
set
of
criteria
for
effectively
identifying
and
managing
potentially
inappropriate
medication
(PIM)
use
in
older
adults.
However,
there
is
currently
lack
evidence
regarding
the
impact
these
on
PIM
among
Chinese
We
used
interrupted
time
series
analysis
prescription
data
outpatients
from
59
hospitals
six
major
geographic
regions
to
compare
changes
overall
prevalence
use,
stratified
by
different
numbers
PIMs,
top
five
PIMs
(i.e.
clopidogrel,
estazolam,
zolpidem,
sliding-scale
insulin,
alprazolam)
2015
(before)
2021
(after)
release
2018.
included
982
605
outpatients.
Compared
with
trends
prior
publication
criteria,
were
significant
decreases
coefficient
change
slope
(β
=
-0.607;
95%
confidence
interval
(CI)
-0.881,
-0.482;
P
<
0.001),
single
-0.368;
CI
-0.465,
-0.272;
multiple
-0.104;
-0.173,
-0.080;
0.019),
clopidogrel
-0.342;
-0.463,
-0.227;
0.006),
estazolam
-0.077;
-0.124,
-0.037;
0.009)
post-publication.
Conversely,
was
increase
after
released
0.030;
0.002,
0.057;
0.036).
found
that
has
had
positive
effect
its
China.
Frontiers in Pharmacology,
Год журнала:
2023,
Номер
14
Опубликована: Авг. 24, 2023
Background:
Older
patients
with
dementia
always
need
multiple
drugs
due
to
comorbidities
and
cognitive
impairment,
further
complicating
drug
treatment
increasing
the
risk
of
potentially
inappropriate
medication.
The
objective
our
study
is
estimate
global
prevalence
polypharmacy
medication
(PIM)
explore
factors
PIM
for
older
dementia.
Methods:
We
searched
PubMed,
Embase
(Ovid),
Web
Science
databases
identify
eligible
studies
from
inception
16
June
2023.
conducted
a
meta-analysis
observational
reporting
in
using
random-effect
model.
associated
were
meta-analyzed.
Results:
Overall,
62
included,
which
53
reported
28
polypharmacy.
pooled
was
43%
(95%
CI
38–48)
62%
52–71),
respectively.
Sixteen
referred
use,
15
pooled.
Polypharmacy
(2.83,
95%
1.80–4.44),
diabetes
(1.31,
1.04–1.65),
heart
failure
(1.17,
1.00–1.37),
depression
(1.45,
1.14–1.88),
history
cancer
(1.20,
1.09–1.32),
hypertension
(1.46,
1.05–2.03),
ischemic
disease
(1.55,
0.77–3.12),
any
cardiovascular
(1.11,
1.06–1.17),
vascular
(1.09,
1.03–1.16),
chronic
obstructive
pulmonary
(1.39,
1.13–1.72),
psychosis
(1.91,
1.04–3.53)
are
positively
use.
Conclusion:
highly
prevalent
Among
different
regions,
use
varied
widely.
Increasing
closely
For
other
such
as
diabetes,
prescribing
should
be
cautioned.
BMJ Open,
Год журнала:
2024,
Номер
14(1), С. e075325 - e075325
Опубликована: Янв. 1, 2024
Objective
To
investigate
the
association
between
older
patients’
willingness
to
have
one
or
more
medications
deprescribed
and:
(1)
change
in
medications,
(2)
appropriateness
of
and
(3)
implementation
prescribing
recommendations
generated
by
electronic
decision
support
system
tested
‘Optimising
PharmacoTherapy
In
Multimorbid
Elderly
Primary
CAre’
(OPTICA)
trial.
Design
A
longitudinal
sub-study
OPTICA
trial,
a
cluster
randomised
controlled
Setting
Swiss
primary
care
settings.
Participants
were
aged
≥65
years,
with
≥3
chronic
conditions
≥5
regular
recruited
from
43
general
practitioner
(GP)
practices.
Exposures
Patients’
was
assessed
using
three
questions
‘revised
Patient
Attitudes
Towards
Deprescribing’
(rPATD)
questionnaire
its
concerns
about
stopping
score.
Measures/analyses
Medication-related
outcomes
collected
at
1
year
follow-up.
Aim
outcome:
number
long-term
baseline
12
month
2
medication
(Medication
Appropriateness
Index).
3
binary
variable
on
whether
any
recommendation
during
review
implemented.
We
used
multilevel
linear
regression
analyses
(aim
aim
2)
logistic
3).
Models
adjusted
for
sociodemographic
variables
clustering
effect
GP
level.
Results
298
patients
completed
rPATD,
45%
women
78
years
median
age.
statistically
significant
found
score
over
time
(per
1-unit
increase
average
use
0.65
higher;
95%
CI:
0.08
1.22).
Other
than
that
we
did
not
find
evidence
associations
agreement
deprescribing
medication-related
outcomes.
Conclusions
an
most
measures
patient
year.
Trial
registration
NCT03724539
.
JAMA Network Open,
Год журнала:
2024,
Номер
7(6), С. e2417988 - e2417988
Опубликована: Июнь 21, 2024
Potentially
inappropriate
medication
(PIM)
exposes
patients
to
an
increased
risk
of
adverse
outcomes.
Many
lists
explicit
criteria
provide
guidance
on
identifying
PIM
and
recommend
alternative
prescribing,
but
the
complexity
available
limits
their
applicability
amount
data
prescribing.
Naunyn-Schmiedeberg s Archives of Pharmacology,
Год журнала:
2025,
Номер
unknown
Опубликована: Апрель 12, 2025
Antimicrobial
resistance
is
a
major
threat
to
public
health,
with
well-established
link
between
antibacterial
consumption
and
bacterial
resistance.
Stewardship
needs
focus
on
reducing
overall
optimising
the
quality
of
prescribing.
The
European
Union's
'One
Health'
approach
aims
for
at
least
65%
be
in
'Access'
category
AWaRe
framework
until
2030.
This
study
advances
field
by
shifting
from
simply
quantifying
nuanced
assessment
prescribing
quality.
Prudent
problematic
behaviour
identified
past
projected
trends,
both
individual
countries
regions.
Progress
towards
EU's
targets
human
sector
assessed
compared
total
consumption.
analyses
data
1997-2023
predicts
future
proportions
drug
classes
2030,
using
ARIMA(1,0,1)
model.
distribution
changes
groups
were
analysed
assess
behaviour.
Total
findings
targets,
bivariate
correlation
are
performed.
Robust
forecast
models
developed
classification
30
countries.
In
group
exceed
Iceland,
Denmark,
Ireland,
Latvia,
Finland,
France,
Netherlands,
Sweden,
Lithuania,
United
Kingdom,
Belgium
Estonia.
On
other
hand,
low
shares
expected
Greece
(43.8%),
Slovakia
Bulgaria
(45.9%),
Italy
(47.3%),
Malta
(49.9%),
Cyprus
(50.9%),
Hungary
(51.8%)
Romania
(53.4%).
10
fall
between,
ranging
56.4%
64.7%.
Of
particular
concern
Italy,
Malta,
low'Access'shares,
high
consumptions
worsening
contrast
exemplary
performance
Norway
Denmark.
Germany
stands
out
its
worryingly
excessive
use
'Reserve'.
Most
forecasts
considered
reliable,
although
some
showed
moderate
or
poor
fit.
predict
that
many
unlikely
meet
target
Countries
higher'Access'shares
lower
tend
have
levels
resistance,
while
those
patterns
face
higher
While
most
Northern
prudent
medicines,
observed
particularly
Southern
Eastern
Europe,
practice
being
apparent
across
medicine
classes.
Regional
differences
highlight
need
tailored
interventions.
For
certain
countries,
proportion
unclassified
substances
suggests
may
not
fully
capture
range
used.
