Drugs & Aging, Год журнала: 2023, Номер 40(6), С. 573 - 583
Опубликована: Май 6, 2023
Язык: Английский
Immunology and Allergy Clinics of North America, Год журнала: 2016, Номер 36(2), С. 261 - 278
Опубликована: Март 10, 2016
Язык: Английский
Процитировано
212
JAMA Network Open, Год журнала: 2023, Номер 6(8), С. e2326910 - e2326910
Опубликована: Авг. 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.
Язык: Английский
Процитировано
77
Frontiers in Neuroscience, Год журнала: 2019, Номер 13
Опубликована: Дек. 5, 2019
Drugs with anticholinergic action are widely prescribed in the elderly population due to their potential clinical benefits. However, these benefits limited by adverse effects which may be serious particular circumstances. This review presents different aspects of use anticholinergics old age a focus psychogeriatric patients. We critically published data on and disadvantages anticholinergics, often controversial. Prevalence, pathophysiology measurement methods drugs discussed. also present most important drawbacks resulting from its use, including cognition healthy cognitively impaired people, aged schizophrenia patients, emergence delirium psychiatric symptoms, influence functionality, hospitalization, institutionalization mortality, limitations discontinuation. Finally, we suggest practical recommendations for safe conditions affecting such as dementia, acute hallucinatory episodes, depression, anxiety, Parkinson's disease, cardiovascular urinary incontinence.
Язык: Английский
Процитировано
111
Therapeutic Advances in Drug Safety, Год журнала: 2016, Номер 8(1), С. 31 - 46
Опубликована: Окт. 1, 2016
Multimorbidity and polypharmacy are increasingly prevalent across healthcare systems settings as global demographic trends shift towards increased proportions of older people in populations. Numerous studies have demonstrated an association between potentially inappropriate prescribing (PIP), reported high prevalence PIP care Europe North America and, a consequence, risk adverse drug reactions, utilization, morbidity mortality. These not focused specifically on with dementia, despite the reactions this patient cohort. This narrative review considers evidence currently available area, including examining how appropriateness is assessed, medications most commonly implicated, clinical consequences, research priorities to optimize for vulnerable group. Although there has been considerable effort develop criteria assess medication recent years, majority tools do focus dementia. Of limited number available, advanced stages dementia which life expectancy limited. The development mild moderate or full spectrum disease severity represents important gap literature beginning attract interest, considering regimen whole, misprescribing, overprescribing underprescribing certain medications/medication classes, anticholinergics, psychotropics, antibiotics analgesics. Further work required validation population, determine large cohorts variants severities, examine impact health outcomes.
Язык: Английский
Процитировано
97
European Journal of Clinical Pharmacology, Год журнала: 2019, Номер 75(4), С. 467 - 481
Опубликована: Янв. 4, 2019
Older people with dementia are at risk of adverse events associated potentially inappropriate prescribing. Aim: to describe (1) how international tools designed identify prescribing have been used in studies older dementia, (2) the prevalence this cohort and (3) advantages/disadvantages Systematic literature review, reported according Preferred Reporting Items for Review Meta-Analysis Protocols (PRISMA-P). MEDLINE, EMBASE, PsychInfo, CINAHL, Cochrane Library, Social Science Citation Index, OpenGrey, Base, GreyLit, Mednar National Database Ageing Research were searched April 2016 describing use a tool or criteria dementia. Three thousand three hundred twenty-six unique papers identified; 26 included review. Eight more than one There variations applied. The Beers most commonly tool. Thirteen 15 using did not full ranged from 14 74% Benzodiazepines, hypnotics anticholinergics common inappropriately prescribed medications. Variations application may least part explain across studies. Recommendations include standardised usage ensuring comprehensive enough all medications kept up date.
Язык: Английский
Процитировано
74
Drugs & Aging, Год журнала: 2021, Номер 38(11), С. 977 - 994
Опубликована: Ноя. 1, 2021
Patients taking medication with high anticholinergic and sedative properties are at increased risk of experiencing poor cognitive physical outcomes. Therefore, precise quantification the cumulative burden their drug regimen is advisable. There no agreement regarding which scale to use simultaneously quantify associated medications. The objective this review was assess strengths limitations available tools medication-related load in older adults. We discuss specific agreements between currently scales models propose a comprehensive table combining drugs categorized as high, moderate, low, or activity excerpted from selected studies. A targeted search carried out using National Library Medicine through PubMed medical subject heading terms text words around following terms: (anticholinergic OR sedative) AND (load scale) for studies published 1 January 1945 5 June 2021. In addition, databases were searched same MEDLINE-EBSCO, APA PsycInfo, CINAHL Plus, Cochrane Library, Scopus, OAIster, OVID-MEDLINE, Web Science, Google Scholar. Screening by titles followed an abstract full-text review. After blind evaluation, reviewers reached establish characteristics categories. 3163 articles identified, 13 included: 11 assigned scores two drugs. Considerable variability observed; included 27 548 generated activities evaluated proposed categorization these based on scientific clinical evidence. Our combines information about 642 categorizes 44, 25, 99, 474 activity, respectively. Variability inconsistency exists among used categorize burden. review, we provide that proposes new longitudinal study will be required validate catalog evidence-based manner.
Язык: Английский
Процитировано
45
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.
Язык: Английский
Процитировано
19
BMJ Open, Год журнала: 2020, Номер 10(1), С. e029172 - e029172
Опубликована: Янв. 1, 2020
Objectives Dementia frequently occurs alongside comorbidities. Coexisting conditions are often managed with multiple medications, leading to increased risk of potentially inappropriate medication and adverse drug reactions. We aimed estimate prevalence of, identify factors reported be associated with, prescribing (PIP) for older individuals diagnosed dementia. Design used a state-of-the-art review approach, selecting papers written in English published from 2007 January 2018. Publications were retrieved Scopus Web Science databases. Inclusion criteria included formal diagnosis dementia, classification PIP as an outcome. Random effects models provide pooled PIP. The Appraisal tool Cross-Sectional Studies (AXIS tool) was assess bias the studies. Results bibliographic search yielded 221 citations, 12 studies meeting inclusion criteria. estimates people living dementia ranged 14% 64%. Prevalence 31% (95% CI 9 52) community, 42% 30 55) nursing/care homes. likely related (eg, hypnotics sedative cholinesterase inhibitors) treatment comorbidities cardiovascular drugs non-steroidal anti-inflammatory medication). Higher levels comorbidity PIP; however, only one study investigated associations specific Conclusion remains significant issue healthcare management PIP, but driving this increase remain unknown. Further work is necessary investigate presence common patients
Язык: Английский
Процитировано
45
Journal of Alzheimer s Disease, Год журнала: 2016, Номер 55(2), С. 691 - 701
Опубликована: Окт. 7, 2016
Background: Potentially inappropriate medication (PIM) in older people is a risk factor for adverse drug effects.This even higher with dementia (PWD).Objective: Our study aimed to determine (1) the prevalence of PIM among primary care patients who were screened positive and (2) sociodemographic clinical variables associated use PIM.Methods: DelpHi-MV (Dementia: life-and person-centered help Mecklenburg-Western Pomerania) general practitioner-based, cluster-randomized, controlled intervention implement evaluate an innovative concept collaborative management Germany.The comprehensive baseline assessment includes home review.The present analyses are based on data from 448 participants (age 70+, DemTect <9).PIMs identified using list Inappropriate Medications Elderly (Priscus).Results: A total 99 (22%) received at least one PIM.The highest was found antidepressants, benzodiazepines, analgetics.The most frequently prescribed PIMs amitriptyline, etoricoxib, doxazosin.(2) Use significantly diagnosis mental or behavioral disorder.Conclusions: The prescription rate community-dwelling PWD comparable rates population Germany (20-29%).Antidepressants anticholinergic properties long-acting benzodiazepines PIMs, despite having unfavorable benefit-risk ratio.This high prescriptions vulnerable indicates that standard should include careful review management.
Язык: Английский
Процитировано
45
Journal of Alzheimer s Disease, Год журнала: 2017, Номер 60(2), С. 349 - 358
Опубликована: Сен. 1, 2017
There is limited evidence regarding the association between potentially inappropriate medications (PIM) and mortality in older people with cognitive impairment.To examine whether use of considered to be impairment (PIMcog) anticholinergic burden (ACB) were associated who attended memory clinics.Cross-sectional longitudinal analyses data from Prospective Research In MEmory clinics (PRIME) study. Participants community-dwelling nine had a diagnosis mild or dementia. PIMcog was defined as any medication for person according Beers STOPP criteria. Anticholinergic calculated using ACB scale. Time-dependent Cox-proportional hazards regression used analyze associations use/ACB score all-cause over three-year follow-up period. The model included baseline variables: age, gender, education, diagnoses, total number medications, disease-burden, cognition, physical function, neuropsychiatric symptoms.Of 964 participants, 360 (37.3%) one more at some time during study; most commonly anticholinergics sedatives. 624 (64.7%) participants potential definite properties (ACB>0) point Both (adjusted hazard ratio: 1.42 95% CI: 1.12-1.80) 1.18 1.06-1.32) mortality.Use PIMcogs common among clinic patients both mortality.
Язык: Английский
Процитировано
43