International Anesthesiology Clinics, Год журнала: 2023, Номер unknown
Опубликована: Фев. 22, 2023
aDepartment of Anesthesiology & Critical Care Medicine, University New Mexico, Albuquerque, Mexico bDepartment Pharmacy, Hospital, address correspondence to: Rebecca M. Gerlach, MD, Department MSC10 6000 1 NM 87131. E-mail: [email protected]
Язык: Английский
Healthcare, Год журнала: 2023, Номер 11(3), С. 422 - 422
Опубликована: Фев. 1, 2023
The demand for long-term care is expected to increase due the rising life expectancy and increased prevalence of illnesses. Nursing home residents are at an risk suffering adverse drug events inadequate prescriptions. main objective this systematic review collect analyze potentially prescriptions based on new version STOPP/START criteria in specific population. Databases (PubMed, Web Science Cochrane) were searched inappropriate prescription use nursing homes according second criteria. bias was assessed with STROBE checklist. A total 35 articles eligibility. One hundred forty more than 6900 evaluated through analysis 13 studies last eight years. reviewed literature returned ranges between 67.8% 87.7% STOPP criteria, START ranged from 39.5% 99.7%. factors associated presence age, comorbidities, polypharmacy. These data highlight that, although initially developed community-dwelling older adults, its may be a starting point help detect efficiently institutionalized patients. We hope that will draw attention need medication monitoring systems vulnerable
Язык: Английский
Процитировано
13
PLoS ONE, Год журнала: 2024, Номер 19(6), С. e0305215 - e0305215
Опубликована: Июнь 17, 2024
Objective The growing deprescribing field is challenged by a lack of consensus around evidence and knowledge gaps. objective this overview systematic reviews was to summarize the review for interventions in older adults. Methods 11 databases were searched from 1 st January 2005 16 th March 2023 identify reviews. We summarized synthesized results two steps. Step reported included (including meta-analyses). 2 involved narrative synthesis outcome. Outcomes medication-related outcomes ( e . g ., medication reduction, appropriateness) or twelve other mortality, adverse events). according subgroups (patient characteristics, intervention type setting) when direct comparisons available within quality assessed using A MeaSurement Tool Assess Reviews (AMSTAR 2). Results retrieved 3,228 unique citations 135 full-text articles eligibility. Forty-eight (encompassing 17 meta-analyses) included. Thirty-one 48 had general focus, focused on specific classes therapeutic categories one both. Twelve meta-analyzed (33 outcomes: 25 favored intervention, 7 found no difference, comparison). indicated that most resulted some reduction while we primarily an effect. mixed events few drug withdrawal events. Limited information people with dementia, frailty multimorbidity. All but scored low critically assessment. Conclusion Deprescribing likely outcomes, particular relating events, vulnerable settings limited. Future research should focus designing studies powered examine harms, patient-reported effects subgroups. Systematic Review Registration PROSPERO CRD42020178860
Язык: Английский
Процитировано
4
Journal of Perioperative Practice, Год журнала: 2025, Номер unknown
Опубликована: Фев. 26, 2025
Polypharmacy is becoming more prevalent due to an ageing population. As patients are undergoing surgical procedures, it important determine which group of at higher risk poorer outcomes. This review aimed provide a summary existing literature and if polypharmacy associated with perioperative outcomes identify any gaps in the literature. systematic was conducted using electronic databases PubMed, Embase Web Science from their inception December 2024. Statistical analysis performed generic inverse variance method. We identified 45 eligible studies different countries populations. Thirty-two (71.11%) defined as use five or medications. significantly postoperative delirium (odds ratio = 1.62, 95% confidence interval 1.32–1.98, I 2 0%). Although found be delirium, relationship between remains complex.
Язык: Английский
Процитировано
0
Journal of Pharmacy Practice and Research, Год журнала: 2025, Номер unknown
Опубликована: Апрель 10, 2025
Abstract Background A number of commonly used psychotropic medicines increase the risk postoperative delirium. In some cases, these could be safely tapered or held prior to planned surgery, which may reduce incidence However, frequency with patients use surgery is unknown. Aim To determine prevalence opioid analgesic, antidepressant, gabapentinoid, and benzodiazepine delirium screening before after in older using high‐risk medicines. Method We conducted a retrospective analysis electronic medical records (EMRs) from four acute‐care hospitals. Patients aged 65 years who underwent over 2‐week period were included. Data relating patient age, gender, type surgical procedure, length anaesthesia, medications on admission, 4AT tests extracted EMRs. This project was exempt due local policy requirements that constitute research by Central Adelaide Local Health Network (CALHN) Human Research Ethics Committee (Reference no: CALHN19857). The justification for this ethics exemption as follows: complies National Medical Council's statement ethical conduct human , met an audit activity, presented no foreseeable harm. Results study included 158 participants median age 75 years, whom 41% taking medicine associated increased their admission; 21% 15% 13% benzodiazepine, 6% gabapentinoid at time admission. addition, 80% had test 61% received least one surgery. Conclusion Among undergoing delirium, not all
Язык: Английский
Процитировано
0
Опубликована: Март 4, 2024
The Brain-Computer Interface (BCI) technology has emerged as a groundbreaking innovation with profound implications across diverse domains, particularly in healthcare. By establishing direct communication pathway between the human brain and external devices, BCI systems offer unprecedented opportunities for diagnosis, treatment, rehabilitation, thereby reshaping landscape of medical practice. However, despite its immense potential, widespread adoption clinical settings faces several challenges. These include need robust signal acquisition processing techniques, ensuring user safety privacy, addressing ethical considerations, optimizing training adaptation. Overcoming these challenges is crucial to unleashing complete potential healthcare realizing promise personalized, patient-centric care. This review work underscores transformative revolutionizing paper offers comprehensive analysis medical-oriented applications by exploring various uses transform patient
Язык: Английский
Процитировано
1
Acta Pharmaceutica, Год журнала: 2024, Номер 74(2), С. 249 - 267
Опубликована: Май 30, 2024
Abstract This umbrella review examined systematic reviews of deprescribing studies by characteristics intervention, population, medicine, and setting. Clinical humanistic outcomes, barriers facilitators, tools for are presented. The Medline database was used. search limited to meta-analyses published in English up April 2022. Reviews reporting were included, while those where depre-scribing not planned supervised a healthcare professional excluded. A total 94 (23 meta--analyses) included. Most explored clinical or outcomes (70/94, 74 %); less attitudes, (17/94, 18 few focused on (8/94, 8.5 %). assessing divided into two groups: with intervention trials (39/70, 56 %; 16 reviewing specific interventions 23 broad medication optimisation interventions), cessation (31/70, 44 Deprescribing feasible resulted reduction inappropriate medications . Complex shown reduce hospitalisation, falls, mortality rates. In trials, higher frequency adverse drug withdrawal events underscores the importance prioritizing patient safety exercising caution when stopping medicines, particularly patients clear appropriate indications.
Язык: Английский
Процитировано
1
Journal of Pharmacy Practice and Research, Год журнала: 2022, Номер 52(5), С. 391 - 401
Опубликована: Окт. 1, 2022
Abstract The average age of surgical candidates is increasing with the ageing population worldwide. Major surgery in older patients associated a significant risk complications due to physiologic changes occurring and individual patient factors such as frailty, polypharmacy, multimorbidity. Periodic medication review should be part routine management all patients, perioperative period presenting an opportune time for this review. Regular medications may need short‐term modification during period. Medications implicated inducing or worsening delirium identified withdrawal considered ahead time. Perioperative commencement aimed at reducing other complications, including cardiovascular events, on basis, analysing risks benefits. Comprehensive careful planning through enhance prospects recovery reduce morbidity mortality patients.
Язык: Английский
Процитировано
5
Drugs & Aging, Год журнала: 2023, Номер 40(4), С. 335 - 342
Опубликована: Март 2, 2023
Prescribing of potentially inappropriate medications and under-prescribing guideline-recommended for cardiovascular risk modification have both been associated with negative outcomes in older adults. Hospitalisation represents an important opportunity to optimise medication use may be achieved through geriatrician-led interventions. We aimed evaluate whether implementation a novel model care called Geriatric Comanagement Vascular (GeriCO-V) surgery patients is improvements prescribing. used prospective pre-post study design. The intervention was geriatric co-management model, where geriatrician delivered comprehensive assessment-based interventions including routine review. included consecutively admitted the vascular unit at tertiary academic centre aged ≥ 65 years expected length stay 2 days who were discharged from hospital. Outcomes interest prevalence least one as defined by Beers Criteria admission discharge, rates cessation present on admission. In subgroup peripheral arterial disease, discharge determined. There 137 pre-intervention group (median [interquartile range] age: 80.0 [74.0–85.0] years, 83 [60.6%] disease) 132 post-intervention 79.0 (73.0–84.0) 75 [56.8%] disease). no change either (pre-intervention: 74.5% vs 75.2% discharge; post-intervention: 72.0% 72.7%, p = 0.65). Forty-five percent had ceased, compared 36% (p 0.11). A higher number disease antiplatelet agent therapy (63 [84.0%] 53 [63.9%], 0.004) lipid-lowering (58 [77.3%] 55 [66.3%], 0.12). improvement prescribing patients. high this population, not reduced co-management.
Язык: Английский
Процитировано
2
Current Geriatrics Reports, Год журнала: 2024, Номер 13(3), С. 152 - 161
Опубликована: Июнь 27, 2024
Abstract Purpose of Review Deprescribing, systematically discontinuing unnecessary or harmful medications, gains importance in healthcare. With rising polypharmacy concerns, optimizing medication management is crucial. This article explores deprescribing within interprofessional teams emphasizing collaborative efforts to address and improve patient outcomes. It examines the necessity effectiveness collaboration initiatives, with a focus on diverse healthcare professionals regimens. Recent Findings Polypharmacy, characterized by simultaneous use multiple poses significant challenges, highlighting deprescribing. Interprofessional collaboration, supported evidence, has demonstrated efficacy reducing improving Furthermore, providers contribute valuable expertise identifying patients who may benefit from non-pharmacological interventions. Summary Successful relies assess appropriateness, mitigate risks, tailor plans preferences. Screening tools identify inappropriate polypharmacy, while frameworks action steps guide implementation. Integrating interventions prioritizing safety enhance care quality for older adults.
Язык: Английский
Процитировано
0
FARMACIA, Год журнала: 2023, Номер 71(3), С. 463 - 470
Опубликована: Июнь 29, 2023
As the elderly population is increasing globally, more and geriatric patients are expected to undergo surgical interventions.With age, incidence of comorbidities also higher, with these being in a significant proportion subject polypharmacy.The present paper comprehensive review prevalence, cause, specific risks associated polypharmacy undergoing elective procedures.The possible implications on hospital stay, perioperative morbidity, healthcare expenditure strategies minimize risk adverse events course due presented.Polypharmacy has high prevalence older can be attributed multiple patient doctor-related causes.Adverse drug reactions significantly number personal medications represent an avoidable cause morbidity.The most frequent complications falls, cardiac events, hemorrhages, postoperative cognitive impairment, delirium.Preoperative management should include medication multidisciplinary approach.Further directions study for deprescribing implementing software tools assess inappropriate associations help clinicians interactions. RezumatCum la nivel global media de vârstă este din ce în mai mare, se așteaptă ca tot mulți pacienți geriatrici să fie supuși intervențiilor chirurgicale.Odată cu vârsta, incidența comorbidităților este, asemenea, acești fiind într-o proporție semnificativă polimedicației.Ne-am propus realizarea unei prezentări cuprinzătoare prevalenței, cauzelor și riscurilor specifice asociate polimedicației persoanele care suferă proceduri chirurgicale elective.Administrarea concomitentă unui număr mare medicamente o prevalență ridicată pacienții vârstnici poate fi atribuită multor cauze legate pacient medic.Reacțiile sunt mod semnificativ numărul individuale reprezintă cauză evitabilă morbidității perioperatorii.Cele frecvente complicații ale căderile, evenimentele cardiace, sângerările, afectarea cognitivă postoperatorie delirul.Gestionarea preoperatorie polifarmaciei trebuie includă revizuire medicamentelor şi abordare multidisciplinară.Alte direcții studiu includ strategii pentru implementarea instrumentelor pot evalua asociațiile inadecvate medicamente, ajutând astfel clinicienii minimizeze riscul interacțiunilor medicamentoase.
Процитировано
1