Polypharmacy in Type 2 Diabetes Patients of the PROLANIS Program in Indonesia: Identification of Potential Drug-Drug Interaction

Jordan Journal of Pharmaceutical Sciences, Год журнала: 2025, Номер 18(1), С. 245 - 257

Опубликована: Март 25, 2025

The identification of potential drug-drug interactions (pDDIs) becomes critical in evaluating medication safety among diabetes mellitus patients. This study aimed to identify the pDDIs polypharmacy type 2 (T2D) patients Chronic Disease Management Program or Pengelolaan Penyakit Kronis (PROLANIS) Program. T2D aged ≥18 were selected consecutively. A total sample prescriptions containing ≥5 drugs was included. mean age 62.70 ± 9.85 years (range 24–92 years), 62% elderly, and 56.8% females. Polypharmacy most prevalent Internal Medicine Department (92.8%). Of 250 prescriptions, approximately 78.4% contained at least one pDDI. 515 identified, with a median per patient. these, 89.7% moderate severity. drug pairs involved moderate-severity glimepiride-metformin, glimepiride-bisoprolol, metformin-ramipril. number prescription is significant predictor (aOR = 7.48; 95% CI 1.73-32.32). Subsequent analysis revealed that eight more 4.31 times likely have than five (p=0.010). Pharmacists must play pivotal role managing chronic disease reduce interaction risks. suggests developing digital system for healthcare professionals improve patient safety.

Язык: Английский

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Potential drug-drug interactions analysis in Polish pediatric hemato-oncologic unit, including acute lymphoblastic leukemia patients

Pharmacological Reports, Год журнала: 2025, Номер unknown

Опубликована: Апрель 1, 2025

Язык: Английский

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The Burden of Potentially Inappropriate Medications in Chronic Polypharmacy

Journal of Clinical Medicine, Год журнала: 2020, Номер 9(11), С. 3728 - 3728

Опубликована: Ноя. 20, 2020

We aimed to describe the burden represented by potentially inappropriate medications (PIMs) in chronic polypharmacy France. conducted a nationwide cross-sectional study using data from French National Insurance databases. The period was 1 January 2016 31 December 2016. Chronic drug use defined as uninterrupted daily lasting ≥6 months. of ≥5 medications, and hyperpolypharmacy ≥10 medications. For individuals aged ≥65 (older adults), PIMs were according Beers Laroche lists, for 45–64 years (middle-aged) PROMPT (Prescribing Optimally Middle-aged People’s Treatments) list. Among with polypharmacy, 4009 (46.2%) middle-aged 18,036 (64.8%) older adults had at least one PIM. hyperpolypharmacy, these figures were, respectively, 570 (75.0%) 2544 (88.7%). most frequent PIM proton pump inhibitors (43.4% polypharmacy), short-acting benzodiazepines adults: 13.7%; middle-aged: 16.1%), hypnotics (6.1%; 7.4%), long-acting sulfonylureas (3.9%; 12.3%). appeared be very high our study, concerning almost half two-thirds polypharmacy. Deprescribing interventions should primarily target hypnotics.

Язык: Английский

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Non-vitamin K antagonist oral anticoagulants in older and frail patients with atrial fibrillation

European Heart Journal Supplements, Год журнала: 2022, Номер 24(Supplement_A), С. A1 - A10

Опубликована: Фев. 1, 2022

Elderly and frail patients with atrial fibrillation (AF) are at increased risk of thrombotic events, bleeding, death compared to their counterparts, making management challenging. With the introduction non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) in past decade, risk:benefit balance such high-risk AF has tipped favor treating these anticoagulation, most cases a NOAC instead VKA. In ≥75 years age AF, each 4 approved NOACs reduced stroke or systemic embolism vs warfarin landmark clinical trial lowered mortality. However, only apixaban edoxaban significantly major bleeding warfarin. A similar pattern was seen even older cohorts (≥80 ≥85 years). Among ≥80 who not candidates for dose, 15 mg may be reasonable alternative. elderly individuals on multiple comedications (particularly if ≥1 moderate strong cytochrome P-450 inhibitor), consistently Regardless specific OAC selected, appropriate dosing (who frequently qualify dose reduction per prescribing label) is critical. factors that modify efficacy-safety profile OACs should carefully considered permit optimal selection vulnerable patients.

Язык: Английский

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Multimorbidity and polypharmacy in hospitalized older patients: a cross-sectional study

BMC Geriatrics, Год журнала: 2023, Номер 23(1)

Опубликована: Июль 11, 2023

Abstract Background The growing trend of ageing population has become a worldwide concern. In comparison with the youth, older people are more likely to suffer from multimorbidity and polypharmacy, both which associated adverse outcomes increased healthcare costs. This study aimed investigate status polypharmacy in large sample hospitalized patients aged 60 years over. Methods A retrospective cross-sectional was conducted among 46,799 eligible over, who were January 1, 2021 December 31, 2021. Multimorbidity defined as presence 2 or morbidities one patient during stay hospital, prescription 5 different oral medications. Spearman rank correlation analysis used assess relationship factors number Odds ratio (OR) 95% confidence interval (95% CI) estimated logistic regression models determine predictors for all-cause death. Results prevalence 91.07% age. 56.32%. Older age, prolonged length (LOS), higher cost on medications significantly an (all P < 0.01). (OR = 1.29, CI: 1.208–1.229) LOS 1.171, 1.166–1.177) potential risk polypharmacy. As death, age 1.107, 1.092–1.122), 1.495, 1.435–1.558) 1.020, 1.013–1.027) factors, but 0.930, 0.907–0.952) 0.764, 0.608–0.960) reduction mortality. Conclusion Morbidities might be inversely Appropriate beneficial clinical hospitalization.

Язык: Английский

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Psychotropic drug-induced adverse drug reactions in 462,661 psychiatric inpatients in relation to age: results from a German drug surveillance program from 1993–2016

Annals of General Psychiatry, Год журнала: 2024, Номер 23(1)

Опубликована: Ноя. 18, 2024

Abstract Background Clinical practice suggests that older adults (i.e., ≥ 65 years of age) experience adverse drug reactions (ADRs) more often than younger patients < age). ADRs such as falls, extrapyramidal symptoms (EPS), metabolic disorders, sedation, and delirium are particularly worrisome associated with psychotropic drugs. Methods This observational study investigated the risk for drug-related in (n = 99,099) 363,562) psychiatric inpatients using data from German pharmacovigilance program “Arzneimittelsicherheit der Psychiatrie” (AMSP) 1993–2016. The aim was to assess whether age influenced specific ADR types if certain drugs posed particular concerns. Results did not differ between (relative 0.98, 95% confidence interval 0.92–1.05). However, had a higher (2.35, 1.85–2.99), hyponatremia (3.74, 2.85–4.90), orthostatic syncope (2.37, 1.72–3.26), well EPS, e.g., parkinsonism (1.89, 1.45–2.48) Pisa-/metronome syndrome (3.61, 2.51–5.18). other ADRs, acute dystonia (0.20, 0.10–0.37), akathisia (0.47, 0.29–0.76), liver dysfunction (0.63, 0.48–0.82), weight gain (0.07, 0.04–0.14), sexual (0.03, CI 0.00–0.25), hyperprolactinemia/galactorrhea (0.05, 0.02–0.17) significantly lower patients. Older treated any type antidepressant (1.33, 1.26–1.40)—especially selective serotonin reuptake inhibitors (1.57, 1.26–1.40) serotonin-norepinephrine (2.03, 1.80–2.29)—and lithium (1.74, 1.52–2.00) Second-generation antipsychotic (0.74, 0.71–0.77) low-potency first-generation (1.19, 1.07–1.33) involving multiple (1.28, 1.22–1.34). were 6.4 times likely result death. Conclusions Clinicians pharmacists should be aware high-risk across groups provide appropriate monitoring. Pharmacovigilance is crucial all ages neglected, even generally considered “safe”.

Язык: Английский

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Decreasing trends in potentially inappropriate medications in older people: a nationwide repeated cross-sectional study

BMC Geriatrics, Год журнала: 2021, Номер 21(1)

Опубликована: Ноя. 2, 2021

Abstract Background Potentially Inappropriate Medications (PIMs) and polypharmacy are widely used indicators of suboptimal prescribing for older people. The aim this study was to describe the changes in prevalence PIMs among people aged 75 years over between 2011 2019 France. Methods were assessed every two using French health insurance data system. Sixteen PIM criteria from 2015 Beers STOPP lists assessed. Polypharmacy (5 9 drugs) hyper-polypharmacy (≥10 defined based on average number drugs dispensed per quarter. Annual Percent Change (APC) 95%CI linear regression models after standardization age sex. Results population included 5,777,645 individuals old 6,328,155 2019. decreased 49.6 39.6% period (APC: − 1.19% [− 1.35;-1.04]). Of sixteen assessed, thirteen Benzodiazepines most frequent (34.7% 26.9% 2019), followed by anticholinergic (12.1% 8.3% oral non-steroidal anti-inflammatory (11.4 7.8%), related antihypertensive (7.4 6.0%). Overall, women 85 more likely receive PIMs. 30.5 25.9% period. Conclusion This study, which is first assess change time comprehensive France, highlights that declined However, remains often involves benzodiazepines.

Язык: Английский

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Prevalence of polypharmacy among older adults in Ethiopia: a systematic review and meta-analysis

Scientific Reports, Год журнала: 2023, Номер 13(1)

Опубликована: Окт. 17, 2023

Abstract Polypharmacy is a significant concern for older adults. Taking multiple medicines to prevent and treat comorbidities very common in adults, potentially leading polypharmacy. associated with the development of geriatric syndromes, including cognitive impairment, delirium, falls, frailty, urinary incontinence, weight loss. The prevalence polypharmacy varies according literature. There paucity data regarding among Therefore, this study aimed estimate pooled adults Ethiopia. A comprehensive search databases, PubMed, MEDLINE, EMBASE, Hinari, Cumulative Index Nursing Allied Health Literature, International Scientific Indexing, Cochrane library Web Science, Google Scholar, was conducted. STATA statistical software (version 17) used analyze data. Forest plot I 2 heterogeneity test were computed examine existence heterogeneity. Subgroup analysis sensitivity done explore source Publication bias evaluated by using funnel plots Egger’s test. random effect model determine After reviewing 123 studies, 13 studies total 3547 fulfilled inclusion criteria included meta-analysis. result from revealed that Ethiopia 37.10% (95CI: 28.28–45.91). Meta-analysis showed level slightly lower Oromia region (I2 = 46.62, P-value 0.154). Higher found cardiovascular disorders (42.7%) admitted patients (51.4%). In general, it high. More than one three take five or more medications at time. Thus, intervention focusing on rational pharmacotherapy unnecessary pill burden, adverse drug events, medical costs, morbidity, mortality. Furthermore, enhancing pharmacist roles towards medication therapy management safety monitoring also indicated.

Язык: Английский

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Strength of primary care in Turkey

Turkish Journal of Family Practice, Год журнала: 2014, Номер 18(2), С. 70 - 79

Опубликована: Янв. 1, 2014

Sağlık sisteminde ilk tıbbi

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Factors related to polypharmacy and hyper‐polypharmacy for the elderly: A nationwide cohort study using National Health Insurance data in South Korea

Clinical and Translational Science, Год журнала: 2022, Номер 16(2), С. 193 - 205

Опубликована: Ноя. 19, 2022

Abstract Polypharmacy may cause adverse health outcomes in the elderly. This study examined prevalence of continuous polypharmacy and hyper‐polypharmacy, factors associated with polypharmacy, most frequently prescribed medications among older adults South Korea. was a retrospective observational using National Health Insurance claims data. In total, 7,358,953 Korean elderly patients aged 65 years were included. Continuous hyper‐polypharmacy defined as use ≥5 ≥10 medications, respectively, for both ≥90 days ≥180 within 1 year. A multivariate logistic regression analysis conducted adjustment general characteristics (sex, age, insurance type), comorbidities (12 diseases, number comorbidities, Elixhauser Comorbidity Index [ECI] classification), healthcare service utilization. Among 7.36 million patients, 47.8% 36.9% had days, 11.9% 7.1% exhibited respectively. Male sex, insurance, (cardio‐cerebrovascular disease, diabetes mellitus, depressive disorder, dementia, an ECI score ≥3), utilization increased probability polypharmacy. The therapeutic class prescriptions drugs acid‐related disorders (ATC A02). outpatient visit more strongly influenced than hospitalizations ED visits. provides policymakers important evidence about critical need to reduce adults.

Язык: Английский

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