Abstract
Prescribing
cascades
are
increasingly
recognized
since
they
were
described
in
the
mid-1990s.
Cascades
more
likely
older
people
with
multimorbidity
and
associated
polypharmacy
where
multiple
medications
can
induce
a
variety
of
side
effects
that
manifest
various
non-specific
symptoms
may
be
misidentified
as
new
geriatric
syndromes
such
falls,
dizziness
new-onset
incontinence.
Geriatricians
encounter
medication
frequently
will
usually
consider
if
an
patient
presenting
could
experiencing
adverse
drug
reaction
or
event.
However,
most
prescribed
to
multimorbid
patients
initiated
continued
by
prescribers
without
specialist
training
who
not
detect
medication-induced
morbidity.
Therefore,
novel
approaches
detection
management
prescribing
needed.
Currently,
knowledge
base
surrounding
is
evolving
towards
better
methods
for
cascade
secondary
prevention.
large
number
literature,
wide-ranging
symptomatology
rapidly
increasing
at
risk
represent
major
challenges
prescribers.
Furthermore,
prospective
prevalence
studies
lacking.
To
correct
during
routine
review
people,
awareness
essential.
turn
requires
explicit
ways
defining
facilitate
their
rapid
correction
review.
Given
another
aspect
inappropriate
(IP),
criteria
should
integrated
other
IP
criteria.
Global Health Research and Policy,
Год журнала:
2023,
Номер
8(1)
Опубликована: Июль 12, 2023
Abstract
Background
Polypharmacy
is
one
of
the
most
important
health
issues
for
its
potential
impacts
on
disease
burden
and
healthcare
costs.
The
aim
this
study
was
to
update
a
comprehensive
picture
prevalence
trends
in
polypharmacy
over
20
years
U.S.
adults.
Methods
Participants
included
55,081
adults
aged
≥
from
National
Health
Nutrition
Examination
Survey,
January
1,
1999,
through
December
31,
2018.
simultaneously
use
5
drugs
individual
defined
as
polypharmacy.
were
evaluated
among
within
different
demo-socioeconomic
status
pre-existing
diseases.
Results
From
1999–2000
2017–2018,
overall
percentages
with
remained
rise,
increasing
8.2%
(7.2–9.2%)
17.1%
(15.7–18.5%)
(average
annual
percentage
change
[AAPC]
=
2.9%,
P
.001).
considerably
higher
elderly
(from
23.5%
44.1%),
heart
40.6%
61.7%),
diabetes
36.3%
57.7%).
Also,
we
observed
greater
increase
rate
men
(AAPC
4.1%,
<
.001),
Mexican
American
6.3%,
non-Hispanic
Black
4.4%,
Conclusions
continually
especially
older,
patients
disease,
or
diabetes.
high
urges
providers
policymakers
manage
specific
population
groups.
Journal of Prescribing Practice,
Год журнала:
2024,
Номер
6(9), С. 374 - 381
Опубликована: Сен. 2, 2024
As
the
population
ages,
understanding
unique
pharmacokinetic
profiles
of
older
adults
is
crucial
for
effective
and
safe
medication
management.
This
article
provides
an
overview
changes
that
occur
with
ageing,
including
alterations
in
absorption,
distribution,
metabolism,
excretion.
Emphasising
implications
prescribing
practice,
highlights
common
challenges
strategies
optimising
pharmacotherapy
patients.
By
recognising
physiological
potential
drug
interactions,
healthcare
providers
can
tailor
their
practices
to
improve
therapeutic
outcomes
minimise
adverse
effects
this
vulnerable
population.
Pharmaceutics,
Год журнала:
2022,
Номер
14(5), С. 931 - 931
Опубликована: Апрель 25, 2022
Therapy
for
Parkinson’s
disease
is
quite
challenging.
Numerous
drugs
are
available
symptomatic
treatment,
and
levodopa
(LD),
in
combination
with
a
dopa
decarboxylase
inhibitor
(e.g.,
benserazide
(BZ)),
has
been
the
drug
of
choice
years.
As
progresses,
therapy
must
be
supplemented
dopamine
agonist
pramipexole
(PDM)).
Side
effects
increase,
as
do
required
dose
dosing
intervals.
For
these
specific
requirements
therapy,
3D
printing
method
fused
deposition
modelling
(FDM)
was
applied
this
study
personalized
therapy.
Hot
melt
extrusion
utilized
to
produce
two
different
compositions
into
filaments:
PDM
polyvinyl
alcohol
rapid
release
fixed
LD/BZ
(4:1)
an
ethylene-vinyl
acetate
copolymer
matrix
prolonged
release.
Since
LD
absorbed
upper
gastrointestinal
tract,
formulation
that
floats
gastric
fluid
desired
prolong
API
absorption.
Using
FDM
process,
polypill
geometries
were
printed
from
both
filaments,
variable
dosages.
Dosage
forms
15−180
mg
could
printed,
showing
similar
rates
(f2
>
50).
In
addition,
mini
delivery
dosage
form
released
75%
within
750
min
used
retentive
system
due
floating
properties
composition.
The
mini-polypill
designed
accommodate
patients’
swallowing
difficulties
allow
individualized
over
longer
period
time.
PAIN Reports,
Год журнала:
2025,
Номер
10(2), С. e1243 - e1243
Опубликована: Фев. 5, 2025
Abstract
Introduction:
Older
adults
with
insomnia
frequently
report
bothersome
pain.
Whether
treatment
reduces
bodily
pain
in
older
without
chronic
conditions
is
not
known.
Objectives:
This
randomized
controlled
trial
aimed
to
determine
whether
of
disorder
cognitive
behavioral
therapy
for
(CBT-I),
as
compared
sleep
education
(SET),
yields
durable
remission
and
moderate
symptoms
over
36
months
disorder.
Methods:
A
community-based
sample
291
ages
60
years
(mean
age,
70.1
years;
57.7%
female)
disorder,
but
no
condition,
were
2
intervention
either
CBT-I
(n
=
156)
or
SET
135).
The
primary
outcome
was
change
measured
by
the
short
form
(SF-36)
health
survey.
Secondary
continuously
sustained
follow-up.
Results:
Improvements
pain,
indexed
increases
SF-36
scores,
found
(adjusted
β
0.18;
95%
CI,
0.004–0.360;
P
0.045)
0.25;
0.035–0.457;
0.023)
groups
remission.
As
those
remission,
associated
improvements
0.19;
0.047–0.325;
0.009)
proportion
participants
who
achieved
a
minimal
clinically
important
difference
(likelihood
ratio
χ
1,16
264.04;
<
0.001).
Conclusions:
Sustained
leads
potential
prevent
disorders
insomnia.
Trial
Registration:
ClinicalTrials.gov
NCT01641263.
Journal of Clinical Medicine,
Год журнала:
2025,
Номер
14(4), С. 1330 - 1330
Опубликована: Фев. 17, 2025
Polypharmacy,
a
common
condition
among
the
older
population,
is
associated
with
adverse
outcomes,
including
higher
mortality,
falls
and
hospitalization
rates,
drug
reactions,
drug-drug
interactions,
medication
nonadherence,
consequently
increased
healthcare
costs.
Background/Objectives:
This
study
aims
to
explore
prevalence
of
polypharmacy
its
factors
adults
across
27
European
countries
Israel.
Methods:
In
this
cross-sectional
analysis,
we
used
data
from
participants
aged
65
years
or
Wave
9
Survey
Health,
Aging,
Retirement
in
Europe
(SHARE)
database.
The
variables
studied
were
classified
into
following
categories:
sociodemographic,
behavioral
factors,
physical
functioning,
health,
mental
living
conditions.
Results:
Our
results
showed
an
overall
36.2%,
ranging
25.0
51.8%.
Slovenia,
Greece,
Switzerland
lowest
prevalence,
whereas
Portugal,
Israel,
Poland
where
was
highest.
Polypharmacy
shown
be
all
categories.
Conclusions:
highly
prevalent
population.
Identification
polypharmacy,
such
as
those
identified
study,
important
identify
monitor
groups,
which
are
most
vulnerable
polypharmacy.
Interventions
designed
reduce
should
consider
these
associations.
International Journal of Molecular Sciences,
Год журнала:
2022,
Номер
24(1), С. 380 - 380
Опубликована: Дек. 26, 2022
Aging
is
associated
with
a
low-grade,
systemic
inflammatory
state
defined
as
“inflammaging”,
ruled
by
the
loss
of
proper
regulation
immune
system
leading
to
accumulation
pro-inflammatory
mediators.
Such
condition
closely
connected
an
increased
risk
developing
chronic
diseases.
A
number
studies
demonstrate
that
olive
oil
phenolic
compound
oleuropein
and
its
derivative
hydroxytyrosol
contribute
modulating
tissue
inflammation
oxidative
stress,
thus
becoming
attractive
potential
candidates
be
used
in
context
nutraceutical
interventions,
order
ameliorate
aging
subjects.
In
this
review,
we
aim
summarize
available
data
about
anti-inflammatory
properties
hydroxytyrosol,
discussing
them
light
molecular
pathways
involved
synthesis
release
mediators
inflammaging.
Cambridge Prisms Precision Medicine,
Год журнала:
2023,
Номер
1
Опубликована: Янв. 1, 2023
Precision
medicine
is
an
approach
to
maximise
the
effectiveness
of
disease
treatment
and
prevention
minimise
harm
from
medications
by
considering
relevant
demographic,
clinical,
genomic
environmental
factors
in
making
decisions.
complex,
even
for
decisions
about
single
drugs
diseases,
as
it
requires
expert
consideration
multiple
measurable
that
affect
pharmacokinetics
pharmacodynamics,
many
patient-specific
variables.
Given
increasing
number
patients
with
conditions
medications,
there
a
need
apply
lessons
learned
precision
monotherapy
management
optimise
polypharmacy.
However,
optimisation
polypharmacy
particularly
challenging
because
vast
interacting
influence
drug
use
response.
In
this
narrative
review,
we
aim
provide
latest
research
findings
achieve
context
Specifically,
review
aims
(1)
summarise
challenges
achieving
specific
polypharmacy;
(2)
synthesise
current
approaches
(3)
summary
literature
field
prediction
unknown
drug-drug
interactions
(DDI)
(4)
propose
novel
For
our
proposed
model
be
implemented
routine
clinical
practice,
comprehensive
intervention
bundle
needs
integrated
into
electronic
medical
record
using
bioinformatic
on
wide
range
data
predict
effects
regimens
individual.
addition,
clinicians
trained
interpret
results
sources
including
pharmacogenomic
testing,
DDI
physiological-pharmacokinetic-pharmacodynamic
modelling
inform
their
medication
reviews.
Future
studies
are
needed
evaluate
efficacy
test
generalisability
so
can
at
scale,
aiming
improve
outcomes
people
Frontiers in Pharmacology,
Год журнала:
2023,
Номер
14
Опубликована: Апрель 21, 2023
Background:
Few
studies
have
examined
the
epidemiology
of
polypharmacy
in
non-institutionalized
elderly
adults
with
regard
to
sex
differences.
This
study
aimed
identify
prevalence
among
people
≥65
years
old
residing
Spain,
analyze
trends
that
from
2011/12
2020,
describe
use
medicines
involved
and
possible
relationship
between
certain
sociodemographic,
health-related
variables,
as
well
care
services
by
sex.
Methods:
A
nationwide
cross-sectional
21,841
Spanish
National
Health
Survey
(2011/2012
2017)
European
Spain
(2014
2020)
was
performed.
We
used
descriptive
statistics,
performing
two
binary
logistic
regressions
determine
factors
related
polypharmacy.
Results:
The
23.2%
(women:
28.1%,
men:
17.2%;
p
<
0.001).
most
commonly
consumed
were
analgesics
tranquillizers,
relaxants
or
sleeping
pills
women,
compared
antihypertensives,
antacids
antiulcer
drugs
statins
for
men.
In
both
sexs,
positive
predictors
included
average,
poor
very
self-perceived
states
health,
overweight
obesity,
being
severely/non-severely
limited
due
a
health
problem,
having
≥
three
chronic
conditions,
visits
family
doctor
hospitalization.
Among
negative
alcohol
intake,
whereas
men
75-84
old,
current
smokers
1,
2
conditions.
Conclusion:
Polypharmacy
has
23.2%,
women
accounting
28.1%
17.2%
total.
Knowledge
important
implications
public
efforts
develop
improve
guidelines
strategies
promoting
proper
medication,
particularly
population
