Interventions to improve the appropriate use of polypharmacy for older people

Cochrane library, Год журнала: 2023, Номер 2023(10)

Опубликована: Окт. 11, 2023

Язык: Английский

---

Potentially inappropriate prescribing and its associations with health‐related and system‐related outcomes in hospitalised older adults: A systematic review and meta‐analysis

British Journal of Clinical Pharmacology, Год журнала: 2021, Номер 87(11), С. 4150 - 4172

Опубликована: Май 18, 2021

Aims To synthesise associations of potentially inappropriate prescribing (PIP) with health‐related and system‐related outcomes in inpatient hospital settings. Methods Six electronic databases were searched: Medline Complete, EMBASE, CINAHL, PyscInfo, IPA Cochrane library. Studies published between 1 January 1991 31 2021 investigating PIP older adults settings, included. A random effects model was employed using the generic inverse variance method to pool risk estimates. Results Overall, 63 studies included . Pooled estimates did not show a significant association all‐cause mortality (adjusted odds ratio [AOR] 1.10, 95% confidence interval [CI] 0.90–1.36; adjusted hazard 1.02, 83% CI 0.90–1.16), readmission (AOR 1.11, 0.76–1.63; 0.89–1.18). associated 91%, 60% 26% increased adverse drug event‐related admissions 1.91, 1.21–3.01), functional decline 1.60, 1.28–2.01), reactions events 1.26, 1.11–1.43), respectively. falls (2/2 studies). The impact on emergency department visits, length stay, quality life inconclusive. Economic cost reported 3 studies, comprised various estimation methods. Conclusions significantly range outcomes. It is important optimise adults' prescriptions facilitate improved care.

Язык: Английский

---

Mental Health during the COVID-19 Crisis in Africa: A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health, Год журнала: 2021, Номер 18(20), С. 10604 - 10604

Опубликована: Окт. 10, 2021

We aim to provide a systematic review and meta-analysis of the prevalence rates mental health symptoms among major African populations during COVID-19 pandemic. include articles from PubMed, Embase, Web Science, PsycINFO, medRxiv between 1 February 2020 6 2021, pooled data using random-effects meta-analyses. identify 28 studies 32 independent samples 12 countries with total 15,071 participants. The anxiety was 37% in 27 studies, depression 45% 24 insomnia 28% 9 studies. anxiety, depression, North Africa (44%, 55%, 31%, respectively) are higher than those Sub-Saharan (31%, 30%, 24%, respectively). find (a) scarcity several high number cases; (b) heterogeneity studies; (c) extent pattern is differs elsewhere—more adults suffer rather COVID 19 compared adult other countries/regions. Hence, our findings carry crucial implications impact future research enable evidence-based medicine Africa.

Язык: Английский

---

Potentially inappropriate medication including drug-drug interaction and the risk of frequent falling, hospital admission, and death in older adults - results of a large cohort study (getABI)

Frontiers in Pharmacology, Год журнала: 2023, Номер 14

Опубликована: Фев. 15, 2023

Introduction: With growing age, multiple chronic diseases may result in polypharmacy. Drugs that should be avoided older adults are called potentially inappropriate medications (PIM). Beyond PIM, drug-drug interactions (DDI) known to related adverse drug events. This analysis examines the risk of frequent falling, hospital admission, and death associated with PIM and/or DDI (PIM/DDI) prescription. Materials methods: post hoc used data a subgroup getABI study participants, large cohort community-dwelling adults. The comprised 2120 participants who provided detailed medication report by telephone interview at 5-year follow-up. risks course following 2 years were analysed logistic regression uni- multivariable models adjustment for established factors. Results: Data all 2,120 was available endpoint death, 1,799 1,349 falling. showed an association PIM/DDI prescription falling (odds ratio (OR) 1.66, 95% confidence interval (CI) 1.06–2.60, p = 0.027) as well admission (OR 1.29, CI 1.04–1.58, 0.018), but not 1.00, 0.58–1.72, 0.999). Conclusion: No found years. alert physicians provide closer look prescriptions.

Язык: Английский

---

Optimising prescribing in older adults with multimorbidity and polypharmacy in primary care (OPTICA): cluster randomised clinical trial

BMJ, Год журнала: 2023, Номер unknown, С. e074054 - e074054

Опубликована: Май 24, 2023

To study the effects of a primary care medication review intervention centred around an electronic clinical decision support system (eCDSS) on appropriateness and number prescribing omissions in older adults with multimorbidity polypharmacy compared discussion about line usual care.Cluster randomised trial.Swiss care, between December 2018 February 2021.Eligible patients were ≥65 years age three or more chronic conditions five long term medications.The to optimise pharmacotherapy eCDSS was conducted by general practitioners, followed shared making practitioners patients, practitioners.Primary outcomes improvement Medication Appropriateness Index (MAI) Assessment Underutilisation (AOU) at 12 months. Secondary included medications, falls, fractures, quality life.In 43 practitioner clusters, 323 recruited (median 77 (interquartile range 73-83) years; 45% (n=146) women). Twenty one 160 assigned group 22 163 control group. On average, recommendation stop start reported be implemented per patient. At months, results intention-to-treat analysis (odds ratio 1.05, 95% confidence interval 0.59 1.87) (0.90, 0.41 1.96) inconclusive. The same case for protocol analysis. No clear evidence found difference safety month follow-up, but fewer events than six months.In this trial adults, inconclusive as whether use led reduction months care. Nevertheless, could safely delivered without causing any harm patients.NCT03724539Clinicaltrials.gov NCT03724539.

Язык: Английский

---

Prevalence of Polypharmacy and Potentially Inappropriate Medications Use in Elderly Chinese Patients: A Systematic Review and Meta-Analysis

Frontiers in Pharmacology, Год журнала: 2022, Номер 13

Опубликована: Июнь 20, 2022

Objectives: Polypharmacy and potentially inappropriate medication (PIM) use among elderly Chinese patients have not yet been investigated by systematic review meta-analysis. The purposes of this study were to investigate the prevalence polypharmacy PIM risk factors associated with in patients. Methods: Databases including PubMed, EMBase, Web Science searched collect studies which used criteria, Beers or STOPP criteria evaluate status from inception August 2021 (PROSPERO Code No: CRD42021262821). Observational reporting meta-analyzed. pooled ratio (RR) calculated a 95% confidence interval (CI). Results: A total 8 articles involving 4,558,786 included. overall (concomitant more than 5 medicines) meta-analysis older was 48% (95% CI: 0.17, 0.79, p = 0.003) (inpatients 73%, outpatients 23%) 39% 0.25, 0.54, < 0.001) 50%, 29%), respectively. (RR: 2.03, 1.13, 3.64) significantly use. Conclusion: This demonstrated high China. Affected quantity quality included studies, aforementioned conclusions need be confirmed large samples high-quality studies.

Язык: Английский

---

Geriatric Emergency Medication Safety Recommendations (GEMS-Rx): Modified Delphi Development of a High-Risk Prescription List for Older Emergency Department Patients

Annals of Emergency Medicine, Год журнала: 2024, Номер 84(3), С. 274 - 284

Опубликована: Март 12, 2024

Язык: Английский

---

Prevalence of Potentially Inappropriate Prescriptions According to the New STOPP/START Criteria in Nursing Homes: A Systematic Review

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

---

Prevalence of potentially inappropriate prescribing in older adults in Central and Eastern Europe: a systematic review and synthesis without meta-analysis

Scientific Reports, Год журнала: 2022, Номер 12(1)

Опубликована: Окт. 6, 2022

Abstract We aimed to systematically review the prevalence of potentially inappropriate prescribing (PIP) in older adults Central and Eastern Europe (CEE) all care settings. searched Embase MEDLINE (up June 2019) checked reference lists included studies relevant reviews. Eligible used validated explicit or implicit tools assess PIP CEE. All study designs were considered, except case‒control case series. assessed risk bias using Joanna Briggs Institute Prevalence Critical Appraisal Tool certainty evidence GRADE approach. Meta-analysis was due heterogeneity outcome measurements. Therefore, we synthesis without meta-analysis approach—summarizing effect estimates method. This twenty-seven with 139,693 participants. Most cross-sectional conducted high-income countries. The data across 26 revealed prevalence: median 34.6%, interquartile range 25.9–63.2%, 6.5–95.8%. this very low bias, imprecision, inconsistency. These findings show that is a prevalent issue CEE region. Further well-designed countries are needed strengthen existing increase generalizability findings.

Язык: Английский

---

Association between potentially inappropriate medications prescription and health‐related quality of life among US older adults

Journal of the American Geriatrics Society, Год журнала: 2024, Номер 72(9), С. 2807 - 2815

Опубликована: Май 10, 2024

Potentially inappropriate medications (PIMs) are associated with worse health outcomes among older adults. Our objective was to examine the association between PIM prescription and health-related quality of life (HRQoL) adults in United States using nationally representative data.

Язык: Английский

---