Journal of the American Geriatrics Society, Год журнала: 2024, Номер unknown
Опубликована: Ноя. 22, 2024
Язык: Английский
Age and Ageing, Год журнала: 2025, Номер 54(2)
Опубликована: Фев. 1, 2025
Medication review is integral in the pharmacological management of older inpatients. To assess association in-hospital medication changes with 28-day postdischarge clinical outcomes. Retrospective cohort 2000 inpatients aged ≥75 years. included number increases (medications started or dose-increased) and decreases stopped dose-decreased) for (i) all medications, (ii) Drug Burden Index (DBI)-contributing medications (iii) Beers Criteria 2015 (potentially inappropriate PIMs). Changes also differences PIMs DBI score, at discharge versus admission. Associations outcomes (28-day ED visit, readmission mortality) were ascertained using logistic regression, adjusted age, gender principal diagnosis. For mortality, sensitivity analysis excluded end-of-life patients due to higher death risk. Patients stratified into : ≤4, 5-9 ≥10 medications. The mean age was 86 years (SD = 5.8), 59.1% female. reduced visits risk prescribed five nine no associations ≤4 ≥ 10 In group, decreasing risks visit (adjusted odds ratio, aOR 0.55, 95% CI 0.34-0.91, P .02) (aOR 0.62, 0.38-0.99, .04). Decreasing DBI-contributing 0.71, 0.51-0.99, Differences 0.65, 0.43-0.99, There mortality analyses groups. associated
Язык: Английский
Процитировано
0
International Journal of Clinical Pharmacy, Год журнала: 2025, Номер unknown
Опубликована: Фев. 15, 2025
Prescribing cascades occur in clinical practice when a medication causes an adverse drug reaction (ADR), which is addressed by prescribing additional medication. The aim was to provide proof-of-concept for pharmacy-led interventions reverse or prevent cascades. Two community pharmacies each tested two approaches. To cascades, ten were selected from literature. Dispensing records screened identify patients with these who started medications associated five of telephoned one month after their first dispensing discuss ADRs. Pharmacists assessed the need intervene together prescribers. Primary outcome proportion treatment change initiated. Secondary outcomes time investment, potential cost-savings, and pharmacists' experiences. 24 included. For eight prescriber consulted, resulting reversal three Forty-four included Six them experienced ADR that could lead cascade. conducted this. estimated investment possibly intervention 4.5 h reversing approach 4.8 preventing approach, while follow-up actions required 1.8 0.5 h, respectively. Both approaches be cost-saving. considered both relevant but identified knowledge gap on how some Pharmacy-led may more efficient screening methods tools are needed before further implementation.
Язык: Английский
Процитировано
0
European Geriatric Medicine, Год журнала: 2025, Номер unknown
Опубликована: Фев. 19, 2025
Abstract Background The growing challenges of population aging create a pressing need for specialized geriatric medicine services to effectively address the complex health needs older adults and influence supportive healthcare policies. Older patients may present clinical complexity with multimorbidity, disability, and/or frailty, necessitating shift from traditional organ-oriented approach holistic, patient-centered care model. Rationale action Despite recommendations World Health Organization scientific professional societies, is not universally recognized as distinct specialty in Europe, education this field remains heterogeneous. A notable discrepancy availability across European countries can be found. Many professionals lack basic training medicine, contributing fragmented poorer outcomes. To these challenges, it essential integrate into undergraduate postgraduate curricula all professionals. Expected outcomes COST Action 21,122 PROGRAMMING (PROmoting GeRiAtric Medicine where still eMergING) initiative aims promote by developing targeted educational goals programs fostering interdisciplinary collaboration. This assess current state identify both global local skills among In addition, seeks establish consensus on core tailored contexts disseminate findings stakeholders, policymakers, public. By uniting diverse aspires sustainable changes Europe. Graphical abstract
Язык: Английский
Процитировано
0
European Geriatric Medicine, Год журнала: 2025, Номер unknown
Опубликована: Март 9, 2025
Abstract Purpose To summarise the association between potentially inappropriate prescribing (PIP) and health-related quality of life (HRQOL) in older adults, with a special focus on those atrial fibrillation (AF) multimorbidity, while exploring potential interventions to improve their impact HRQOL. Methods A comprehensive search strategy was conducted MEDLINE using PubMed interface August 16th, 2024, focusing key terms related “potentially prescribing” “quality life”. Additionally, reference lists included studies were screened. Only utilising validated assessment tools for HRQOL or measuring global self-perceived health status considered. Studies involving populations an average age ≥ 65 years included. Results Of 1810 articles screened, 35 The findings indicate that prescribing, independent polypharmacy, may negatively influence review identified range aimed at improving among including pharmacist-driven, general practitioner-driven, multidisciplinary approaches. Interventions assessed distinct population groups specifically residential care homes. While some demonstrated improvements quality, overall evidence regarding remains limited. Conclusion relationship underexplored adults AF despite high prevalence PIP. Effective pharmacotherapy should be coupled patients' clinical functional parameters, considering Adopting multidisciplinary, integrated, patient-centred approach is essential sustainable appropriate practices enhance
Язык: Английский
Процитировано
0
Kidney Medicine, Год журнала: 2025, Номер unknown, С. 100995 - 100995
Опубликована: Март 1, 2025
Язык: Английский
Процитировано
0
Medical Clinics of North America, Год журнала: 2025, Номер unknown
Опубликована: Апрель 1, 2025
Язык: Английский
Процитировано
0
Frontiers in Pharmacology, Год журнала: 2024, Номер 15
Опубликована: Сен. 10, 2024
Current research on potentially inappropriate prescribing (PIP) in polymedicated older adults with atrial fibrillation (AF) and multimorbidity is predominantly focused PIP of oral anticoagulants (OAC). Our study aimed to assess (i) the overall prevalence multimorbid AF, (ii) potential associated factors PIP, (iii) association adverse health outcomes a nationwide sample Swedish adults.
Язык: Английский
Процитировано
3
Journal of the American Geriatrics Society, Год журнала: 2024, Номер unknown
Опубликована: Сен. 5, 2024
See the related reply by Fontana et al .
Язык: Английский
Процитировано
1
Journal of the American Geriatrics Society, Год журнала: 2024, Номер unknown
Опубликована: Сен. 5, 2024
See the related letter by Lee et al .
Язык: Английский
Процитировано
1
Journal of the American Geriatrics Society, Год журнала: 2024, Номер unknown
Опубликована: Окт. 17, 2024
Язык: Английский
Процитировано
0