Multi-Morbidity and Polypharmacy in Older People: Challenges and Opportunities for Clinical Practice

Опубликована: Сен. 2, 2020

Multi-morbidity and polypharmacy are common in older people pose a challenge for health social care systems especially context of global population ageing. They complex interrelated concepts the that require early detection patient centred decision making underpinned by principles multidisciplinary led comprehensive geriatric assessment (CGA). Personalised plans need to remain responsive adaptable needs patient, enabling an individual maintain their independence.

Язык: Английский

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Using the behavior change wheel to link published deprescribing strategies to identified local primary healthcare needs

Research in Social and Administrative Pharmacy, Год журнала: 2021, Номер 18(8), С. 3350 - 3357

Опубликована: Дек. 5, 2021

Язык: Английский

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Epidemiology of adverse drug events and medication errors in four nursing homes in Japan: the Japan Adverse Drug Events (JADE) Study

BMJ Quality & Safety, Год журнала: 2022, Номер 31(12), С. 878 - 887

Опубликована: Апрель 21, 2022

Worldwide, the emergence of super-ageing societies has increased number older people requiring support for daily activities. Many elderly residents nursing homes (NHs) take drugs to treat chronic conditions; however, there are few reports medication safety in NHs, especially from non-western countries.We examined incidence and nature adverse drug events (ADEs) errors (MEs) NHs Japan.The Japan Adverse Drug Events Study is a prospective cohort study that was conducted among all residents, except short-term admissions, at four 1 year.Trained physicians psychologists, five six number, respectively, reviewed charts identify suspected ADEs MEs, which were then classified by into ADEs, potential other MEs after exclusion ineligible events, assessment their severity preventability. The kappa score presence an ADE preventability 0.89 0.79, respectively.We enrolled 459 this yielded 3315 resident-months observation time. We identified 1207 600 (incidence: 36.4 18.1 per 100 resident-months, respectively) during period. About one-third preventable, most frequently observed monitoring stage (72%, 433/600), with 71% occurring due inadequate following physician's prescription.In Japan, common NHs. appropriate adjustment preadmission postadmission needed improve safety, when single physician responsible prescribing medications as usually case Japan.

Язык: Английский

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Deprescribing: A Prime Opportunity to Optimize Care of Cancer Patients

Current Oncology, Год журнала: 2023, Номер 30(11), С. 9701 - 9709

Опубликована: Ноя. 2, 2023

Patients with incurable cancers have an increasing number of comorbidities, which can lead to polypharmacy and its associated adverse events (drug-to-drug interaction, prescription a potentially inappropriate medication, drug event). Deprescribing is patient-centered process aimed at optimizing patient outcomes by discontinuing medication(s) deemed no longer necessary or inappropriate. Improved quality life, risk reduction side effects worse clinical outcomes, decrease in healthcare costs are well-documented benefits deprescribing. advance care planning both require consideration patients’ values, preferences, goals. Here, we provide overview comorbidities risks cancer patients, as well useful tools resources for deprescribing daily practice, shed light on how facilitate discussions patients who advanced limited life expectancy.

Язык: Английский

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Inappropriate medication use and polypharmacy in end-stage cancer patients: Isn't it the family doctor's role to de-prescribe much earlier?

International Journal of Clinical Practice, Год журнала: 2018, Номер 72(4), С. e13061 - e13061

Опубликована: Янв. 23, 2018

Elderly patients are exposed to increased number of medications, often with no proof a positive benefit/risk ratio. Unfortunately, this trend does not spare those limited life expectancy, including end-stage cancer who require only palliative treatment. For many medications in subpopulation, the risk adverse drug events outweighs possible benefits and yet, still poly-medicated during their last year life.To describe extent polypharmacy among patients, at time admission homecare hospice.A retrospective chart review 202 admitted Homecare Hospice Israel Cancer Association died before January 2015.Average lifespan from until death was 39.2 ± 5.4 days. 63% within first month, 89% 3 months. Excluding oncological treatments, 181 (90%) 46 (23%) were treated ≥ 6 12 drugs for chronic diseases, respectively. Two months death, 32 (16%) blood pressure lowering drugs, 62 (31%) statins 48 aspirin.Though representative whole patient population, our study demonstrates that these extensive polypharmacy. Most could have probably been safely de-prescribed much earlier course malignant disease. Considering prolonged trust-based relationship family physicians should be encouraged implement approach reduce reaching hospice settings.

Язык: Английский

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