Journal of the American Geriatrics Society,
Год журнала:
2023,
Номер
72(1), С. 126 - 138
Опубликована: Дек. 20, 2023
Abstract
Background
Potentially
inappropriate
medications
(PIMs)
in
older
adults
are
which
risks
often
outweigh
benefits
and
suggested
to
be
avoided.
Worldwide,
many
distinct
guidelines
tools
classify
PIMs
adults.
Collating
these
tools,
mapping
them
a
medication
classification
system,
creating
crosswalk
will
enhance
the
utility
of
PIM
guidance
for
research
clinical
practice.
Methods
We
used
Anatomical
Therapeutic
Chemical
(ATC)
Classification
System,
hierarchical
map
from
eight
(2019
Beers
Criteria,
Screening
Tool
Older
Person's
Appropriate
Prescriptions
[STOPP],
STOPP‐Japan,
German
PRISCUS,
European
Union‐7
Inappropriate
Medication
[PIM]
list,
Centers
Medicare
&
Medicaid
Services
[CMS]
High‐Risk
Medication,
Anticholinergic
Burden
Scale,
Drug
Index).
Each
was
mapped
ATC
Level
5
(drug)
4
(drug
class).
then
(1)
compare
drug
classes
across
determine
number
that
were
index
(drug‐induced
adverse
event)
or
marker
(treatment
drug‐induced
prescribing
cascades,
(2)
estimate
prevalence
use
continuously
enrolled
with
fee‐for‐service
2018
as
cases.
Data
visualization
descriptive
statistics
assess
both
Results
Out
480
unique
identified,
only
three
medications—amitriptyline,
clomipramine,
imipramine
two
classes—N06AA
(tricyclic
antidepressants)
N06AB
(selective
serotonin
reuptake
inhibitors),
noted
all
tools.
Using
crosswalk,
50%
drugs
47%
known
cascades
PIMs.
Additionally,
88%
beneficiaries
dispensed
≥1
Conclusion
created
system
Our
findings
could
expand
ease
identification
harmonization
practice
purposes.
Geriatrics and gerontology international/Geriatrics & gerontology international,
Год журнала:
2023,
Номер
24(1), С. 61 - 67
Опубликована: Дек. 12, 2023
Aim
Multiple
risk
factors
are
involved
in
geriatric
syndrome
(GS)
occurring
older
adults.
Although
drug
therapy
often
contributes
to
GS,
the
specific
causes
among
adults
Japan
remain
unclear.
In
this
study,
we
examined
possible
prescribing
cascade
rate
outpatients
eligible
for
Late‐stage
Elderly
Health
Insurance
and
elucidated
differences
between
GS
associated
with
medication
(GSAM)
trends.
Methods
This
retrospective
study
enrolled
patients
from
health
insurance
claims
data
October
2018
March
2019;
hospitalized
were
excluded.
Two
groups
identified
participants
GS:
(no
use
of
GS‐causing
medications)
possible‐GSAM
(p‐GSAM;
medications).
The
collected
analyzed
using
Bell
Curve
Excel,
statistical
significance
was
set
at
P
<
0.05.
Results
total,
137
781
enrolled.
Of
32
259
who
did
not
medications,
7342
classified
into
group.
Among
105
522
used
8347
as
having
p‐GSAM.
mean
number
prescriptions
significantly
higher
p‐GSAM
group
than
(
0.01).
Furthermore,
all
symptoms
showed
significant
differences,
impaired
appetite
being
most
prevalent
A
suspected
2826
(33.9%)
Conclusion
Impaired
taking
medications
might
lead
cascades.
Further
studies
needed
prevent
such
Geriatr
Gerontol
Int
2024;
24:
61–67
.
Older
adults
living
with
dementia
may
express
challenging
responsive
behaviours.
One
management
strategy
is
pharmacologic
treatment
though
these
options
often
have
limited
benefit,
which
lead
to
multiple
treatments
being
prescribed.The
aim
of
the
present
study
was
describe
psychoactive
medication
polypharmacy
and
explore
factors
associated
in
a
cohort
older
Nova
Scotia,
Canada,
including
gender-stratified
analysis.
This
retrospective
those
aged
65
years
or
recorded
diagnosis
between
2005
2015.
Medication
dispensation
data
collected
from
April
1,
2010,
(cohort
entry)
either
death
March
31,
2015
exit).
Psychoactive
claims
were
captured.
defined
as
presence
three
more
prescription
medications
dispensed
one
subject
overlapping
for
than
30
days.
episodes
described
duration,
quantity,
implicated
medications.
Regression
analysis
examined
experience
frequency
polypharmacy.
All
stratified
by
gender.The
included
15,819
(mean
age
80.7
years;
70.0%
female),
99.4%
(n
=
15,728)
receiving
at
least
over
period
follow-up.
19.3%
cohort.
The
gender
specific
logistic
regressions
demonstrated
that
both
men
women
younger
an
increased
risk
(women:
OR
0.97,
95%CI[0.96,
0.98],
men:
0.96,
95%CI[0.95,
0.97]).
Men
less
likely
if
their
location
residence
urban
(OR
0.86,
95%CI[0.74,
0.99]).
There
no
significant
association
(urban
rural)
dementia.
Antidepressants
most
class,
while
quetiapine
medication.This
suggests
ages
rural
locations
benefit
access
non-pharmacological
management.
Pharmaceutical Care España,
Год журнала:
2024,
Номер
26
Опубликована: Март 16, 2024
Objetivo:
analizar
las
características
demográficas,
clínicas
y
funcionales
de
personas
residentes
en
un
centro
sociosanitario
público.
Caracterizar
a
la
población
función
del
riesgo
anticolinérgico
según
escala
DBI.
Metodología:
estudio
observacional
descriptivo
una
cohorte
público
Andalucía.
Se
llevó
cabo
desde
septiembre
hasta
diciembre
2020.Se
recogieron
variables
sociodemográficas,
funcionales,
farmacoterapia
carga
anticolinérgica
asociada
realizó
análisis
general
otro
diferencial
anticolinérgica.
Resultados:
se
incluyeron
148
(mediana
73
años
[IQR:
15,25]).
El
19,8%
era
analfabeta.
43,9%
presentaba
tabaquismo
el
22,3%
consumía
alcohol
diario.
50,3%
presentaban
polifarmacia
excesiva
(≥10
medicamentos)
73,6%.
los
pacientes
y/sedante
DBI
(definido
por
presentar
puntuación
DBI>0).
Los
principios
activos
con
actividad
y/o
sedante
más
frecuentemente
prescritos
fueron
lorazepam,
tramadol,
tamsulosina
trazodona.
delirio
ansiedad,
junto
infecciones
repetición
tracto
urinario,
prevalentes
grupo
que
(p<0,05).
Conclusiones:
presenta
alto
índice
analfabetismo,
elevada
prevalencia
consumo
tabaco
alcohol.
polimedicación
es
elevado,
así
como
porcentaje
asociado
farmacoterapia.
La
delirium
ITUs
Estudios
multicéntricos
mayor
número
serían
necesarios
para
confirmar
estos
hallazgos.
Cardiology Research,
Год журнала:
2024,
Номер
15(2), С. 75 - 85
Опубликована: Апрель 1, 2024
Patients
with
heart
failure
(HF)
have
a
high
prevalence
of
polypharmacy,
which
can
lead
to
drug
interactions,
cognitive
impairment,
and
medication
non-compliance.
However,
the
definition
polypharmacy
in
these
patients
is
still
inconsistent.
The
aim
this
scoping
review
was
find
most
common
HF
patients.
We
conducted
searching
Medline,
Embase,
CINAHL,
Cochrane
using
terms
including
deprescribing,
resulted
7,949
articles.
Articles
without
articles
included
<
18
years
age
were
excluded;
only
59
included.
Of
articles,
49%
(n
=
29)
retrospective,
20%
12)
prospective,
10%
6)
cross-sectional,
27%
16)
Twenty
percent
focused
on
reduced
ejection
fraction,
preserved
fraction
69%
41)
either
both
diagnoses
or
did
not
clarify
specific
type
HF.
cutoff
for
five
medications
(59%,
n
35).
There
no
consensus
regarding
inclusion
exclusion
over-the-counter
medications,
supplements,
vitamins.
Some
newer
studies
used
10
(14%,
8),
may
be
more
practical
meaningful
Cardiol
Res.
2024;15(2):75-85
doi:
https://doi.org/10.14740/cr1636
Research Square (Research Square),
Год журнала:
2023,
Номер
unknown
Опубликована: Апрель 3, 2023
Abstract
Background:
Older
adults
with
dementia
may
express
challenging
responsive
behaviours.
One
management
strategy
is
pharmacologic
treatment
though
these
options
have
limited
benefit.
The
benefit
lead
to
multiple
treatments
being
prescribed.
Methods:
aim
of
the
present
study
was
describe
psychoactive
medication
polypharmacy
and
explore
factors
associated
in
a
cohort
older
Nova
Scotia,
Canada,
including
gender-stratified
analysis.
This
retrospective
those
aged
65
years
or
recorded
diagnosis
between
2005
2015.
Medication
dispensation
data
collected
from
April
1,
2010,
(cohort
entry)
either
death
March
31,
2015
exit).
Psychoactive
claims
were
captured.
defined
as
presence
three
more
prescription
medications
dispensed
one
subject
overlapping
for
than
30
days.
episodes
described
duration,
quantity,
implicated
medications.
Regression
analysis
examined
experience
frequency
polypharmacy.
All
stratified
by
gender.
Results:
included
15,819
(mean
age
80.7
years;
70.0%
female),
54.3%
(n
=
15,728)
receiving
at
least
medication.
19.3%
met
definition
Logistic
regression
adjusted
diagnosis,
year
rural
urban
location
residence
demonstrated
both
men
women
that
younger
increased
risk
(women:
OR
0.97,
95%CI[0.96,
0.98],
men:
0.96,
95%CI[0.95,
0.97]).
Men
less
likely
if
their
(OR
0.86,
95%CI[0.74,
0.99]),
but
there
no
significant
association
(urban
rural)
dementia.
Antidepressants
most
class,
while
quetiapine
Conclusions:
suggests
are
living
locations
access
non-pharmacological
management.
Journal of the American Geriatrics Society,
Год журнала:
2023,
Номер
72(1), С. 126 - 138
Опубликована: Дек. 20, 2023
Abstract
Background
Potentially
inappropriate
medications
(PIMs)
in
older
adults
are
which
risks
often
outweigh
benefits
and
suggested
to
be
avoided.
Worldwide,
many
distinct
guidelines
tools
classify
PIMs
adults.
Collating
these
tools,
mapping
them
a
medication
classification
system,
creating
crosswalk
will
enhance
the
utility
of
PIM
guidance
for
research
clinical
practice.
Methods
We
used
Anatomical
Therapeutic
Chemical
(ATC)
Classification
System,
hierarchical
map
from
eight
(2019
Beers
Criteria,
Screening
Tool
Older
Person's
Appropriate
Prescriptions
[STOPP],
STOPP‐Japan,
German
PRISCUS,
European
Union‐7
Inappropriate
Medication
[PIM]
list,
Centers
Medicare
&
Medicaid
Services
[CMS]
High‐Risk
Medication,
Anticholinergic
Burden
Scale,
Drug
Index).
Each
was
mapped
ATC
Level
5
(drug)
4
(drug
class).
then
(1)
compare
drug
classes
across
determine
number
that
were
index
(drug‐induced
adverse
event)
or
marker
(treatment
drug‐induced
prescribing
cascades,
(2)
estimate
prevalence
use
continuously
enrolled
with
fee‐for‐service
2018
as
cases.
Data
visualization
descriptive
statistics
assess
both
Results
Out
480
unique
identified,
only
three
medications—amitriptyline,
clomipramine,
imipramine
two
classes—N06AA
(tricyclic
antidepressants)
N06AB
(selective
serotonin
reuptake
inhibitors),
noted
all
tools.
Using
crosswalk,
50%
drugs
47%
known
cascades
PIMs.
Additionally,
88%
beneficiaries
dispensed
≥1
Conclusion
created
system
Our
findings
could
expand
ease
identification
harmonization
practice
purposes.
