Special Care in Dentistry,
Год журнала:
2022,
Номер
42(S1), С. 3 - 32
Опубликована: Янв. 1, 2022
General
anaesthesia
(GA)
may
be
required
to
support
the
care
of
those
seen
in
Special
Care
Dentistry
(SCD)
services
for
various
reasons,
such
as
enabling
extensive
dental
people
with
severe
learning
disabilities
or
phobia.
Guidance
is
needed
teams
delivering
SCD
using
GA
due
potential
risks,
implications,
and
costs
deliver
care.To
present
evidence-based
recommendations,
where
possible,
involved
providing
adults
within
services.A
multidisciplinary
working
group,
supported
by
a
formal
literature
search
stakeholder
involvement,
iteratively
produced
refined
recommendations
presented.There
was
little
evidence
inform
guidelines.
Recommendations
are
therefore
based
mainly
on
group's
expert
consensus
opinion.
Clinical
guidelines
presented
set
overarching
principles
followed
six
key
sections
reflecting
patients'
pathways
from
referral
through
their
during
after
GA.Guidelines
provide
SCD.
The
need
comprehensive
person-centered
assessment
planning
emphasized.
Expert Opinion on Drug Safety,
Год журнала:
2018,
Номер
17(12), С. 1185 - 1196
Опубликована: Дек. 2, 2018
Polypharmacy,
the
use
of
multiple
medications
by
one
individual,
is
increasingly
common
among
older
adults.
Caring
for
growing
number
people
with
complex
drug
regimens
and
multimorbidity
presents
an
important
challenge
in
coming
years.This
article
reviews
international
trends
prevalence
polypharmacy,
summarizes
results
from
previous
on
polypharmacy
negative
health
outcomes,
updates
a
review
clinical
consequences
focusing
studies
published
after
2013.
This
narrative
review,
which
based
literature
search
MEDLINE
EMBASE
January
1990
to
June
2018,
was
undertaken
identify
relevant
articles.
Search
terms
included
variations
medications.The
increasing
worldwide.
More
than
half
population
exposed
some
settings.
Polypharmacy
associated
broad
range
consequences.
However,
methods
assess
dangers
should
be
refined.
In
our
opinion,
issue
'confounding
multimorbidity'
has
been
underestimated
better
accounted
future
studies.
Moreover,
researchers
develop
more
clinically
definitions
including
measures
inappropriate
or
problematic
polypharmacy.
Therapeutic Advances in Drug Safety,
Год журнала:
2020,
Номер
11
Опубликована: Янв. 1, 2020
A
high
rate
of
polypharmacy
is,
in
part,
a
consequence
the
increasing
proportion
multimorbidity
ageing
population
worldwide.
Our
understanding
potential
harm
taking
multiple
medications
an
older,
multi-morbid
population,
who
are
likely
to
be
on
regime,
is
limited.
This
narrative
literature
review
that
aims
appraise
and
summarise
recent
studies
published
about
polypharmacy.
We
searched
MEDLINE
using
search
terms
(and
its
variations,
e.g.
prescriptions,
inappropriate
drug
use,
etc.)
titles.
Systematic
reviews
original
English
between
2003
2018
were
included.
In
this
review,
we
provide
current
definitions
identify
determinants
prevalence
reported
different
studies.
Finally,
some
findings
regarding
association
health
outcomes
older
adults,
with
focus
frailty,
hospitalisation
mortality.
Polypharmacy
was
most
often
defined
number
being
taken
by
individual
at
any
given
time.
showed
varied
10%
as
around
90%
populations.
Chronic
conditions,
demographics,
socioeconomics
self-assessed
factors
independent
predictors
associated
various
adverse
after
adjusting
for
conditions.
Optimising
care
valid,
reliable
measures,
relevant
all
patients,
will
improve
adult
population.
European Geriatric Medicine,
Год журнала:
2021,
Номер
12(3), С. 443 - 452
Опубликована: Март 10, 2021
Abstract
Background
The
number
of
older
adults
has
been
constantly
growing
around
the
globe.
Consequently,
multimorbidity
and
related
polypharmacy
have
become
an
increasing
problem.
In
absence
accepted
agreement
on
definition
polypharmacy,
data
its
prevalence
in
various
studies
are
not
easily
comparable.
Besides,
evidence
potential
adverse
clinical
outcomes
to
is
limited
though
linked
numerous
outcomes.
This
narrative
review
aims
find
summarize
recent
publications
definitions,
epidemiology
consequences
polypharmacy.
Methods
MEDLINE
database
was
used
identify
definition,
using
their
respective
common
terms
variations.
Systematic
reviews
original
published
between
2015
2020
were
included.
Results
One
hundred
forty-three
definitions
associated
found.
Most
them
numerical
definitions.
Its
ranges
from
4%
among
community-dwelling
people
over
96.5%
hospitalized
patients.
addition,
with
Conclusion
term
imprecise,
yet
subject
ongoing
debate.
clinically
oriented
found
this
such
as
appropriate
or
necessary
more
useful
relevant.
Regardless
highly
prevalent
adults,
particularly
nursing
home
residents
Approaches
increase
appropriateness
can
improve
adults.
OECD health working papers,
Год журнала:
2020,
Номер
unknown
Опубликована: Май 30, 2020
While
health
care
quality
has
been
improving
on
average
in
OECD
members
countries,
patient
safety
remains
a
central
priority
for
policy
makers
and
leaders.
A
growing
research
body
found
that
PSC
is
associated
with
numerous
positive
outcomes,
including
improved
experience,
organisational
productivity
staff
satisfaction.
Tools
to
measure
have
proliferated
recent
decades
are
now
wide-spread
use.
This
report
includes
findings
from
countries
the
state
of
art
measurement
practices
related
PSC.
Overall,
prevalent
across
though
application,
purpose,
tools
vary.
International
learning
benchmarking
significant
potential
better
understanding
improvement
quality.
Abstract
Introduction
Polypharmacy
is
commonly
associated
with
adverse
health
outcomes.
There
are
currently
no
meta-analyses
of
the
prevalence
polypharmacy
or
factors
polypharmacy.
We
aimed
to
estimate
pooled
and
in
a
systematic
review
meta-analysis.
Methods
MEDLINE,
EMBASE,
Cochrane
databases
were
searched
for
studies
restrictions
on
date.
included
observational
that
reported
among
individuals
over
age
19.
Two
reviewers
extracted
study
characteristics
including
definitions,
design,
setting,
geography,
participant
demographics.
The
risk
bias
was
assessed
using
Newcastle-Ottawa
Scales.
main
outcome
prevalence.
estimates
95%
confidence
intervals
determined
random
effects
Subgroup
analyses
undertaken
evaluate
such
as
design
geography.
Meta-regression
conducted
assess
associations
between
year.
Results
106
full-text
articles
identified.
estimated
54
reporting
all
medication
classes
37%
(95%
CI:
31-43%).
Differences
different
numerical
thresholds,
publication
Sex,
geographical
location
not
differences
Discussion
Our
highlights
common
particularly
older
adults
those
inpatient
settings.
Clinicians
should
be
aware
populations
who
have
an
increased
likelihood
experiencing
efforts
made
appropriateness
prescribed
medications
occurrence
potentially
Conclusions
implications
undertake
minimize
inappropriate
whenever
possible.
BJGP Open,
Год журнала:
2020,
Номер
4(3), С. bjgpopen20X101096 - bjgpopen20X101096
Опубликована: Июль 28, 2020
Background
Managing
polypharmacy
is
a
challenge
for
healthcare
systems
globally.
It
also
health
inequality
concern
as
it
can
expose
some
of
the
most
vulnerable
in
society
to
unnecessary
medications
and
adverse
drug-related
events.
Care
patients
with
multimorbidity
occurs
primary
care.
Safe
deprescribing
interventions
reduce
exposure
inappropriate
polypharmacy.
However,
these
are
not
fully
accepted
or
routinely
implemented.
Aim
To
identify
barriers
facilitators
safe
adults
Design
&
setting
A
systematic
review
studies
published
from
2000,
examining
Method
search
electronic
databases:
MEDLINE,
Embase,
Cumulative
Index
Nursing
Allied
Health
Literature
(CINHAL),
Cochrane,
Management
Information
Consortium
(HMIC)
inception
26
Feb
2019,
using
an
agreed
strategy.
This
was
supplemented
by
handsearching
relevant
journals,
screening
reference
lists
citations
included
studies.
Results
In
total,
40
14
countries
were
identified.
Cultural
organisational
included:
culture
diagnosing
prescribing;
evidence-based
guidance
focused
on
single
diseases;
lack
care
older
people
multimorbidities;
shared
communication,
decision-making
systems,
tools,
resources.
Interpersonal
individual-level
professional
etiquette;
fragmented
care;
prescribers’
patients’
uncertainties;
gaps
tailored
support.
Facilitators
prudent
greater
availability
acceptability
non-pharmacological
alternatives;
resources;
improved
collaboration,
knowledge,
understanding;
patient-centred
decision-making.
Conclusion
whole
approach
required,
involving
key
decision-makers,
professionals,
patients,
carers.
OECD health working papers,
Год журнала:
2022,
Номер
unknown
Опубликована: Сен. 13, 2022
Poor
medication
practices
and
inadequate
system
infrastructure—resulting
in
poor
adherence,
medication-related
harms,
errors—too
often
results
patient
harm.
As
many
as
1
10
hospitalizations
OECD
countries
may
be
caused
by
a
event
one
five
inpatients
experience
harms
during
hospitalization.
Together,
costs
from
avoidable
admissions
due
to
events
added
length
of
stay
preventable
hospital-acquired
total
over
USD
54
billion
countries.
This
report
includes
four
components;
it
1)
assess
the
human
impact
economic
safety
countries,
2)
explores
opportunities
improve
prescribing
3)
examines
state-of-the
art
systems
policies
for
improving
safety,
4)
provides
recommendations
at
national
level.
The Lancet Healthy Longevity,
Год журнала:
2024,
Номер
5(4), С. e287 - e296
Опубликована: Март 4, 2024
Multimorbidity
(multiple
conditions)
and
polypharmacy
medications)
are
increasingly
common,
yet
there
is
a
need
to
better
understand
the
prevalence
of
co-occurrence.
In
this
systematic
review,
we
examined
multimorbidity
among
adults
(≥18
years)
older
(≥65
in
clinical
community
settings.
Six
electronic
databases
were
searched,
87
studies
retained
after
two
levels
screening.
Most
focused
on
65
years
done
population-based
Although
operational
definitions
varied
across
studies,
consistent
cut-points
(two
or
more
conditions
five
used
most
studies.
adult
samples,
ranged
from
4·8%
93·1%,
while
2·6%
86·6%.
High
heterogeneity
between
indicates
for
reporting
specific
lists
medications
definitions.
