Effects of warning information at medication initiation on deprescribing intentions in older adults: A hypothetical vignette

Patient Education and Counseling, Год журнала: 2025, Номер 133, С. 108654 - 108654

Опубликована: Янв. 11, 2025

Язык: Английский

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Antibiotic Use and Risk of Microscopic Colitis in Older Adults: A Nationwide Self‐Controlled Case Series Study

Alimentary Pharmacology & Therapeutics, Год журнала: 2025, Номер unknown

Опубликована: Фев. 11, 2025

ABSTRACT Background Several drugs have been linked to the risk of microscopic colitis (MC), a condition characterised by watery, non‐bloody diarrhoea. Antibiotics can induce similar symptoms, but their connection MC remains unclear. Aim To investigate antibiotic‐related risks in adults aged 65 years and older. Methods This was nationwide, self‐controlled case series study including ≥ with new prescription for antibiotics biopsy‐confirmed, incident (Sweden, 2007–17). We identified cases from nationwide histopathology cohort ESPRESSO individually several registers. Using conditional Poisson regression, we estimated incidence rate ratios (IRR) four periods: on treatment, 1–14, 15–91, 92–365 days post‐treatment, compared non‐treatment periods same individual. also conducted negative control outcome analysis assess whether association specific or due diagnostic workup. E‐values were used robustness unmeasured confounding. Results 2393 persons biopsy‐confirmed (median age at diagnosis 74; 67% women). Compared periods, age‐adjusted increased antibiotic treatment (IRR: 1.44 [95% CI: 1.13–1.84], E‐value: 2.24), 1–14 1.12 [0.83–1.49]), 15–91 (1.12 [0.97–1.31]) post‐treatment (1.19 [1.07–1.32]). The showed normal mucosa after use. Conclusion observed between use may result detection bias rather than causal relationship.

Язык: Английский

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Patterns of medication use and the burden of polypharmacy in patients with chronic kidney disease: the German Chronic Kidney Disease study

Clinical Kidney Journal, Год журнала: 2019, Номер 12(5), С. 663 - 672

Опубликована: Март 27, 2019

Patients with chronic kidney disease (CKD) bear a substantial burden of comorbidities leading to the prescription multiple drugs and risk polypharmacy. However, data on medication use in this population are scarce.A total 5217 adults an estimated glomerular filtration rate (eGFR) between 30 60 mL/min/1.73 m2 or eGFR ≥60 mL/min/1.73m2 overt proteinuria (>500 mg/day) were studied. Self-reported current assessed at baseline (2010-12) after 4 years follow-up (FU). Prevalence factors associated polypharmacy (defined as regular five more per day) well initiation termination evaluated using multivariable logistic regression.The prevalence FU was almost 80%, ranging from 62% patients CKD Stage G1 86% those G3b. The median number different medications taken day eight (range 0-27). β-blockers, angiotensin-converting enzyme inhibitors statins most frequently used. Increasing G stage, age body mass index, diabetes mellitus, cardiovascular history smoking significantly both its maintenance during FU. Diabetes mellitus also [odds ratio (OR) 2.46, (95% confidence interval 1.36-4.45); P = 0.003].Medication is high. Further research appears warranted address implications polypharmacy, risks drug interactions strategies for reduction vulnerable patient population.

Язык: Английский

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Drug related problems in clinical practice: a cross-sectional study on their prevalence, risk factors and associated pharmaceutical interventions

Scientific Reports, Год журнала: 2021, Номер 11(1)

Опубликована: Янв. 13, 2021

Abstract Drug-related problems (DRP) cause preventable negative health outcomes, especially during hospital admissions. The aim of our study was to examine the prevalence and characteristics DRP in regular clinical pharmacy, as well determine those factors associated with a higher risk setting. We analyzed data from standardized registry database pharmacy practice (2015- 2016). were classified according Pharmaceutical Care Network Europe v6.2 classification. Cross-sectional obtained 1602 adults admitted medical wards. Crude adjusted binary logistic regressions performed identify associations between potential DRP. Overall high across specialties (45,1%), population characterized by advanced age, polypharmacy multimorbidity. Problems leading mainly into two domains (effectiveness adverse reactions), being drug dose selection most frequent causes. Interventions accepted totally or partially solved 74.1% 4.81% cases, respectively. In model polypharmacy, allergies, BMI > 25 kg/m2 clearance < 30 mL/min participation pharmacists multidisciplinary teams promotes detection solution Polypharmacy, obesity, renal impairment allergy are admission.

Язык: Английский

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Hypertension and Drug Adherence in the Elderly

Frontiers in Cardiovascular Medicine, Год журнала: 2020, Номер 7

Опубликована: Апрель 7, 2020

Hypertension is highly prevalent after the age of 65 years affecting more than 60% individuals in developed countries. Today, there sufficient evidence from clinical trials that treating elderly subjects with hypertension antihypertensive medications has a positive benefit/risk ratio even very patients (>80 years). In recent years, partial or total non-adherence been recognized as major issues long-term management all categories. However, whether frequent hypertensive older not still matter debate and common belief adherence lower younger patients. Are data supporting this belief? brief review, we discuss topic drug context medical treatment hypertension. Studies show actually better aged to 80 when compared (80 years) prevalence does increase. patients' group, are specific risk factors for such cognitive ability, depression health believes, addition classical non-adherence. One important aspect prescription potentially inappropriate will interfere necessary treatments. context, an interesting new concept was few ago, i.e. process deprescribing. Thus, today, conventional guidelines recommendations (use single pill combinations, individualization treatments), evaluation abilities, regular assessment deprescribing appear be three additional steps improve thereby ameliorate global

Язык: Английский

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“Inactive” ingredients in oral medications

Science Translational Medicine, Год журнала: 2019, Номер 11(483)

Опубликована: Март 13, 2019

Inactive ingredients in oral medications are generally poorly appreciated, and many include materials associated with adverse reactions patients.

Язык: Английский

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Incidence of and Risk Factors for Hepatic Encephalopathy in a Population‐Based Cohort of Americans With Cirrhosis

Hepatology Communications, Год журнала: 2019, Номер 3(11), С. 1510 - 1519

Опубликована: Сен. 6, 2019

Hepatic encephalopathy (HE) is a devastating complication of cirrhosis. Data are limited regarding the incidence and risk factors for HE among contemporary patients in context shifting epidemiology We examined 20% random sample U.S. Medicare enrollees with cirrhosis Part D prescription coverage from 2008 to 2014. modelled incident using demographic, clinical, pharmacologic data. Risk were evaluated, including demographics/socioeconomics, etiology, severity liver disease, pharmacotherapy, along gastroenterology consultation, as time‐varying covariates. Among 166,192 followed 5.25 (interquartile range [IQR], 2.00‐7.00) years, overall was 11.6 per 100 patient‐years. The cohort's median age 65 years (IQR, 57‐72), 31% had alcohol‐related cirrhosis, 49% likely nonalcoholic fatty disease two strongest associations (adjusted hazard ratio [AHR], 1.44; 95% confidence interval [CI], 1.40, 1.47, relative nonviral cirrhosis) presence portal hypertension (AHR, 3.42; CI, 3.34, 3.50). Adjusting confounders, benzodiazepines 1.24; 1.21, 1.27), gamma aminobutyric acid (GABA)ergics 1.17; 1.14, 1.21), opioids proton pump inhibitors (PPIs) 1.41; 1.38, 1.45) all associated HE. Only benzodiazepines, however, hospitalization (incidence‐rate ratio, 1.23; 1.20, 1.26). Conclusion: Novel data provided. an older population Americans high, particularly those hypertension. Several medication classes, namely PPIs, opiates, GABAergics, represent potentially modifiable

Язык: Английский

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Polypharmacy: A general review of definitions, descriptions and determinants

Therapies, Год журнала: 2019, Номер 75(5), С. 407 - 416

Опубликована: Окт. 28, 2019

Язык: Английский

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Prevalence of adverse drug reactions in the primary care setting: A systematic review and meta-analysis

PLoS ONE, Год журнала: 2021, Номер 16(5), С. e0252161 - e0252161

Опубликована: Май 26, 2021

Background Adverse drug reactions (ADRs) represent a major cause of iatrogenic morbidity and mortality in patient care. While substantial body work has been undertaken to characterise ADRs the hospital setting, overall burden primary care remains unclear. Objectives To investigate prevalence setting factors affecting heterogeneity estimates. Methods Studies were identified through searching Medline, Embase, CINAHL IPA databases. We included observational studies that reported information on patients receiving Disease treatment specific excluded. Quality assessed using Smyth adapted scale. A random-effects model was used calculate pooled estimate. Potential source heterogeneity, including age groups, definitions, detection methods, study quality studies, sample size, investigated sub-group analysis meta-regression. Results Thirty-three with total population 1,568,164 individuals included. The 8.32% (95% CI, 7.82, 8.83). percentage preventable ranged from 12.35–37.96%, estimate 22.96% 38.09). Cardiovascular system drugs most commonly implicated medication class. detection, group, size contributed significantly Conclusion constitute significant health problem setting. Further research should focus examining whether affect subsequent clinical outcomes, particularly high-risk therapeutic areas. This may better inform strategies reduce

Язык: Английский

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An Increasing Trend in the Prevalence of Polypharmacy in Sweden: A Nationwide Register-Based Study

Frontiers in Pharmacology, Год журнала: 2020, Номер 11

Опубликована: Март 18, 2020

Polypharmacy is becoming a global health problem. The aims of this study were to evaluate the temporal trends in prevalence polypharmacy Sweden and explore disparities by age, gender, education, immigration status.Polypharmacy excessive evaluated using data extracted from Swedish Prescribed Drug Register between 2006 2014. was defined as being exposed five or more drugs 10 during 1 month respectively. Average annual percent change (AAPC) calculated Joinpoint Statistical Software.The increased 16.9% 19.0% 2014 with an AAPC 1.3; excess 3.8% 5.1% 3.4. dramatically age peaked up 79.6% 36.4% individuals aged 90 above Females lower education level associated higher rate polypharmacy. Immigrants Middle-Eastern countries had highest polypharmacy, whereas Western Europe lowest rate.The has gradually past decade. Individuals older female sex, have showed

Язык: Английский

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