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Dmitri Zintchouk, Merete Gregersen, Torsten Lauritzen, Else Marie Damsgaard
BACKGROUND AND PURPOSE: Eighty-eight percent of older adults referred to Danish non-hospital-based rehabilitation units used ≥5 regular drugs per day at the beginning of rehabilitation. The aim of the study was to explore whether geriatrician-performed comprehensive geriatric care had an impact on medication use and cognitive function in older adults after a 90-day follow-up. METHODS: There were 368 individuals aged ≥65 years recruited from 2 Danish non-hospital-based rehabilitation units and randomized to geriatric care (the intervention group) or usual care (the control group)...
October 25, 2018: American Journal of Medicine
Paolo Fabbietti, Carmelinda Ruggiero, Federica Sganga, Sergio Fusco, Federica Mammarella, Norma Barbini, Laura Cassetta, Graziano Onder, Andrea Corsonello, Fabrizia Lattanzio, Mirko Di Rosa
AIM: To comparatively investigate the effects of hyperpolypharmacy and potentially inappropriate medications (PIMs) on functional decline in older patients after hospital discharge. METHODS: Our series consisted of 733 patients aged ≥65 consecutively enrolled in a multicenter observational longitudinal study. PIMs were defined on the basis of updated versions of Beers and STOPP criteria. The occurrence of functional decline was defined as the loss of independency in at least 1 basic activity of daily living (BADL) from discharge through 3-month follow-up visit...
July 2018: Archives of Gerontology and Geriatrics
Gulcin Done Unutmaz, Pinar Soysal, Busra Tuven, Ahmet Turan Isik
Background: Polypharmacy and inappropriate drug use cause numerous complications, such as cognitive impairment, frailty, falls, and functional dependence. The present study aimed to determine the effect of the comprehensive geriatric assessment (CGA) on polypharmacy, potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs), and to evaluate the economic reflections of medication changes. Methods: One thousand five hundred and seventy-nine older patients, who had undergone CGA, were retrospectively evaluated...
2018: Clinical Interventions in Aging
George O Agogo, Christine M Ramsey, Danijela Gnjidic, Daniela C Moga, Heather Allore
ABSTRACTBackground:Longitudinal studies of older adults are characterized by high dropout rates, multimorbid conditions, and multiple medication use, especially proximal to death. We studied the association between multiple medication use and incident dementia diagnoses including Alzheimer's disease (AD), vascular dementia (VD), and Lewy-body dementia (LBD), simultaneously accounting for dropout. METHODS: Using the National Alzheimer's Coordinating Center data with three years of follow-up, a set of covariate-adjusted models that ignore dropout was fit to complete-case data, and to the whole-cohort data...
October 2018: International Psychogeriatrics
Natasha Slater, Simon White, Rebecca Venables, Martin Frisher
OBJECTIVES: While older age and ill health are known to be associated with polypharmacy, this paper aims to identify whether wealth, body mass index (BMI), smoking and alcohol consumption are also associated with polypharmacy (5-9 prescribed medications) and hyperpolypharmacy prevalence (≥10 prescribed medications), among older people living in England. DESIGN: Cross-sectional study. SETTING: The English Longitudinal Study of Ageing Wave 6 (2012-2013)...
March 14, 2018: BMJ Open
Ben Schöttker, Kai-Uwe Saum, Dana Clarissa Muhlack, Liesa Katharina Hoppe, Bernd Holleczek, Hermann Brenner
PURPOSE: The objective was to investigate whether the association of polypharmacy with non-cancer mortality is independent from comorbidity and is not a result of confounding by indication. METHODS: Analyses were conducted in 2687 participants of a German, population-based cohort of older adults with data collection 2008-2010. Polypharmacy was defined as ≥5 drugs and hyperpolypharmacy as ≥10 drugs. Drugs without relevant propensity of causing adverse drug reactions or drug-drug interactions were not counted...
August 2017: European Journal of Clinical Pharmacology
Marta Gutiérrez-Valencia, Mikel Izquierdo, Vincenzo Malafarina, Javier Alonso-Renedo, Belén González-Glaría, Beatriz Larrayoz-Sola, María Pilar Monforte-Gasque, Pello Latasa-Zamalloa, Nicolás Martínez-Velilla
AIM: Polypharmacy is a highly prevalent geriatric syndrome, and hospitalizations can worsen it. The aim of the present study was to analyze the influence of hospitalization on polypharmacy and indicators of quality of prescribing, and their possible association with health outcomes. METHODS: A retrospective study of 200 patients discharged from an acute geriatric unit was carried out. Indicators of quality of prescription were registered at admission and discharge: polypharmacy defined as ≥5 medications, hyperpolypharmacy (≥10), potentially inappropriate prescribing by Beers and Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria, potentially prescribing omissions by Screening Tool to Alert doctors to the Right Treatment (START) criteria, drug interactions and anticholinergic burden measured with the Anticholinergic Risk Scale...
December 2017: Geriatrics & Gerontology International
Kai-Uwe Saum, Ben Schöttker, Andreas D Meid, Bernd Holleczek, Walter E Haefeli, Klaus Hauer, Hermann Brenner
OBJECTIVES: To investigate the relationship between polypharmacy and frailty. DESIGN: Longitudinal, observational cohort study. SETTING: Saarland, Germany. PARTICIPANTS: 3,058 community-dwelling adults aged between 57 and 84 years. MEASUREMENTS: Frailty was assessed according to the frailty phenotype, described by Fried et al. Polypharmacy and hyperpolypharmacy were defined as the concomitant use of five or more and 10 or more drugs, respectively...
February 2017: Journal of the American Geriatrics Society
Piergiorgio Cojutti, Luca Arnoldo, Giovanni Cattani, Silvio Brusaferro, Federico Pea
PURPOSE: The aim of this point-prevalence study was to assess the occurrence of polypharmacy and hyperpolypharmacy and the risk of potentially inappropriate prescriptions (PIPs) among elderly and very elderly patients in different health-care settings of the Friuli-Venezia Giulia region in the North-East of Italy. METHODS: Prescription pattern of elderly (65-79 years) and very elderly (>79 years) patients in three different health-care settings [hospitals, general practitioners, and long-term care facilities (LTCFs)] was assessed in March 2014, and PIPs were assessed according to the Beers criteria...
September 2016: Pharmacoepidemiology and Drug Safety
Ruth E Hubbard, Nancye M Peel, Ian A Scott, Jennifer H Martin, Alesha Smith, Peter I Pillans, Arjun Poudel, Leonard C Gray
OBJECTIVES: To investigate medication changes for older patients admitted to hospital and to explore associations between patient characteristics and polypharmacy. DESIGN: Prospective cohort study. PARTICIPANTS AND SETTING: Patients aged 70 years or older admitted to general medical units of 11 acute care hospitals in two Australian states between July 2005 and May 2010. All patients were assessed using the interRAI assessment system for acute care...
April 20, 2015: Medical Journal of Australia
Prasad S Nishtala, Mohammed Saji Salahudeen
BACKGROUND: Polypharmacy and hyperpolypharmacy are proxy indicators for inappropriate medicine use. Inappropriate medicine use in older people leads to adverse clinical outcomes. OBJECTIVE: The objectives of this study were to investigate the prevalence and trends of polypharmacy and hyperpolypharmacy in older people in New Zealand from 2005 to 2013, analyzing the pharmaceutical collections maintained by the Ministry of Health. METHODS: A repeated cross-sectional analysis of population-level dispensing data was conducted from January 1, 2005 to December 31, 2013...
2015: Gerontology
Maureen Runganga, Nancye M Peel, Ruth E Hubbard
BACKGROUND: Older adults with a range of comorbidities are often prescribed multiple medications, which may impact on their function and cognition and increase the potential for drug interactions and adverse events. AIMS: This study investigated the extent of polypharmacy and potentially inappropriate medications in patients receiving post-discharge transitional home care and explored the associations of polypharmacy with patient characteristics, functional outcomes, and frailty...
2014: Clinical Interventions in Aging
D Gnjidic, S N Hilmer, F M Blyth, V Naganathan, R G Cumming, D J Handelsman, A J McLachlan, D R Abernethy, E Banks, D G Le Couteur
Evidence about the association between treatment with high-risk medicines and frailty in older individuals is limited. We investigated the relationship between high-risk prescribing and frailty at baseline, as well as 2-year incident frailty, in 1,662 men ≥70 years of age. High-risk prescribing was defined as polypharmacy (≥5 medicines), hyperpolypharmacy (≥10 medicines), and by the Drug Burden Index (DBI), a dose-normalized measure of anticholinergic and sedative medicines. At baseline, frail participants had adjusted odds ratios (ORs) of 2...
March 2012: Clinical Pharmacology and Therapeutics
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