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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Antonio Nuñez-Montenegro, Alonso Montiel-Luque, Esther Martin-Aurioles, Felicisima Garcia-Dillana, Monica Krag-Jiménez, Jose A González-Correa
To asses inappropriate prescribing and its predisposing factors in polymedicated patients over the age of 65 in primary health care. DESIGN: cross-sectional study. SETTING: Primary care centres in the Costa del Sol Health District and Northern Health Area of Malaga in southern Spain. PARTICIPANTS: Patients older than 65 years who use multiple medications. Data collection was conducted during 1 year in a population of 425 individuals who comprised a stratified randomized sample of the population of health care users in the study area...
March 4, 2019: Journal of Clinical Medicine
Ewa Deskur-Śmielecka, Jerzy Chudek, Agnieszka Neumann-Podczaska, Małgorzata Mossakowska, Barbara Wizner, Katarzyna Wieczorowska-Tobis
BACKGROUND: Numerous medications should be avoided, or require dose adjustment in subjects with impaired kidney function. We aimed to assess the prevalence of potentially inappropriate use of renal risk drugs in a nation-wide, community-dwelling Polish older adult population. METHODS: We analysed regular intake of 38 medications that should be avoided, requiring dose modification, increase the risk of pre-renal kidney injury, or may cause potassium retention in subjects with moderately to severely impaired renal function in the PolSenior data base (N = 4514, mean age 76 ± 11 yrs)...
March 5, 2019: BMC Geriatrics
Fabienne Flamme-Obry, Stéphanie Belaiche, Marc Hazzan, Nassima Ramdan, Christian Noël, Pascal Odou, Bertrand Décaudin
INTRODUCTION: Drug related problems (DRP) can lead to severe consequences in kidney recipients. The aim of the study was to assess the impact of the clinical pharmacist interventions on the incidence of DRP. METHOD: The number of DRP were evaluated according to 3periods: Without intervention, with medication reconciliation at admission, and with medication reconciliation at admission associated with an interview with the clinical pharmacist at discharge. RESULTS: Patients concerned were mainly men, 55years old (median age), stage3 of CKD, transplanted for less than 3months or more than 1year, with cardiovascular risk factors and receiving an average of 9drugs/day...
April 2018: Néphrologie & Thérapeutique
Denis Curtin, Paul F Gallagher, Denis O'Mahony
Polypharmacy and prescribing of potentially inappropriate medications (PIMs) are the key elements of inappropriate medication use (IMU) in older multimorbid people. IMU is associated with a range of negative healthcare consequences including adverse drug events and unplanned hospitalizations. Furthermore, prescribing guidelines are commonly derived from randomized controlled clinical trials which have specifically excluded older adults with multimorbidity. Consequently, indiscriminate application of single disease pharmacotherapy guidelines to older multimorbid patients can lead to increased risk of drug-drug interactions, drug-disease interactions and poor drug adherence...
2019: Therapeutic Advances in Drug Safety
Jo-Anne Manski-Nankervis, Sharmala Thuraisingam, Janet K Sluggett, Gary Kilov, John Furler, David O'Neal, Alicia Jenkins
BACKGROUND: Previous studies in general practice and hospital settings have identified that prescribing of non-insulin diabetes medications may be sub-optimal in people with type 2 diabetes (T2D) and renal impairment. Since these publications, a number of new medications have become available for the management of T2D. Study aims were to, in a cohort of Australians with T2D and renal impairment attending general practice, (1) investigate whether the prescribing of non-insulin diabetes medications is consistent with dosing adjustments recommended within current Australian Diabetes Society (ADS) guidelines; and (2) identify patient socio-demographic and clinical factors associated with at least one prescription of a non-insulin diabetes medication inconsistent with current ADS guidelines for medication doses...
February 18, 2019: BMC Family Practice
Krystina Parker, Ingrid Bull-Engelstad, Willy Aasebø, Nanna von der Lippe, Morten Reier-Nilsen, Ingrid Os, Knut Stavem
INTRODUCTION: Elderly patients with chronic kidney disease (CKD) stage 5 with or without dialysis treatment usually have concomitant comorbidities, which often result in multiple pharmacological therapies. This study aimed to identify factors associated with medication complexity and medication adherence, as well as the association between medication complexity and medication adherence, in elderly patients with CKD. METHODS: This prospective study involved elderly patients with CKD stage 5 (estimated glomerular filtration rate < 15 ml/min/1...
February 19, 2019: Hemodialysis International
Marko Stojanović, Milica Vuković, Milan Jovanović, Srđan Dimitrijević, Miroslav Radenković
RATIONALE, AIMS, AND OBJECTIVE: There is limited information about the comparative effectiveness of the START/STOPP (Screening Tool of Older Person's Prescriptions/Screening Tool to Alert doctors to Right Treatment) criteria and the Ghent Older People's Prescriptions community Pharmacy Screening tool (GheOP3 S tool) for the screening of potentially inappropriate prescribing (PIP) in the geriatric population. Considering this, the aim of this study was to compare the ability of the START/STOPP criteria and GheOP3 S tool to identify the PIP and potential prescribing omissions (PPOs) among elderly patients visiting their primary care physician...
February 5, 2019: Journal of Evaluation in Clinical Practice
Stefanie Thevelin, Leïla El Mounaouar, Sophie Marien, Benoit Boland, Séverine Henrard, Olivia Dalleur
BACKGROUND: Older persons are at significant risk of drug-related admissions (DRAs). We previously demonstrated that 27% of hospitalizations in geriatric patients were associated with potentially inappropriate medicines (PIMs) and/or potential prescribing omissions (PPOs) identified by the Screening Tool of Older People's Prescriptions/Screening Tool to Alert to Right Treatment (STOPP/START) criteria version 1 (v1 ). The updated STOPP/START criteria version 2 (v2 ) comprised a 31% increase in prescribing criteria...
January 29, 2019: Drugs & Aging
U G S Siripala, S P K Premadasa, N R Samaranayake, C A Wanigatunge
Background There is a dearth of published data from resource-limited settings on appropriateness of medicines in older adults using explicit criteria, but it is unclear if the STOPP/START criteria can be helpful. Objective To assess the usefulness of STOPP/START criteria in assessing appropriateness of medicines in a resource-limited setting. Setting Medical, diabetic and psychiatric clinics of a tertiary care hospital and elderly living in a selected locality in Colombo district. Method A descriptive cross-sectional study was conducted over a 2 months period among adults > 60 years on long-term medicines...
January 22, 2019: International Journal of Clinical Pharmacy
Kieran Dalton, Denis O'Mahony, David O'Sullivan, Marie N O'Connor, Stephen Byrne
BACKGROUND: Two randomised controlled trials (RCTs) conducted simultaneously in the same Irish university teaching hospital have shown that provision of Screening Tool of Older Persons' Prescriptions (STOPP)/Screening Tool to Alert doctors to Right Treatment (START) recommendations to attending prescribers by a physician or a pharmacist can reduce in-hospital adverse drug reactions (ADRs) in older adults (≥ 65 years). The aims of this study were to compare the prescriber implementation rates of STOPP/START recommendations between the physician approach and the pharmacist approach in these two RCTs and to provide a narrative summary of the comparable clinical outcomes...
January 19, 2019: Drugs & Aging
Elizabeth Manias, Andrea Maier, Gopika Krishnamurthy
BACKGROUND: Oldest old patients aged 85 years and over are at risk of experiencing potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) across transitions of care. Geriatricians also face enormous challenges in prescribing medications for these patients. METHODS: A mixed-methods, sequential explanatory design was undertaken of electronic medical records and semi-structured interviews with geriatricians at a public teaching hospital...
January 10, 2019: Aging Clinical and Experimental Research
Irum Butool, Shabnam Nazir, Maryam Afridi, Syed Majid Shah
Background & Objectives: Rational prescribing can prevent medication errors and the associated harm, especially in old age patients, as they are being frequently prescribed with drugs for various ailments. Moreover, polypharmacy is a common practice in them. Therefore, a significant threat of potential drug interactions and adverse effects exist. Current study focuses on assessment of Potentially Inappropriate Medication (PIM) in medication prescribed to old age patients. Methods: It was a forty days, descriptive and observational study conducted from August 15th 2017 to September 25th 2017 in which prescriptions given to elderly patients were reimbursed for collecting various sets of information...
November 2018: Pakistan Journal of Medical Sciences Quarterly
Wubshet H Tesfaye, Barbara C Wimmer, Gregory M Peterson, Ronald L Castelino, Matthew D Jose, Charlotte McKercher, Syed Tabish R Zaidi
OBJECTIVES: Potentially inappropriate medications (PIMs) use is associated with increased morbidity and mortality in chronic kidney disease (CKD). However, there is paucity of data on how hospitalization affects PIMs use in older adults with CKD. Therefore, we aimed to measure the impact of hospitalization on PIMs use in older CKD patients, and identify factors predicting PIMs use. METHODS: A retrospective cohort study was conducted in older adults (≥ 65 years) with CKD admitted to an Australian tertiary care hospital over a 6-month period...
December 17, 2018: Current Medical Research and Opinion
R Rodríguez-Blanco, M Álvarez-García, C Villalibre-Calderón, L D Piña-Ferreras, S Junquera-Alonso, J C Alonso-Lorenzo
INTRODUCTION: The aim of this study is to determine the rate of potentially inappropriate prescriptions (PIP) in people older than 64 years of age in Avilés, Asturias, Spain. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted in six Health Care Centres. A sample of 400 people was selected, obtained by a random sampling proportional to the population registered in each Health Centre. A review was made of the computerised clinical records, and the STOPP-START (version 2014 with 114 items) criteria were applied to evaluate the PIP...
December 10, 2018: Semergen
Eiji Kose, Toshiyuki Hirai, Toshiichi Seki
AIM: The association between potentially inappropriate medications (PIM) use and nutritional status is unclear in Japan. The aim of the present study was to establish whether PIM use during hospitalization affects the nutritional status among geriatric patients in the convalescing stage. METHODS: This retrospective longitudinal cohort study included consecutive geriatric patients admitted and discharged from convalescent rehabilitation wards between 2010 and 2016...
November 29, 2018: Geriatrics & Gerontology International
Bianca F Nieves-Pérez, Sullynette Guerrero-De Hostos, Mariela I Frontera-Hernández, Iadelisse Cruz González, José Josué Hernández Muñoz
OBJECTIVES: Prevalence of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs). DESIGN: Cross-sectional study through review of residents' records. SETTING: Three nursing homes of Puerto Rico's metropolitan area. PARTICIPANTS: Nursing home residents. INTERVENTION: Records of residents 65 years of age and older with documented medications and chronic diseases were reviewed. Hospitalized and hospice/palliative care residents were excluded. Beers criteria-2015 and START-STOPP criteria-2014 were applied to identify PIMs and PPOs...
November 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Philippe Martin, Robyn Tamblyn, Andrea Benedetti, Sara Ahmed, Cara Tannenbaum
Importance: High rates of inappropriate prescribing persist among older adults in many outpatient settings, increasing the risk of adverse drug events and drug-related hospitalizations. Objective: To compare the effectiveness of a consumer-targeted, pharmacist-led educational intervention vs usual care on discontinuation of inappropriate medication among community-dwelling older adults. Design, Setting, and Participants: A cluster randomized trial (D-PRESCRIBE [Developing Pharmacist-Led Research to Educate and Sensitize Community Residents to the Inappropriate Prescriptions Burden in the Elderly]) that recruited community pharmacies in Quebec, Canada, from February 2014 to September 2017, with follow-up until February 2018, and randomly allocated them to intervention or control groups...
November 13, 2018: JAMA: the Journal of the American Medical Association
Daryl U Nnani, Timothy Nguyen, Archna Jariwala, Vijay Lapsia
No abstract text is available yet for this article.
April 19, 2018: American Journal of Therapeutics
Katharina Schmidt-Mende, Björn Wettermark, Morten Andersen, Monique Elsevier, Juan-Jesus Carrero, Tero Shemeikka, Jan Hasselström
The aim of this population-based, cross-sectional study was to analyse the prevalence of renally inappropriate medicines (RIMs) in older people with renal impairment. We included 30 372 people aged ≥65 years with chronic kidney disease (CKD) stage 3, and 2161 with stage 4 attending primary care in Stockholm, Sweden. We used data derived from SCREAM, a database linking patient-specific data on demography, morbidity, healthcare consumption and dispensed drugs to creatinine measurements. Estimated glomerular filtration rate was calculated with CKD-EPI based on the first non-hospital serum creatinine in 2010...
October 17, 2018: Basic & Clinical Pharmacology & Toxicology
Emily Reeve, Jennifer L Wolff, Maureen Skehan, Elizabeth A Bayliss, Sarah N Hilmer, Cynthia M Boyd
Importance: Use of harmful and/or unnecessary medications in older adults is prevalent. This can lead to avoidable harms such as adverse drug reactions, falls, hospitalization, and mortality. Primary care physicians report that patient resistance to discontinuing medication use is a significant barrier to deprescribing. Objective: To describe the attitudes of older adults toward deprescribing and to determine whether individual characteristics are associated with these attitudes...
October 15, 2018: JAMA Internal Medicine
2018-10-18 06:48:36
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