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Jerry Teng CL, Yeh SP, Chen TY, Hung YC, Lin YC, Li SS, Wang MC, Huang SY. Treatment pattern among patients with relapsed/refractory multiple myeloma (RRMM) who had received pomalidomide-based regimens in Taiwan. Hematology 2024; 29:2365096. [PMID: 38958506 DOI: 10.1080/16078454.2024.2365096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 06/03/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND/PURPOSE The treatment landscape of relapsed/refractory multiple myeloma (RRMM) is rapidly evolving in Taiwan. The present study aimed to assess the treatment patterns among RRMM patients in Taiwan. METHODS This retrospective, chart review-based, non-interventional study collected data on RRMM patients (≥20 years old) receiving pomalidomide-based treatment between January 2017 and December 2020 across five sites in Taiwan. RESULTS Median age of the study population was 65.6 years. Approximately 75% patients received a doublet regimen and 25% were on a triplet regimen. Disease progression was the most common cause for switching to pomalidomide-based treatments in doublet (71.2%) and triplet (58.3%) groups. Patients in doublet and triplet groups (>80%) received 4 mg pomalidomide as a starting dose. Overall response rate (ORR: 31.5% and 45.8%) and median progression-free survival (PFS: 4.7 and 6.8 months) were reported in the doublet and triplet regimen. Doublet regimen was discontinued mainly due to disease progression or death (78.1%); however, triplet regimen patients mainly terminated their treatment due to reimbursement limitations (29.2%). Healthcare resource utilization (HRU) was comparable between doublet and triplet groups. CONCLUSION In Taiwan, half of RRMM patients received pomalidomide-based triplet regimens. Triplet regimens showed a trend towards better outcomes with longer PFS and higher response rates compared to doublets. Notably, the duration of triplet use is influenced by reimbursement limitations. This study provides insight into RRMM treatment patterns in Taiwan and the findings suggest that triplet regimens may be a better alternative than doublet regimens.
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Affiliation(s)
- Chieh-Lin Jerry Teng
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Division of Hematology/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Su-Peng Yeh
- Hematology Department, China Medical University Hospital, Taichung, Taiwan
| | - Tsai-Yun Chen
- Hematology Department, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Yu-Chin Hung
- Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Yu lin, Taiwan
| | - Yun-Chu Lin
- Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Sin Syue Li
- Hematology Department, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Ming-Chung Wang
- Hematology Department, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Shang-Yi Huang
- Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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2
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Ullah H, Khan H, Prieto Lage MA, Daglia M. Editorial: Herbal medical products and natural products targeting aging and age-related disorders--ethnopharmacological perspectives. Front Pharmacol 2024; 15:1368389. [PMID: 38357309 PMCID: PMC10864503 DOI: 10.3389/fphar.2024.1368389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 01/19/2024] [Indexed: 02/16/2024] Open
Affiliation(s)
- Hammad Ullah
- Department of Pharmacy, University of Napoli Federico II, Naples, Italy
| | - Haroon Khan
- Department of Pharmacy, Abdul Wali Khan University Mardan, Mardan, Pakistan
| | - Miguel Angel Prieto Lage
- Universidade de Vigo, Nutrition and Bromatology Group, Department of Analytical Chemistry and Food Science, Instituto de Agroecoloxía e Alimentaci on (IAA)–CITEXVI, Vigo, Spain
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Bragança, Portugal
| | - Maria Daglia
- Department of Pharmacy, University of Napoli Federico II, Naples, Italy
- International Research Center for Food Nutrition and Safety, Jiangsu University, Zhenjiang, China
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Jambo A, Edessa D, Adem F, Gashaw T. Appropriateness of antimicrobial selection for treatment of pneumonia in selected public hospitals of Eastern Ethiopia: A cross-sectional study. SAGE Open Med 2023; 11:20503121231163792. [PMID: 37065976 PMCID: PMC10102944 DOI: 10.1177/20503121231163792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/27/2023] [Indexed: 04/18/2023] Open
Abstract
Objective Inappropriate antimicrobial use leads to drug resistance and poor clinical outcomes. Considering the lack of data regarding the drug use patterns in the treatment of pneumonia in selected study areas, the authors felt compelled to assess the appropriateness of antimicrobial usage in the treatment of pneumonia at Hiwot Fana Specialized Comprehensive University Hospital and Jugal Hospital from May 1 to 31, 2021. Methods A cross-sectional retrospective study was conducted using the medical cards of 693 admitted patients with pneumonia. The collected data were analyzed using SPSS version 26. Bivariable and multivariable logistic regression analyses were used to identify the factors associated with an initial inappropriate antibiotic use. A p value of 0.05 was used to determine the statistical significance of the association using an adjusted odds ratio with 95% confidence interval. Results Of the total participants, 116 (16.74%, 95% confidence interval: 14.1-19.6) of them received an initial inappropriate antimicrobial regimen. Ceftriaxone plus azithromycin was the most prescribed antimicrobial agent. Patients who were younger than 5 years (adjusted odds ratio = 1.71; 95% confidence interval: 1.00-2.94), between 6 and 14 years (adjusted odds ratio = 3.14; 95% confidence interval: 1.64-6.00), and older than 65 years (adjusted odds ratio = 2.97; 95% confidence interval: 1.07-2.66), with comorbid conditions (adjusted odds ratio = 1.74; 95% confidence interval: 1.10-2.72) and prescribed by medical interns (adjusted odds ratio = 1.80; 95% confidence interval: 1.14-2.84) were associated with an initial inappropriate antimicrobial use. Conclusion Around one out of every six patients had received initial inappropriate treatments. Adherence to the recommendation of guidelines and attention to extreme-aged groups and comorbidity may improve antimicrobial use.
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Affiliation(s)
- Abera Jambo
- Clinical Pharmacy Department, School of
Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar,
Ethiopia
- Abera Jambo, Clinical Pharmacy Department,
School of Pharmacy, College of Health and Medical Sciences, Haramaya University,
Harar, Ethiopia.
| | - Dumessa Edessa
- Clinical Pharmacy Department, School of
Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar,
Ethiopia
| | - Fuad Adem
- Clinical Pharmacy Department, School of
Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar,
Ethiopia
| | - Tigist Gashaw
- Department of Pharmacology and
Toxicology, School of Pharmacy, College of Health and Medical Sciences, Haramaya
University, Harar, Ethiopia
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da Silva LGR, da Silva Pinto AW, de Queiroz WE, Coelho CC, Blatt CR, Oliveira MG, de Lima Pimentel AC, Elseviers M, Baldoni AO. Deprescribing clonazepam in primary care older patients: a feasibility study. Int J Clin Pharm 2022; 44:489-498. [PMID: 35022954 DOI: 10.1007/s11096-021-01371-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 12/16/2021] [Indexed: 12/23/2022]
Abstract
Background Inappropriate use of clonazepam by older adults is associated with cognitive impairment, delirium, and falls. Strategies to optimize its use are important to increase patient safety. Objective To evaluate the feasibility of a clonazepam deprescription protocol in the elderly. Methods This is a quasi-experimental study. Elderly people with chronic use of clonazepam and attended in primary care units in two Brazilian municipalities were selected. A deprescription protocol was used, which included five fortnightly meetings between the older adults and the research team, to reduce the dose by 25%. Patients received instructions on sleep hygiene behaviors and the advantages of clonazepam deprescription; family physicians followed a flowchart for gradual dose reduction. In the 1st and 5th meetings, there were medical appointments for anamnesis and discharge. The monitoring of patients and the application of tests were carried out by the research team. Results Of the 35 elderly people included in the study, 27 reached the end; 81.5% achieved deprescription: 22.2% stopped completely and 59.3% decreased the dose. At the last meeting, 20% of elderly patients reported an increase in blood pressure. Conclusion The high rate of deprescription and the little relevance of clonazepam withdrawal reactions, showed that the use of the protocol was effective. However, the increase in blood pressure and the worsening of sleep quality in the last meeting show the need for adjustment in the last stage of the deprescription process.
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Affiliation(s)
- Luanna Gabriella Resende da Silva
- Center for Teaching and Research in Clinical Pharmacy, Federal University of São João del-Rei, Campus Centro-Oeste Dona Lindu, Sebastião Gonçalves Coelho Street, 400, Chanadour, Divinópolis City, Minas Gerais, 35501-296, Brazil.
| | - Athos Wellington da Silva Pinto
- Center for Teaching and Research in Clinical Pharmacy, Federal University of São João del-Rei, Campus Centro-Oeste Dona Lindu, Sebastião Gonçalves Coelho Street, 400, Chanadour, Divinópolis City, Minas Gerais, 35501-296, Brazil
| | | | | | - Carine Raquel Blatt
- Department of Pharmacosciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre City, Rio Grande do Sul, Brazil
| | - Marcio Galvão Oliveira
- Master's Program in Collective Health, Multidisciplinary Institute for Health, Federal University of Bahia, Vitória da Conquista City, Bahia, Brazil
| | | | - Monique Elseviers
- Clinical Pharmacology Research Unit, Heymans Institute of Pharmacology, Ghent University, Ghent, Belgium
- Centre for Research and Innovation in Care (CRIC), University of Antwerp, Antwerp, Belgium
| | - André Oliveira Baldoni
- Center for Teaching and Research in Clinical Pharmacy, Federal University of São João del-Rei, Campus Centro-Oeste Dona Lindu, Sebastião Gonçalves Coelho Street, 400, Chanadour, Divinópolis City, Minas Gerais, 35501-296, Brazil
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Marques LO, Vasconcelos RC, Baldoni AO, Pestana ACNR, Chequer FMD. Cardiovascular drug labeling: Do they have information on necessary precautions for older people? GERIATRICS, GERONTOLOGY AND AGING 2020. [DOI: 10.5327/z2447-212320202000054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE: To analyze the existence of information on drug labeling intended for health professionals on the precaution of cardiovascular drugs use in older people. METHODS: This is a documentary study, carried out with the analysis of data contained in drug labelings. The existence of information on precautions in the use of drugs for older people as described in the 2016 Brazilian Consensus on Potentially Inappropriate Drugs for Older People (Consenso Brasileiro de Medicamentos Potencialmente Inapropriados para Idosos de 2016). RESULTS: Of the 29 drugs belonging to the cardiovascular system group that should be avoided by older people and are available in Brazil, 15 are independent of the clinical condition. Of these fifteen, only three drugs (20%) have explicit information in accordance with the Consensus (methyldopa, digoxin, and spironolactone); two (13.33%) have missing explicit information; four (26.66%) have explicitly discordant information; and six drug labels (40%) were categorized as non-explicit information. Regarding drug precautions according to clinical condition, 14 drugs were included. Of these, 12 (85.71%) have equal contraindications of that of Consensus on their drug labels, however, non-explicit; and two (14.28%) contraindications are missing. CONCLUSION: Most drug labels lack information on the precautions for the use of drugs in older people.
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Veloso RCDSG, Figueredo TPD, Barroso SCC, Nascimento MMGD, Reis AMM. Factors associated with drug interactions in elderly hospitalized in high complexity hospital. CIENCIA & SAUDE COLETIVA 2019; 24:17-26. [PMID: 30698236 DOI: 10.1590/1413-81232018241.32602016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 01/27/2017] [Indexed: 01/17/2023] Open
Abstract
This study aims to determine the frequency of potential drug-drug interactions (PDI) in hospitalized elderly and associated factors. This is a cross-sectional study in a teaching hospital. The dependent variable was the occurrence of potential drug interactions identified using DrugReax software. Patients with adverse drug reactions (ADR) related to clinical manifestations of PDIs were also identified. Multivariate logistic regressions was performed to analyze the association between the occurrence of PDIs and independent variables. In total, 237 older adults were included in the study. The prevalence of PDIs and interaction-related ADRs was 87.8% and 6.8%, respectively. The multivariate analysis showed a positive association between the detection of PDIs (OR 8.6; 95% CI, 2.5-30.0), and hospitalization due to a diagnosed circulatory system disease and number of medications > 14 (OR 9.8; 95% CI, 2.8-34.3%). The study showed a high prevalence of PDIs in the drug treatment of the elderly, but a lower prevalence of ADRs, as well as a positive association between PDIs and hospitalization due to a diagnosed circulatory system disease and number of medications > 14. The identification of factors associated with PDIs guides prevention measures for people that are more exposed to adverse events.
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Affiliation(s)
- Ronara Camila de Souza Groia Veloso
- Residência Integrada Multiprofissional em Saúde, Hospital das Clínicas, Universidade Federal de Minas Gerais. Alameda Álvaro Celso 117, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Tácita Pires de Figueredo
- Residência Integrada Multiprofissional em Saúde, Hospital das Clínicas, Universidade Federal de Minas Gerais. Alameda Álvaro Celso 117, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Soraya Coelho Costa Barroso
- Residência Integrada Multiprofissional em Saúde, Hospital das Clínicas, Universidade Federal de Minas Gerais. Alameda Álvaro Celso 117, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
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Li H, Pu S, Liu Q, Huang X, Kuang J, Chen L, Shen J, Cheng S, Wu T, Li R, Li Y, Mo L, Jiang W, Song Y, He J. Potentially inappropriate medications in Chinese older adults: The beers criteria compared with the screening tool of older persons' prescriptions criteria. Geriatr Gerontol Int 2017; 17:1951-1958. [PMID: 28224703 DOI: 10.1111/ggi.12999] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 11/25/2016] [Accepted: 12/07/2016] [Indexed: 02/05/2023]
Abstract
AIM The present study aimed to assess the prevalence of potentially inappropriate medications (PIM) use in West China Hospital residents aged ≥65 years, using two sets of criteria - the Beers and Screening Tool of Older Persons' Prescriptions (STOPP) criteria - and to compare the Beers and STOPP criteria, and to determine the better criteria for assessing PIM of older adults in China. METHODS This was a retrospective cross-sectional study, and all patients were aged ≥65 years and admitted through the Information Center of West China Hospital from October 2010 to April 2013. The Beers and STOPP criteria were used to identify PIM. A multivariate logistic regression study was used to identify the predictors of PIM use. RESULTS In the 6337 patients included, the mean age was 81.30 years (SD 6.75), 4795 (75.70%) were male and 5033 (79.42%) were prescribed at least one PIM by either criterion. The Beers criteria identified PIM use in 4593 (72.48%) of patients, and 3278 (51.73%) of patients used at least one PIM according to the STOPP criteria. The most prevalent PIM according to the Beers criteria were benzodiazepines (34.40%); according to the STOPP criteria, it was calcium channel blockers with chronic constipation (18.52%). Increasing age, sex (female), the number of diagnostic diseases and the number of prescribed medications predicted PIM use by both criteria. CONCLUSION The present study showed a high frequency of PIM in China. The Beers criteria had a higher detection rate and were more sensitive for assessing PIM of older adults in China. Geriatr Gerontol Int 2017; 17: 1951-1958.
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Affiliation(s)
- Hong Li
- Department of Pharmacy, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China.,Laboratory of Clinical Pharmacy and Adverse Drug Reaction, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China
| | - Shiyun Pu
- Department of Pharmacy, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China.,Laboratory of Clinical Pharmacy and Adverse Drug Reaction, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China
| | - Qinhui Liu
- Laboratory of Clinical Pharmacy and Adverse Drug Reaction, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China
| | - Xin Huang
- Department of Pharmacy, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China.,Laboratory of Clinical Pharmacy and Adverse Drug Reaction, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China
| | - Jiangying Kuang
- Department of Pharmacy, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China.,Laboratory of Clinical Pharmacy and Adverse Drug Reaction, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China
| | - Lei Chen
- Department of Pharmacy, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China.,Laboratory of Clinical Pharmacy and Adverse Drug Reaction, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China
| | - Jing Shen
- Department of Pharmacy, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China.,Laboratory of Clinical Pharmacy and Adverse Drug Reaction, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China
| | - Shihai Cheng
- Department of Pharmacy, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China.,Laboratory of Clinical Pharmacy and Adverse Drug Reaction, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China
| | - Tong Wu
- Department of Pharmacy, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China.,Laboratory of Clinical Pharmacy and Adverse Drug Reaction, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China
| | - Rui Li
- Department of Pharmacy, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China.,Laboratory of Clinical Pharmacy and Adverse Drug Reaction, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China
| | - Yanping Li
- Department of Pharmacy, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China.,Laboratory of Clinical Pharmacy and Adverse Drug Reaction, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China
| | - Li Mo
- The Center of Gerontology and Geriatrics, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China
| | - Wei Jiang
- Molecular Medicine Research Center, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China
| | - Yi Song
- Department of Pharmacy, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China
| | - Jinhan He
- Department of Pharmacy, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China.,Laboratory of Clinical Pharmacy and Adverse Drug Reaction, West China Hospital of Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan, China
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Lopes LM, Figueiredo TPD, Costa SC, Reis AMM. Utilização de medicamentos potencialmente inapropriados por idosos em domicílio. CIENCIA & SAUDE COLETIVA 2016; 21:3429-3438. [DOI: 10.1590/1413-812320152111.14302015] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 10/25/2015] [Indexed: 12/14/2022] Open
Abstract
Resumo O objetivo foi avaliar a frequência de utilização em domicílio de medicamentos potencialmente inapropriados por idosos e analisar a significância clínica. Trata-se de estudo transversal retrospectivo, recorte de um estudo de utilização de medicamentos desenvolvido em um hospital público. Os medicamentos inapropriados foram classificados empregando os três grupos de critérios explícitos incluídos na Lista de Beers de 2012. Houve inclusão de 190 idosos na pesquisa e a prevalência encontrada para utilização de medicamentos inapropriados foi 44,2%. As classes terapêuticas de medicamentos inapropriados mais utilizados foram antiinflamatórios não esteroidais, agentes cardiovasculares, benzodiazepínicos e antidepressivos. Identificou-se associação positiva entre utilização de medicamentos inapropriados e polifarmácia, polipatologia e hipertensão. Na Rename 2013 identificou-se 35(34,3%) fármacos inapropriados. O estudo demonstrou alta prevalência de utilização de medicamentos inapropriados pelos idosos. As consequências clínicas da utilização de medicamentos inapropriados são importantes para a saúde pública devido ao risco de eventos adversos e impacto negativo na funcionalidade do idoso. Na atenção ao idoso é importante desenvolver ações para promover o uso racional de medicamentos.
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Oliveira LPBAD, Santos SMAD. [An integrative review of drug utilization by the elderly in primary health care]. Rev Esc Enferm USP 2016; 50:167-79. [PMID: 27007434 DOI: 10.1590/s0080-623420160000100021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 10/10/2015] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To identify knowledge produced about drug utilization by the elderly in the primary health care context from 2006 to 2014. METHOD An integrative review of the PubMed, LILACS, BDENF, and SCOPUS databases, including qualitative research papers in Portuguese, English, and Spanish. It excluded papers with insufficient information regarding the methodological description. RESULTS Search found 633 papers that, after being subjected to the inclusion and exclusion criteria, made up a corpusof 76 publications, mostly in English and produced in the United States, England, and Brazil. Results were pooled in eight thematic categories showing the current trend of drug use in the elderly, notably the use of psychotropics, polypharmacy, the prevention of adverse events, and adoption of technologies to facilitate drug management by the elderly. Studies point out the risks posed to the elderly as a consequence of changes in metabolism and simultaneous use of several drugs. CONCLUSION There is strong concern about improving communications between professionals and the elderly in order to promote an exchange of information about therapy, and in this way prevent major health complications in this population.
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Jang K, Chung H, Yoon JS, Moon SJ, Yoon SH, Yu KS, Kim K, Chung JY. Pharmacokinetics, Safety, and Tolerability of Metformin in Healthy Elderly Subjects. J Clin Pharmacol 2016; 56:1104-10. [DOI: 10.1002/jcph.699] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 12/21/2015] [Accepted: 12/21/2015] [Indexed: 12/16/2022]
Affiliation(s)
- Kyungho Jang
- Department of Clinical Pharmacology and Therapeutics; Seoul National University College of Medicine and Hospital; Seoul Republic of Korea
| | - Hyewon Chung
- Department of Clinical Pharmacology and Therapeutics; Seoul National University College of Medicine and Hospital; Seoul Republic of Korea
| | - Jang-soo Yoon
- Department of Clinical Pharmacology and Therapeutics; Seoul National University College of Medicine and Hospital; Seoul Republic of Korea
| | - Seol-Joo Moon
- Department of Clinical Pharmacology and Therapeutics; Seoul National University College of Medicine and Hospital; Seoul Republic of Korea
| | - Seo Hyun Yoon
- Department of Clinical Pharmacology and Therapeutics; Seoul National University College of Medicine and Hospital; Seoul Republic of Korea
| | - Kyung-Sang Yu
- Department of Clinical Pharmacology and Therapeutics; Seoul National University College of Medicine and Hospital; Seoul Republic of Korea
| | - Kwangil Kim
- Department of Internal Medicine; Seoul National University College of Medicine and Bundang Hospital; Seongnam Republic of Korea
| | - Jae-Yong Chung
- Department of Clinical Pharmacology and Therapeutics; Seoul National University College of Medicine and Bundang Hospital; Seongnam Republic of Korea
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Martins GA, Acurcio FDA, Franceschini SDCC, Priore SE, Ribeiro AQ. Uso de medicamentos potencialmente inadequados entre idosos do Município de Viçosa, Minas Gerais, Brasil: um inquérito de base populacional. CAD SAUDE PUBLICA 2015; 31:2401-12. [DOI: 10.1590/0102-311x00128214] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Accepted: 05/04/2015] [Indexed: 12/13/2022] Open
Abstract
Resumo Avaliou-se o uso de medicamentos potencialmente inadequados entre idosos de Viçosa, Minas Gerais, Brasil, de acordo com os critérios de Beers 2012 e STOPP, bem como os fatores associados a esse uso. Estudo transversal com 621 idosos não institucionalizados, abordados por entrevista domiciliar. As variáveis explicativas foram sexo, idade, escolaridade, percepção da saúde, restrição de atividades nos últimos 15 dias, capacidade funcional, história de internação hospitalar, número de doenças autorreferidas e polifarmácia. Realizou-se análise de regressão de Poisson multivariada. Observou-se alta prevalência de uso de medicamentos potencialmente inadequados, 43,8% (IC95%: 37,8%-47,8%) e 44,8% (IC95%: 40,9%-48,8%), segundo os critérios de Beers 2012 e STOPP respectivamente. Sexo feminino e polifarmácia se mantiveram independentemente associados ao uso de medicamentos potencialmente inadequados, de acordo com os critérios de Beers. Para o critério STOPP, as variáveis independentemente associadas ao uso de medicamentos potencialmente inadequados foram sexo feminino, percepção de saúde regular e polifarmácia. Esforços são necessários para se qualificar a prática da polifarmácia entre idosos.
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12
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Ganassin AR, Matos VTGD, Toffoli-Kadri MC. Potentially inappropriate medication use in institutionalized older adults according to the Beers Criteria. BRAZ J PHARM SCI 2014. [DOI: 10.1590/s1984-82502014000400018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The need for specific care, coupled with new family arrangements, has contributed to the increasing institutionalization of elderly members. The purpose of this study was to evaluate drug use by institutionalized older adults according to Beers Criteria. This prospective, longitudinal study was conducted in the three non-profit long-stay geriatric care institutions of Campo Grande, in the Central-West region of Brazil. All subjects aged 60 years and above on November 2011 were included and followed until November 2012. Eighteen subjects were excluded and the final sample consisted of 133 individuals aged 60 to 113 years. Overall, 212 medications were used at geriatric care institution A, 532 at B, and 1329 at C. Thirty-four drugs were inappropriately prescribed 89 times at geriatric care institution A (41.98%), 49 prescribed 177 times at B (33.27%), and 91 prescribed 461 times at C (34.68%). Statistical differences in the inappropriate drug use were found between genders (p=0.007). The most commonly used potentially inappropriate medication were first-generation antihistamines (15.34%). There was a high frequency in the use of potentially inappropriate medications which can initiate marked side effects and may compromise the fragile health of institutionalized elderly. Thus, adopting the Beers Criteria in prescribing medication contributes to minimize adverse reactions and drug interactions.
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Ataollahi Eshkoor S, Hamid TA, Nudin SSH, Mun CY. Do medical treatments increase the risk of substance abuse in older people with dementia. JOURNAL OF SUBSTANCE USE 2014. [DOI: 10.3109/14659891.2014.909893] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Baldoni ADO, Ayres LR, Martinez EZ, Dewulf NDLS, Santos VD, Obreli-Neto PR, Pereira LRL. Pharmacoepidemiological profile and polypharmacy indicators in elderly outpatients. BRAZ J PHARM SCI 2013. [DOI: 10.1590/s1984-82502013000300006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
This cross-sectional study was carried out with 1000 elderly outpatients assisted by a Basic Health District Unit (UBDS) from the Brazilian Public Health System (SUS) in the municipality of Ribeirão Preto. We analyzed the clinical, socioeconomic and pharmacoepidemiological profile of the elderly patients in order to identify factors associated with polypharmacy amongst this population. We used a truncated negative binomial model to examine the association of polypharmacy with the independent variables of the study. The software SAS was used for the statistical analysis and the significance level adopted was 0.05. The most prevalent drugs were those for the cardiovascular system (83.4%). There was a mean use of seven drugs per patient and 47.9% of the interviewees used >7 drugs. The variables that showed association with polypharmacy (P value < 0.01) were female gender, age >75 years, self-medication, number of health problems, number of medical appointments, presence of adverse drug events, use of over-the-counter drugs, use of psychotropic drugs, lack of physical exercise and use of sweeteners. The exposition to all these factors justified the high prevalence of polypharmacy amongst the interviewees. These results showed the need to adopt clinical intervention and educational and managerial measures to analyze and promote rationality in the use of drugs amongst the elderly users of SUS.
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