662 results match your criteria polypharmacy median


Polypharmacy and mortality association by chronic kidney disease status: The REasons for Geographic And Racial Differences in Stroke Study.

Pharmacol Res Perspect 2021 Aug;9(4):e00823

Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA.

Many Americans take multiple medications simultaneously (polypharmacy). Polypharmacy's effects on mortality are uncertain. We endeavored to assess the association between polypharmacy and mortality in a large U. Read More

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Polypharmacy is a determinant of hospitalization in Parkinson's disease.

Eur Rev Med Pharmacol Sci 2021 Jul;25(14):4810-4817

Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 

Objective: Patients with Parkinson's disease (PD) are at a higher risk of hospitalization and recurrent hospitalizations, with consequent complications. Polypharmacy is associated with several adverse outcomes, including hospitalization, increased length of hospital stay, and mortality. The aim of this study was to evaluate among patients with PD the association between the number of medications and incident hospitalizations. Read More

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[End of life in patients under the care of paediatric palliative care teams. Multicentre observational study].

An Pediatr (Barc) 2021 Jul 21. Epub 2021 Jul 21.

Unidad de Atención Integral Paliativa Pediátrica, Hospital Infantil Universitario Niño Jesús, Madrid, España.

Introduction: Around 2000 children and adolescents die each year in Spain, however, we know little about the particularities of deaths in paediatrics. The purpose of this study is to document the characteristics of patients who die in the care of paediatric palliative care teams in Spain.

Patients And Methods: Retrospective, descriptive, multicentre study. Read More

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Evaluation of drug-drug interactions in cancer patients treated at a university hospital in North Cyprus using two interaction databases.

Niger J Clin Pract 2021 Jul;24(7):1067-1071

Department of Clinical Pharmacy, Faculty of Pharmacy, Near East University, North Cyprus, Mersin, Turkey.

Background: Drug interactions in oncology are of clinical importance owing to the inherent use of multiple medications in cancer treatment which predisposes patients to drug-related problems.

Aim: This study aimed to compare two electronic databases based on the frequency, mechanism and severity of drug-drug interactions (DDIs) in cancer treatment at Near East University Hospital.

Method: A retrospective observational study of hospitalized cancer patients who had received more than one chemotherapy and/or supportive-care drugs from April 2017 to April 2019. Read More

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Optimizing Therapy to Prevent Avoidable Hospital Admissions in Multimorbid Older Adults (OPERAM): cluster randomised controlled trial.

BMJ 2021 07 13;374:n1585. Epub 2021 Jul 13.

Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Objective: To examine the effect of optimising drug treatment on drug related hospital admissions in older adults with multimorbidity and polypharmacy admitted to hospital.

Design: Cluster randomised controlled trial.

Setting: 110 clusters of inpatient wards within university based hospitals in four European countries (Switzerland, Netherlands, Belgium, and Republic of Ireland) defined by attending hospital doctors. Read More

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MediQuit, an Electronic Deprescribing Tool for Patients on Polypharmacy: Results of a Feasibility Study in German General Practice.

Drugs Aging 2021 Jul 12. Epub 2021 Jul 12.

Institute of General Practice, Hannover Medical School, Hannover, Germany.

Background: Deprescribing is an important task for general practitioners (GPs) in the face of risky polypharmacy. The electronic tool "MediQuit" was developed to guide GPs and patients through a deprescribing consultation that entails a drug-selection phase, shared decision making, and advice on safe implementation.

Objectives: A pilot study was conducted to determine the target group of patients that is selected for consultation and to assess the impact, patient involvement, and feasibility of the tool. Read More

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Polypharmacy among pediatric cancer patients dying in the hospital.

Isr Med Assoc J 2021 Jul;23(7):426-431

Department of Pediatric Hematology Oncology, Rambam Health Care Campus, Haifa, Israel.

Background: Decisions on medication treatment in children dying from cancer are often complex and may result in polypharmacy and increased medication burden. There is no information on medication burden in pediatric cancer patients at the end of life (EOL).

Objectives: To characterize medication burden during the last hospitalization in children dying from cancer. Read More

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How much can medical management alone improve the outcome of adult drug-resistant epilepsy? An exploratory study on possibilities and limitations of combining multiple therapeutic actions.

Authors:
Ruggero Serafini

Epilepsy Behav 2021 Jul 6;122:108065. Epub 2021 Jul 6.

Department of Neurology, University of Utah Clinical Neuroscience Center, George E. Wahlen VA Medical Center, 175 North Medical Drive East, 5th Floor, Salt Lake City, UT 84132, USA. Electronic address:

Purpose: Failure to control epileptic seizures with two medications, adequately chosen and dosed, indicates drug-resistant epilepsy (DRE). The chance of pharmacologically controlling seizures is low for patients with DRE and uncontrolled seizures who are not candidates for surgery, who have already undergone surgery, or who already had a vagus nerve stimulator (VNS) placed. Patients experiencing these conditions must instead rely on medical management of their seizures, and there is no breakthrough solution on the horizon. Read More

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Using soluble urokinase plasminogen activator receptor to stratify patients for medication review in the emergency department.

Br J Clin Pharmacol 2021 Jul 9. Epub 2021 Jul 9.

Department of Clinical Research, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark.

Aims: To investigate whether the association between levels of medication use (including polypharmacy and potentially inappropriate medications [PIMs]) and health outcomes such as readmission and mortality is dependent on baseline soluble urokinase plasminogen activator receptor (suPAR).

Methods: This registry-based cohort study included medical patients admitted to the emergency department at Copenhagen University Hospital Hvidovre, Denmark. Patients were grouped according to their admission suPAR levels: low (0-3 ng/mL), intermediate (3-6 ng/mL), or high (>6 ng/mL). Read More

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External validation of the Medication Risk Score in polypharmacy patients in general practice: A tool for prioritizing patients at greatest risk of potential drug-related problems.

Basic Clin Pharmacol Toxicol 2021 Jul 8. Epub 2021 Jul 8.

Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark.

Drug-related problems are important causes of patient harm and increased healthcare costs. To assist general practitioners in prioritizing patients in need of a critical medication review, we aimed to assess the ability of the Medication Risk Score (MERIS) to stratify patients with polypharmacy in general practice according to their risk of drug-related problems. We conducted a cross-sectional multi-centre external validation study. Read More

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Attitudes of ambulatory care older Nepalese patients towards deprescribing and predictors of their willingness to deprescribe.

Ther Adv Drug Saf 2021 17;12:20420986211019309. Epub 2021 Jun 17.

School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4000, Australia.

Introduction: Older adults continue to receive potentially inappropriate medications necessitating the need for medication optimization, by deprescribing. To ensure a holistic approach to deprescribing, it is essential to understand the perception of older adults towards deprescribing. This study aimed to assess the attitude of older ambulatory patients towards deprescribing and to identify factors predicting their willingness to deprescribe. Read More

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Profile of Prescription Medication in an Internal Medicine Ward.

Healthcare (Basel) 2021 Jun 10;9(6). Epub 2021 Jun 10.

Research Unit for Inland Development, Polytechnic Institute of Guarda (UDI-IPG), 6300-559 Guarda, Portugal.

Aging-related loss of resilience associated with the lack of evidence regarding the therapeutic efficacy of medicines can prompt a lack of efficacy of treatments and multiple prescriptions. This work aims to characterize the medication profile of Portuguese older adult inpatients and explore the relationship between hospitalization days and the consumption of medicines. A retrospective data analysis study in older patients who were admitted to a medical internal medicine ward during 2019. Read More

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Long-Term Effects of Renal Artery Denervation.

Medicina (Kaunas) 2021 Jun 27;57(7). Epub 2021 Jun 27.

Clinic of Heart and Vessel Diseases, Institute of Clinical Medicine at the Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania.

: Renal artery denervation (RDN) procedure is a broadly discussed method in the treatment of resistant hypertension. Many studies report short-term (3-12 months) results for blood pressure and arterial stiffness. The primary endpoints were changes in 24 h mean systolic blood pressure (BP) and office systolic BP 48 months after RDN. Read More

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Ethnic differences in guideline-indicated statin initiation for people with type 2 diabetes in UK primary care, 2006-2019: A cohort study.

PLoS Med 2021 Jun 29;18(6):e1003672. Epub 2021 Jun 29.

University College London, London, United Kingdom.

Background: Type 2 diabetes is 2-3 times more prevalent in people of South Asian and African/African Caribbean ethnicity than people of European ethnicity living in the UK. The former 2 groups also experience excess atherosclerotic cardiovascular disease (ASCVD) complications of diabetes. We aimed to study ethnic differences in statin initiation, a cornerstone of ASCVD primary prevention, for people with type 2 diabetes. Read More

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Comparison of isoflurane and propofol sedation in critically ill COVID-19 patients-a retrospective chart review.

J Anesth 2021 Jun 25. Epub 2021 Jun 25.

Department of Anesthesiology, Intensive Care and Pain Medicine, Saarland University Hospital Medical Center, Kirrberger Str. 100, 66421, Homburg, Saarland, Germany.

Purpose: In this retrospective study, we compared inhaled sedation with isoflurane to intravenous propofol in invasively ventilated COVID-19 patients with ARDS (Acute Respiratory Distress Syndrome).

Methods: Charts of all 20 patients with COVID-19 ARDS admitted to the ICU of a German University Hospital during the first wave of the pandemic between 22/03/2020 and 21/04/2020 were reviewed. Among screened 333 days, isoflurane was used in 97 days, while in 187 days, propofol was used for 12 h or more. Read More

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High Prevalence of Multimorbidity and Polypharmacy in Elderly Patients With Chronic Pain Receiving Home Care are Associated With Multiple Medication-Related Problems.

Front Pharmacol 2021 8;12:686990. Epub 2021 Jun 8.

Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Clinical Pharmacology and Toxicology, Berlin, Germany.

To measure the extent of polypharmacy, multimorbidity and potential medication-related problems in elderly patients with chronic pain receiving home care. Data of 355 patients aged ≥65 years affected by chronic pain in home care who were enrolled in the study in Berlin, Germany, were analyzed. History of chronic diseases, diagnoses, medications including self-medication were collected for all patients. Read More

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Baseline characteristics and comparability of older multimorbid patients with polypharmacy and general practitioners participating in a randomized controlled primary care trial.

BMC Fam Pract 2021 Jun 22;22(1):123. Epub 2021 Jun 22.

Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland.

Objectives: Recruiting general practitioners (GPs) and their multimorbid older patients for trials is challenging for multiple reasons (e.g., high workload, limited mobility). Read More

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Can primary palliative care education change life-sustaining treatment intensity of older adults at the end of life? A retrospective study.

BMC Palliat Care 2021 Jun 21;20(1):84. Epub 2021 Jun 21.

Department of Geriatrics, Beijing Tongren Hospital, Capital Medical University, Dongjiaominxiang No.1, Dongcheng District, Beijing, 100730, China.

Background: Palliative care education has been carried out in some hospitals and palliative care has gradually developed in mainland China. However, the clinical research is sparse and whether primary palliative care education influence treatment intensity of dying older adults is still unknown. This study aims to explore the changes to the intensity of end-of-life care in hospitalized older adults before and after the implementation of primary palliative care education. Read More

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Causes of discrepancies between medications listed in the national electronic prescribing system and patients' actual use of medications.

Basic Clin Pharmacol Toxicol 2021 Jun 16. Epub 2021 Jun 16.

Department of Clinical Pharmacology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.

Discrepancies between registered prescriptions and patients' actual use of medications are described as frequent and often resulting in adverse medication events. We aimed to assess the extent of and causes behind discrepancies between medications listed in the Danish national prescription system (Shared Medication Record) and patients' actual use of medications. We prospectively reconciled medication for 260 consecutively admitted polypharmacy patients (>50 years and ≥5 prescriptions) at two hospitals in the Capital Region of Denmark. Read More

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Older people's attitudes towards deprescribing cardiometabolic medication.

BMC Geriatr 2021 06 16;21(1):366. Epub 2021 Jun 16.

Unit of PharmacoTherapy, Epidemiology and Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands.

Background: Overtreatment with cardiometabolic medication in older patients can lead to major adverse events. Timely deprescribing of these medications is therefore essential. Self-reported willingness to stop medication is usually high among older people, still overtreatment with cardiometabolic medication is common and deprescribing is rarely initiated. Read More

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Implementing a specialist Paediatric Clinical Pharmacology Service in a UK Children's Hospital.

Br J Clin Pharmacol 2021 Jun 16. Epub 2021 Jun 16.

Alder Hey Children's Hospital, Eaton Road, Liverpool.

Introduction: Royal College of Paediatrics and Child Health sub-specialist training in Paediatric Clinical Pharmacology and Therapeutics has been delivered in the UK for 20 years, but no specialist clinical services have been set up previously.

Methods: Prospective audit and service evaluation of paediatric clinical pharmacology service pilot phase and dedicated service at a UK children's hospital.

Results: Pilot scheme (May-Oct 2019), then weekly service (established June 2020). Read More

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Antipsychotic Polypharmacy Is Associated With Adverse Drug Events in Psychiatric Inpatients: The Japan Adverse Drug Events Study.

J Clin Psychopharmacol 2021 Jul-Aug 01;41(4):397-402

From the Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine.

Background: Antipsychotic (AP) polypharmacy (APP), the coprescription of more than 1 AP, is frequently practiced in psychiatric inpatients and is considered to be a risk factor for adverse drug events (ADEs). However, the association between APP and ADEs among psychiatric inpatients has not been well investigated.

Methods: The Japan Adverse Drug Events (JADE) study was a series of cohort studies conducted in several clinical settings. Read More

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Polypharmacy among older adults with dementia compared with those without dementia in the United States.

J Am Geriatr Soc 2021 Jun 8. Epub 2021 Jun 8.

Division of Geriatrics, University of California, San Francisco, California, USA.

Background/objectives: In older persons with dementia (PWD), extensive medication use is often unnecessary, discordant with goals of care, and possibly harmful. The objective of this study was to determine the prevalence and medication constituents of polypharmacy among older PWD attending outpatient visits in the United States.

Design: Cross-sectional analysis. Read More

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Clinical frailty and polypharmacy in older emergency critical care patients: a single-centre retrospective case series.

Eur J Hosp Pharm 2021 Jun 2. Epub 2021 Jun 2.

Critical Care, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.

Background And Objectives: Admission of complex and frail patients to critical care units is common. Little is known about the relationship between clinical frailty and polypharmacy measures in critical care patients or how a critical care admission affects polypharmacy.We sought to: (1) Describe the extent and relationship between clinical frailty and polypharmacy in a cohort of older emergency general critical care patients, and to (2) Describe the effect of the critical care pathway on patient polypharmacy measures. Read More

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Predictors of surgical treatment burden, outcomes, and overall survival in older adults with basal cell carcinoma: Results from the prospective, multicenter BATOA cohort.

J Am Acad Dermatol 2021 Jun 1. Epub 2021 Jun 1.

Department of Dermatology, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.

Background: Incorporating patient-related factors associated with treatment outcomes could improve personalized care in older patients with basal cell carcinoma (BCC).

Objective: To evaluate and identify predictors of treatment burden, treatment outcomes, and overall survival in patients aged ≥70 years, surgically treated for BCC in the head and neck area.

Methods: The data from the prospective, multicenter Basal Cell Carcinoma Treatment in Older Adults (BATOA) cohort study were extracted to evaluate the experienced treatment burden (visual analog scale, 0-10 cm; lower scores indicating higher treatment burden), treatment outcomes, and mortality. Read More

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Impact of the COVID-19 lockdown on the adherence of stroke patients to direct oral anticoagulants: a secondary analysis from the MAAESTRO study.

J Neurol 2021 Jun 3. Epub 2021 Jun 3.

Department of Neurology and Stroke Centre, University Hospital Basel and University of Basel, Basel, Switzerland.

Background: The negative impact of the COVID-19 outbreak on stroke care has been reported, but no data exist on the influence of the lockdown on medication adherence to antithrombotic treatment for stroke prevention. We present a comparison of electronic adherence data of stroke patients treated with direct oral anticoagulants (DOAC) prior to and during the COVID-19 lockdown in spring 2020 in Switzerland.

Methods: This is a secondary analysis using data from the ongoing MAAESTRO study, in which stroke patients with atrial fibrillation electronically monitor their adherence to DOAC treatment. Read More

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Polypharmacy and Cognition Function Among Rural Adults.

J Alzheimers Dis 2021 ;82(2):607-619

Graduate School of Biomedical Sciences, Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, USA.

Background: Polypharmacy (using≥5 medications) is associated with poor health outcomes. Mixed results from past studies surrounding chronic medication use, control of chronic conditions, and their effects on cognitive performance warrant further attention.

Objective: Investigate a link between polypharmacy and cognition function in rural-dwelling adults in Texas, USA. Read More

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January 2021

The integrated management of childhood illness (IMCI) and its potential to reduce the misuse of antibiotics.

J Glob Health 2021 May 22;11:04030. Epub 2021 May 22.

WHO, Regional office for Europe, Copenhagen, Denmark.

Background: The Strategy of the Integrated Management of Childhood Illness (IMCI) was introduced in Central Asia and Europe to address the absence of evidence-based guidelines, the misuse of antibiotics, polypharmacy and over-hospitalization of children. A study carried out in 16 countries analysed the status and strengths of as well as the barriers to IMCI implementation and investigated how different health systems affect the problems IMCI aims to address. Here we present findings in relation to IMCI's effects on the rational use of drugs, particularly the improved rational use of antibiotics in children, the mechanisms through which these were achieved as well as counteracting system factors. Read More

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Association between gait speed and the SHARE Frailty Instrument in a Falls and Syncope Clinic.

Eur Geriatr Med 2021 May 15. Epub 2021 May 15.

Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland.

Purpose: Identifying physical frailty is useful in the context of falls and syncope assessment. The phenotype-based SHARE Frailty Instrument for Primary Care (SHARE-FI) does not measure gait speed. We evaluated the association between SHARE-FI and gait speed in a Falls' and Syncope Unit (FASU). Read More

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Attitudes toward deprescribing among adults with heart failure with preserved ejection fraction.

J Am Geriatr Soc 2021 Jul 12;69(7):1948-1955. Epub 2021 May 12.

Department of Medicine, Weill Cornell Medicine, New York, New York, USA.

Background/objectives: Attitudes toward deprescribing could vary among subpopulations. We sought to understand patient attitudes toward deprescribing among patients with heart failure with preserved ejection fraction (HFpEF).

Design: Retrospective cohort study. Read More

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