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Polypharmacy

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241. Polypharmacy Reduction Strategies: Tips on Incorporating American Geriatrics Society Beers and Screening Tool of Older People's Prescriptions Criteria. (Abstract)

Polypharmacy Reduction Strategies: Tips on Incorporating American Geriatrics Society Beers and Screening Tool of Older People's Prescriptions Criteria. There is no single definition of polypharmacy. Use of 5 or more medications commonly is used. An alternative, quantitative definition, such as use of more medications than clinically indicated or use of unnecessary or harmful prescribing, has been proposed. Protocols or algorithms to improve polypharmacy and prescribing in older adults have been (...) developed. The American Geriatrics Society (AGS) Beers Criteria and Screening Tool of Older People's Prescriptions (STOPP) explicit criteria reflect elements that are common across protocols and algorithms. Concepts in AGS Beers and STOPP can be incorporated into polypharmacy reduction strategies to improve outcomes of care for older adults.Copyright © 2017 Elsevier Inc. All rights reserved.

2017 Clinics in Geriatric Medicine

242. Polypharmacy and Delirium in Critically Ill Older Adults: Recognition and Prevention. (Abstract)

Polypharmacy and Delirium in Critically Ill Older Adults: Recognition and Prevention. Among older adults, polypharmacy is a sequelae of admission to the intensive care unit and is associated with increased medication-associated adverse events, drug interactions, and health care costs. Delirium is prevalent in critically ill geriatric patients and medications remain an underappreciated modifiable risk for delirium in this setting. This article reviews the literature on polypharmacy and delirium (...) , with a focus on highlighting the relationships between polypharmacy and delirium in critically ill, older adults. Discussed are clinician strategies on how to recognize and reduce medication-associated delirium and recommendations that help prevent polypharmacy when interventions to reduce the burden of delirium in this vulnerable population are being formulated.Copyright © 2017 Elsevier Inc. All rights reserved.

2017 Clinics in Geriatric Medicine

243. Geriatric Polypharmacy: Pharmacist as Key Facilitator in Assessing for Falls Risk. (Abstract)

Geriatric Polypharmacy: Pharmacist as Key Facilitator in Assessing for Falls Risk. This article highlights the significant health impact of falls among older adults. An emphasis is placed on the vital role of the pharmacist, regardless of practice setting, in assessing and reducing falls risk for this growing population. In addition, the importance of a stepwise comprehensive approach to falls assessment by pharmacists in collaboration with other clinicians is elucidated.Copyright © 2017

2017 Clinics in Geriatric Medicine

244. Can Managed Care Manage Polypharmacy? (Abstract)

Can Managed Care Manage Polypharmacy? Polypharmacy has come to mean the inappropriate use of multiple medications. Polypharmacy can occur as a result of a range of situations, including the excessive application of clinical guidelines, lack of coordination among multiple prescribers, treating adverse drug events, misaligned medications across transitions of care, patient self-treatment, and inappropriate overtreatment. Polypharmacy is a problem because the benefits of a specific medication

2017 Clinics in Geriatric Medicine

245. Geriatric Polypharmacy: Two Physicians' Personal Perspectives. (Abstract)

Geriatric Polypharmacy: Two Physicians' Personal Perspectives. Being a clinical provider in today's health care environment has become complex with more levels of care to negotiate. Who is caught in the middle of this complexity? Senior citizens. As we evolve into the new quality model, new problems and complexities occur. Numerous protocols and guidelines necessitate the initiation of drugs for given diagnoses and aggressive treatments. This article discusses geriatric polypharmacy from two

2017 Clinics in Geriatric Medicine

246. Attributes of primary care in relation to polypharmacy: a multicenter cross-sectional study in Japan. Full Text available with Trip Pro

Attributes of primary care in relation to polypharmacy: a multicenter cross-sectional study in Japan. To investigate the association between attributes of primary care and polypharmacy.Cross-sectional study.A primary care practice-based research network in Japan (28 primary care clinics).Adult outpatients filled out a standardized questionnaire.Polypharmacy defined as the use of five or more concurrent prescription or over-the-counter medications.Attributes of primary care were assessed via (...) patient experience using the Japanese version of Primary Care Assessment Tool (JPCAT). Poisson mixed effects model was used to adjust for clustering within clinics and covariates.Data were analyzed for 544 primary care outpatients. After adjusting for patients' sociodemographic and health characteristics, the JPCAT community orientation score was found to be inversely associated with polypharmacy at the clinic level [risk ratio per 1 standard deviation increase = 0.83; 95% confidence interval (CI

2017 International Journal for Quality in Health Care

247. Correlates and predictors of antipsychotic drug polypharmacy in real-life settings: Results from a nationwide cohort study. (Abstract)

Correlates and predictors of antipsychotic drug polypharmacy in real-life settings: Results from a nationwide cohort study. Reasons for using antipsychotic polypharmacy (APP) in routine clinical practice, despite a potentially unfavorable risk-benefit ratio, are poorly understood. This research aimed to determine (1) if severe courses of schizophrenia were associated with APP and (2) if a schizophrenia-related acute event would predict a switch to APP in the short term. Observational

2017 Schizophrenia Research

248. The challenge of polypharmacy in an aging population and implications for future antiretroviral therapy development. (Abstract)

The challenge of polypharmacy in an aging population and implications for future antiretroviral therapy development. : It is estimated that by 2030 nearly three-quarters of persons living with HIV will be 50 years and older. The aging HIV population presents a new clinical concern for HIV providers: adverse effects from polypharmacy. An aging population means more comorbidities and potentially more drug-drug interactions for providers to manage. This review discusses major comorbidities

2017 AIDS

249. Current and future perspectives on the management of polypharmacy. Full Text available with Trip Pro

Current and future perspectives on the management of polypharmacy. Because of ageing populations, the growth in the number of people with multi-morbidity and greater compliance with disease-specific guidelines, polypharmacy is becoming increasingly common. Although the correct drug treatment in patients with complex medical problems can improve clinical outcomes, quality of life and life expectancy, polypharmacy is also associated with an increased risk of adverse drug events, some severe (...) understanding of their conditions and their treatment, and maintain a record of changes made to patient's medication. In the longer term, developments such as the introduction of artificial intelligence and clinical decision support systems also have the potential to improve prescribing and minimise the risks from polypharmacy. Finally, there is considerable scope to improve the quality of prescribing and reduce risks from poly-pharmacy using non-medical groups such as pharmacists, specialist nurses

2017 BMC Family Practice

250. Opioids and Other Central Nervous System-Active Polypharmacy in Older Adults in the United States. Full Text available with Trip Pro

Opioids and Other Central Nervous System-Active Polypharmacy in Older Adults in the United States. To determine patterns of and trends in contributions to central nervous system (CNS) polypharmacy, defined by the Beers Criteria as three or more CNS-active medications of each medication class, of adults aged 65 and older seen in U.S. outpatient medical practices.National Ambulatory Medical Care Survey (2004-2013).U.S. outpatient medical care.Visits by older adults to outpatient physicians (N (...) = 97,910).Visits including three or more CNS medications including antipsychotics, benzodiazepines, nonbenzodiazepine benzodiazepine receptor agonist hypnotics (NBRAs), tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), and opioids. The proportion of CNS polypharmacy that each medication class contributed during 2011 to 2013 was determined, and then logistic regression was used to determine trends from 2004 to 2013 in the contribution of individual medication classes

2017 Journal of the American Geriatrics Society

251. Polypharmacy as a Risk Factor for Clinically Relevant Sarcopenia: Results From the Berlin Aging Study II. Full Text available with Trip Pro

Polypharmacy as a Risk Factor for Clinically Relevant Sarcopenia: Results From the Berlin Aging Study II. Sarcopenia affects more than 10% of older adults. Next to age-associated physiologic changes, diseases like diabetes or inflammatory, neurological, malignant and endocrine disorders may contribute to the development of sarcopenia. Likewise, polypharmacy, i.e., multiple drug use, is common among older adults. Although the two conditions frequently co-occur, the association of polypharmacy (...) with sarcopenia has not yet been examined. We investigated the association of polypharmacy and sarcopenia in a large cohort of community-dwelling older adults (60-84 years).Thousand five hundred and two participants from the Berlin Aging Study II were included. Polypharmacy was defined as concurrent use of 5 or more drugs (prescription and nonprescription). Body composition was assessed with dual-energy X-ray absorptiometry, and appendicular lean mass (ALM) was calculated as sum of the four limbs' lean mass

2017 Biological Sciences and Medical Sciences

252. A tailored programme to implement recommendations for multimorbid patients with polypharmacy in primary care practices-process evaluation of a cluster randomized trial. Full Text available with Trip Pro

A tailored programme to implement recommendations for multimorbid patients with polypharmacy in primary care practices-process evaluation of a cluster randomized trial. We developed and evaluated a tailored programme to implement three evidence-based recommendations for multimorbid patients with polypharmacy into primary care practices: structured medication counselling including brown bag reviews, the use of medication lists and medication reviews. No effect on the primary outcome was found

2017 Implementation Science Controlled trial quality: uncertain

253. Evaluation of the individual safe correction of antipsychotic agent polypharmacy in Japanese patients with chronic schizophrenia: validation of safe corrections for antipsychotic polypharmacy and the high-dose method. Full Text available with Trip Pro

Evaluation of the individual safe correction of antipsychotic agent polypharmacy in Japanese patients with chronic schizophrenia: validation of safe corrections for antipsychotic polypharmacy and the high-dose method. Polypharmacy for schizophrenia treatment is not justified by the available clinical evidence. We evaluated a treatment reduction approach that reduces the dose and number of antipsychotic medications simultaneously prescribed to patients.In a randomized open study of the Safe (...) Correction of Antipsychotic Polypharmacy and High-Dose Prescriptions program funded by the Japanese Ministry of Health, Labour, and Welfare, we evaluated a drug reduction method consisting of a dose reduction intervention performed on 163 patients with schizophrenia for twelve or 24 weeks. One antipsychotic medication was removed each week from each patient's treatment regimen by reducing the dose by 0 to 50 chlorpromazine equivalents. Data on health-related indices of quality of life, clinical symptoms

2015 The international journal of neuropsychopharmacology / official scientific journal of the Collegium Internationale Neuropsychopharmacologicum (CINP) Controlled trial quality: uncertain

254. Impact of polypharmacy in older adults in Navarra, Spain

Impact of polypharmacy in older adults in Navarra, Spain Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation web address: Timing and effect measures Timing

2018 PROSPERO

255. What quantitative and qualitative evidence exists to support the safe withdrawal of medication in older people with multimorbidity and polypharmacy?

What quantitative and qualitative evidence exists to support the safe withdrawal of medication in older people with multimorbidity and polypharmacy? Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith

2018 PROSPERO

256. Risk factors of polypharmacy among adults in South Asia: a systematic review protocol

Risk factors of polypharmacy among adults in South Asia: a systematic review protocol Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation web address: Timing

2018 PROSPERO

257. Health professionals experience of polypharmacy: a meta-ethnography

Health professionals experience of polypharmacy: a meta-ethnography Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation web address: Timing and effect measures

2018 PROSPERO

258. Polypharmacy, hyperpolypharmacy and the association with frailty states: a systematic review and meta-analysis

Polypharmacy, hyperpolypharmacy and the association with frailty states: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence

2018 PROSPERO

259. Polypharmacy and health outcomes in atrial fibrillation

Polypharmacy and health outcomes in atrial fibrillation Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation web address: Timing and effect measures Timing

2018 PROSPERO

260. Optimising a whole-person-centred approach to stopping medicines in older people with multimorbidity and polypharmacy: a realist review within the tailor medication syntheses

Optimising a whole-person-centred approach to stopping medicines in older people with multimorbidity and polypharmacy: a realist review within the tailor medication syntheses Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email

2018 PROSPERO

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