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Polypharmacy

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2641. Polypharmacy prevalence rates in the treatment of unipolar depression in an outpatient clinic. Full Text available with Trip Pro

Polypharmacy prevalence rates in the treatment of unipolar depression in an outpatient clinic. Unipolar depression is a complex illness with an ever increasing number of pharmacological treatments available. As the number of available medication options increases, so does the potential for polypharmacy, a practice with possible complications. Such complications include a greater number of side effects with the initiation of additional medications and the consequences of drug-drug interactions (...) . Therefore, it is important to understand the effects of polypharmacy on efficacy of treatment as well as whether polypharmacy is instituted after appropriate initial monotherapy trials. This study attempts to answer these questions.Patient names for this investigation were provided by residents in the UMass Medical School Psychiatry Residency program. The charts of these patients were analyzed to collect data regarding demographics, clinical data about the illness, medication names, types, duration

2008 Journal of Affective Disorders

2642. Dietary Supplement Polypharmacy: An Unrecognized Public Health Problem? Full Text available with Trip Pro

Dietary Supplement Polypharmacy: An Unrecognized Public Health Problem? Excessive and inappropriate use of medications, or 'polypharmacy', has been recognized as a public health problem. In addition, there is growing use of dietary supplements in the United States; however, little is known about the patterns of supplement use. Recent reports in the literature of cases of excessive or inappropriate use of herbal dietary supplements leading to the term 'polyherbacy'. The clinical vignettes (...) described in this article highlight the need for further research on the nature and extent of multiple and inappropriate dietary supplement use or 'dietary supplement polypharmacy'. Clinical interviewing and population surveys both address this issue in complementary ways, and provide a further understanding of dietary supplement use patterns.

2007 Evidence-based Complementary and Alternative Medicine (eCAM)

2643. The Influence of Educational Level on Polypharmacy and Inappropriate Drug Use: A Register-Based Study of More Than 600,000 Older People. (Abstract)

The Influence of Educational Level on Polypharmacy and Inappropriate Drug Use: A Register-Based Study of More Than 600,000 Older People. To investigate whether low educational attainment is associated with polypharmacy and potential inappropriate drug use (IDU) in older people.Cross-sectional register-based study.Sweden.Older people aged 75 to 89 who, filled at least one drug prescription between August and October 2005 and, consequently, were listed in the Swedish Prescribed Drug Register (...) (SPDR) (N=626,258). Data were obtained from the SPDR, the inpatient register, and the education register.The main outcome measures were polypharmacy (concurrent use of > or =5 drugs), excessive polypharmacy (concurrent use of > or =10 drugs), and potential IDU. Four quality indicators developed by the Swedish National Board of Health and Welfare were used for the assessment of potential IDU: concurrent use of three or more psychotropic drugs, prescription of long-acting benzodiazepines, prescription

2008 Journal of the American Geriatrics Society

2644. Results of chart reviews conducted to evaluate primary care patients seen by second and third year family medicine residents for potential adverse polypharmacy Full Text available with Trip Pro

Results of chart reviews conducted to evaluate primary care patients seen by second and third year family medicine residents for potential adverse polypharmacy To determine the prescribing patterns of family medicine residents for patients aged more than 60 years with 2 or more chronic diseases and seen at least twice in a 12 month timeframe.This is a descriptive analysis which was based on chart reviews. The setting was the University of Illinois-Rockford Family Practice Residency. Patients (...) aged 60 years with 2 or more chronic diseases who were seen at least twice by second and third year residents.FINDINGS FROM THIS CHART REVIEW INCLUDE: 28.8% of the prescribed medications were not effective for the documented condition, 26.3% of the prescribed doses were incorrect, and 44.5% of the drugs prescribed were not the least expensive alternative.This preliminary study suggests a need for a focused intervention with family medicine residents regarding inappropriate polypharmacy issues

2007 Pharmacy Practice

2645. Antipsychotic Polypharmacy: Prevalence, Background and Consequences

Antipsychotic Polypharmacy: Prevalence, Background and Consequences Antipsychotic Polypharmacy: Prevalence, Background and Consequences - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Antipsychotic (...) Polypharmacy: Prevalence, Background and Consequences The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT00541398 Recruitment Status : Completed First Posted : October 10, 2007 Last Update Posted : November 2, 2009 Sponsor: Glostrup University Hospital, Copenhagen Collaborator: National Board of Health

2007 Clinical Trials

2646. Antipsychotic Polypharmacy in Schizophrenia

Antipsychotic Polypharmacy in Schizophrenia Antipsychotic Polypharmacy in Schizophrenia - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Antipsychotic Polypharmacy in Schizophrenia The safety and scientific (...) of this study will subsequently serve to guide physicians in making appropriately informed decisions regarding the continuation of multiple antipsychotic drugs. Our primary hypothesis is that we expect to find no difference in the primary variable of interest (BPRS) following reduction to antipsychotic monotherapy (placebo group) versus continuing antipsychotic polypharmacy. This proposed study is the first study to systematically address the reduction of antipsychotic polypharmacy to monotherapy

2007 Clinical Trials

2647. Polypharmacy, appropriate and inappropriate Full Text available with Trip Pro

Polypharmacy, appropriate and inappropriate 16834872 2006 11 30 2018 11 13 0960-1643 56 528 2006 Jul The British journal of general practice : the journal of the Royal College of General Practitioners Br J Gen Pract Polypharmacy, appropriate and inappropriate. 484-5 Aronson Jeffrey K JK eng Comment Editorial England Br J Gen Pract 9005323 0960-1643 IM Br J Gen Pract. 2006 Jul;56(528):504-10 16834876 Drug Prescriptions Humans Polypharmacy Professional Practice standards 2006 7 13 9 0 2006 12 9 9

2006 The British Journal of General Practice

2648. Pediatric Psychotropic Polypharmacy Full Text available with Trip Pro

Pediatric Psychotropic Polypharmacy This study was a literature review designed to assess the rates of psychotropic "polypharmacy" in the pediatric population. Psychotropic polypharmacy was defined as the practice of prescribing two or more medications (e.g. concomitant psychotropic medications) for one or more diagnosed psychiatric conditions and/or behavioral symptoms.A literature review of relevant articles pertaining to polypharmacy was completed using the Pub Med database from 1994 through (...) April 2004 for pediatric populations under 18 years old.Studies were reviewed from various pediatric settings. While the extent of polypharmacy varied from the different populations, all the studies comparing these rates across time showed an increase in this practice. The use of stimulants with another psychotropic medication was the most frequent combination.There is limited information about the actual rates of psychotropic polypharmacy in the pediatric population. However, the data

2005 Psychiatry (Edgmont)

2649. The effects of pharmacist interventions on patients with polypharmacy Full Text available with Trip Pro

The effects of pharmacist interventions on patients with polypharmacy Polypharmacy, the state of being prescribed or taking more medications than clinically appropriate, can result in a variety of negative outcomes for both patients and healthcare facilities. These include negative outcomes such as adverse drug effects, hospitalizations, and poor patient health, as well as economic outcomes such as increased drug cost and costs associated with increased utilization of health services. Available (...) data suggests pharmacists have the potential to have a large effect in combating this problem through a variety of interventions such as reducing the number of medications taken, reducing the number of doses taken, increasing patient adherence, preventing adverse drug reactions (ADRs), improving patient quality of life and decreasing facility and drug costs. A small number of studies have been performed on the pharmacists' role in addressing the problem of polypharmacy; however, they include

2006 Pharmacy Practice

2650. Patient sheet: Tips for avoiding problems with polypharmacy Full Text available with Trip Pro

Patient sheet: Tips for avoiding problems with polypharmacy 17030937 2006 10 16 2008 11 20 1488-2329 175 8 2006 Oct 10 CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne CMAJ Patient sheet: tips for avoiding problems with polypharmacy. 876 Hogan David B DB Health Sciences Centre, Calgary, Alta. Kwan Marilyn M eng Journal Article Patient Education Handout Canada CMAJ 9711805 0820-3946 AIM IM Age Factors Aged Drug Interactions Family Health Humans (...) Polypharmacy 2006 10 13 9 0 2006 10 17 9 0 2006 10 13 9 0 ppublish 17030937 175/8/876 10.1503/cmaj.060888 PMC1586083

2006 CMAJ : Canadian Medical Association Journal

2651. Pharmacological treatment in patients with heart failure: patients knowledge and occurrence of polypharmacy, alternative medicine and immunizations. Full Text available with Trip Pro

Pharmacological treatment in patients with heart failure: patients knowledge and occurrence of polypharmacy, alternative medicine and immunizations. To evaluate in patients with heart failure (HF) due to systolic dysfunction the occurrence of polypharmacy, alternative medicine, immunization against influenza, and patients' knowledge about their medication.Sixty-five patients, 49 men, mean age 60.5+/-12.0 years answered a confidential questionnaire during 2002. Polypharmacy was frequent, 48 (74 (...) help to eliminate liquids, 12 patients (38%) recognized this effect with low dose spironolactone and 23% or less with other drugs. Only 12 patients (42%) treated with acenocoumarol and 13 of those treated with aspirin (32%) recognized the action of these drugs.Patients with HF and systolic dysfunction have a poor knowledge about the medication they receive. Polypharmacy, over-the-counter, homeopathic and alternative medicine use is frequent whereas the rate of immunization against influenza is low.

2004 European Journal of Heart Failure

2652. Specialist care of heart failure improves appropriate pharmacotherapy at the expense of greater polypharmacy and drug-interactions. Full Text available with Trip Pro

Specialist care of heart failure improves appropriate pharmacotherapy at the expense of greater polypharmacy and drug-interactions. There is growing concern at the nature and extent of polypharmacy in heart failure (HF), which may be associated with increased drug interactions, adverse drug effects and a poor understanding of and compliance with therapy.This study evaluates polypharmacy in a relatively unselected community heart failure population following emergency admission and determines (...) the impact of an in-hospital, specialist heart failure care programme on appropriate pharmacotherapy, polypharmacy and drug interactions.We analysed the medication profiles of 91 consecutive patients with an emergency admission for HF to our institution on admission and discharge. The numbers of inappropriate medicines, inappropriate dosages and omitted medicines according to guidelines were recorded. Medication profiles were analysed for potential drug-drug, drug-liver and drug-kidney interactions using

2004 European Journal of Heart Failure

2653. Polypharmacy and prescribing quality in older people. (Abstract)

Polypharmacy and prescribing quality in older people. To evaluate the relationship between inappropriate prescribing, medication underuse, and the total number of medications used by patients.Cross-sectional study.Veterans Affairs Medical Center.One hundred ninety-six outpatients aged 65 and older who were taking five or more medications.Inappropriate prescribing was assessed using a combination of the Beers drugs-to-avoid criteria (2003 update) and subscales of the Medication Appropriateness

2006 Journal of the American Geriatrics Society

2654. Prevalence, trends, and factors associated with antipsychotic polypharmacy among Medicaid-eligible schizophrenia patients, 1998-2000. (Abstract)

Prevalence, trends, and factors associated with antipsychotic polypharmacy among Medicaid-eligible schizophrenia patients, 1998-2000. To determine the prevalence, trends, and factors associated with antipsychotic polypharmacy categorized according to type of antipsychotic and duration of use and to contrast usage patterns with published treatment guidelines.A retrospective cohort study was designed, and Medicaid recipients > or = 16 years of age with a schizophrenia diagnosis (ICD-9-CM = 295.xx (...) ) between 1998 and 2000 were identified from the California (20% random sample) and Georgia Medicaid claims databases. Use of anti-psychotic polypharmacy was categorized based on duration (long-term polypharmacy was defined as lasting > 2 months), and long-term use was further categorized based on type of antipsychotic combinations (clozapine, conventional, and atypical). The prevalence, mean duration, and frequency of and yearwise trends in antipsychotic polypharmacy were estimated. A stepwise logistic

2004 Journal of Clinical Psychiatry

2655. Does antipsychotic polypharmacy increase the risk for metabolic syndrome? Full Text available with Trip Pro

Does antipsychotic polypharmacy increase the risk for metabolic syndrome? To determine whether the coprescribing of two or more antipsychotics, a relatively frequent practice with little data to support its safety and efficacy, is associated with an increased prevalence of metabolic syndrome.364 newly admitted adults treated with second-generation antipsychotics underwent assessments evaluating antipsychotic polytherapy, and of the presence of metabolic syndrome and triglycerides/high-density (...) of aripiprazole treatment (r(2): 0.14, p<0.0001). Antipsychotic polypharmacy dropped out of both multivariate models.Compared with patients receiving antipsychotic monotherapy, patients on antipsychotic polytherapy have higher rates of metabolic syndrome and lipid markers of insulin resistance. However, antipsychotic polytherapy is not independently associated with the prevalence of these abnormalities, which are related to known demographic, clinical and anthropometric risk factors.

2007 Schizophrenia Research

2656. Polypharmacy and excessive dosing: psychiatrists' perceptions of antipsychotic drug prescription. Full Text available with Trip Pro

Polypharmacy and excessive dosing: psychiatrists' perceptions of antipsychotic drug prescription. Despite extensive research and recommendations regarding the optimal prescription of antipsychotic drugs, polypharmacy and excessive dosing still prevail.To identify the factors associated with the polypharmacy and excessive dosing phenomena.We studied 139 patients with schizophrenia, in 19 acute psychiatric units in Japanese hospitals, who were due to be discharged between October and December

2005 British Journal of Psychiatry

2657. Polypharmacy and Medication Adherence: Small Steps on a Long Road Full Text available with Trip Pro

Polypharmacy and Medication Adherence: Small Steps on a Long Road 11251767 2001 05 10 2018 11 13 0884-8734 16 2 2001 Feb Journal of general internal medicine J Gen Intern Med Polypharmacy and medication adherence: small steps on a long road. 137-9 Murray M D MD Kroenke K K eng Comment Editorial United States J Gen Intern Med 8605834 0884-8734 IM J Gen Intern Med. 2001 Feb;16(2):83-8 11251758 J Gen Intern Med. 2001 Feb;16(2):77-82 11251757 J Gen Intern Med. 2001 Feb;16(2):112-5 11251762 Home (...) Care Services Humans Medication Errors prevention & control Patient Compliance psychology Polypharmacy 2001 3 17 10 0 2001 5 22 10 1 2001 3 17 10 0 ppublish 11251767 jgi01229 PMC1495172 Am J Med. 1985 Aug;79(2):149-52 4025372 JAMA. 1996 Dec 25;276(24):1955-6 8971062 Ann Pharmacother. 1996 Jul-Aug;30(7-8):739-44 8826552 Lancet. 2000 Jan 8;355(9198):134-8 10675182 N Engl J Med. 2000 Dec 21;343(25):1826-32 11117973 J Gen Intern Med. 2001 Feb;16(2):77-82 11251757 J Gen Intern Med. 2001 Feb;16(2):83-8

2001 Journal of General Internal Medicine

2658. Reduction of polypharmacy in the elderly: a systematic review of the role of the pharmacist. (Abstract)

Reduction of polypharmacy in the elderly: a systematic review of the role of the pharmacist. Polypharmacy in the elderly complicates therapy, increases cost, and is a challenge for healthcare agencies. In the context of the evolving role of the pharmacist, this systematic review examines the effectiveness of interventions led by pharmacists in reducing polypharmacy. A computerised search was conducted using Medline, Embase geriatrics and gerontology (2001 edition), the Cochrane Library (...) and International Pharmaceutical Abstracts (IPA) databases. A manual search of articles on polypharmacy and the role of pharmacists in the therapy of the elderly and of the reference sections of all retrieved articles was also carried out. Search terms used were 'polypharmacy', 'elderly', 'aged', 'intervention' and 'pharmacist(s)'. Articles that fulfilled the following criteria were included: only elderly people were included in the study, or all ages were included but the study gave separate results

2003 Drugs & Aging

2659. Rational polypharmacy. (Abstract)

Rational polypharmacy. The development of assays for plasma antiepileptic drug concentrations has led to the discovery of many pharmacokinetic interactions, some causing drug intoxication and others resulting in ineffective drug concentrations. In the 1970s, a number of epileptologists began to argue that single drug therapy was desirable in the treatment of epilepsy and this has become the accepted policy when initiating therapy. About 75% of patients treated in this way will achieve remission

1995 Seizure : the journal of the British Epilepsy Association

2660. Is it possible to reduce polypharmacy in the elderly? A randomised, controlled trial. (Abstract)

Is it possible to reduce polypharmacy in the elderly? A randomised, controlled trial. The present trial was originally designed to investigate the effectiveness of comprehensive day hospital care in chronically ill elderly patients. Another aim, reported here, was to investigate to what extent it is possible to reduce polypharmacy and simplify drug regimens during the short term tight control conditions of day hospital care.All home care patients (n = 174, mean age 77 years) in a rural area (...) was reduced significantly (p = 0.02) during the 2-month day hospital period compared with the control group. However, the patients compensated for the reductions by increasing the use of OTC drugs during the day hospital period (p = 0.05). In addition, only 3 months after the trial, the number of drugs had already returned to the baseline level.In real life it seems to be difficult to reduce polypharmacy in the elderly. Some drug reductions may be achieved with tight control under trial conditions

2001 Drugs & Aging Controlled trial quality: uncertain

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