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Polypharmacy

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61. Influence of Polypharmacy on the Effectiveness and Safety of Rivaroxaban versus Warfarin in Patients with Nonvalvular Atrial Fibrillation. (Abstract)

Influence of Polypharmacy on the Effectiveness and Safety of Rivaroxaban versus Warfarin in Patients with Nonvalvular Atrial Fibrillation. Patients with nonvalvular atrial fibrillation (NVAF) often have multiple comorbidities requiring concomitant medications in addition to their oral anticoagulant (OAC). The objective of this study was to evaluate the impact of polypharmacy on the effectiveness and safety of rivaroxaban versus warfarin in patients with NVAF managed in routine clinical (...) experiencing polypharmacy (concomitant prescription claims for five or more unique chronic medication claims) were included. Patients who had concomitant prescription claims for ≥ 10 unique chronic medication claims constituted the substantial polypharmacy cohort used in the secondary analysis. Patients receiving rivaroxaban were propensity-score matched in a 1:1 ratio to patients receiving warfarin (13,981 patients in each polypharmacy OAC group, and 1765 patients in each substantial polypharmacy OAC

2018 Pharmacotherapy

62. How Chronic Is Polypharmacy in Old Age? A Longitudinal Nationwide Cohort Study. Full Text available with Trip Pro

How Chronic Is Polypharmacy in Old Age? A Longitudinal Nationwide Cohort Study. To evaluate the chronicity of polypharmacy among older adults and to identify factors associated with chronic polypharmacy.Longitudinal cohort study using register data.Nationwide, Sweden.All 711,432 older adults (aged 65 years and older) living in Sweden with five or more prescription drugs in October 2010 were included and followed up until December 2013. Mean age at baseline was 77 (SD = 7.8) years, 59% were (...) women, and 7% lived in nursing homes.Monthly changes in the exposure to polypharmacy. Data regarding prescription drug use were extracted from the Swedish Prescribed Drugs Register.Overall, 82% were continuously exposed to polypharmacy for 6 months or longer, and 74% for 12 months or longer. The proportion of individuals who remained exposed until the end of the study was 55%. Among the 21,361 individuals who had not been exposed to polypharmacy during the 6-month period before baseline (ie

2018 Journal of the American Geriatrics Society

63. Predictors of polypharmacy among elderly Thais with depressive and anxiety disorders: findings from the DAS study. Full Text available with Trip Pro

Predictors of polypharmacy among elderly Thais with depressive and anxiety disorders: findings from the DAS study. Polypharmacy is a geriatric syndrome defined variously as the use of potentially inappropriate drugs and/or the concurrent use of multiple medications including prescription and over-the-counter drugs. An association has been shown between polypharmacy and physical health, increased morbidity and increased mortality. However, there is little information regarding the association (...) between polypharmacy and physical disease, personality trait and mental health problems in elderly. The aim of this study was to investigate potential predictive psychosocial factors related to polypharmacy in elderly Thai people.The study analysed the secondary data from the Depressive Disorders, Anxiety Disorders, Suicide Risk and Associated Factors Among Elderly Thai People Program (DAS Study) which was funded by National Research Council of Thailand and conducted between January 2012 and April

2018 BMC Geriatrics

64. Antipsychotic polypharmacy and metabolic syndrome in schizophrenia: a review of systematic reviews. Full Text available with Trip Pro

Antipsychotic polypharmacy and metabolic syndrome in schizophrenia: a review of systematic reviews. There is conflicting evidence on the association between antipsychotic polypharmacy and metabolic syndrome in schizophrenia. We conducted a review of published systematic reviews to evaluate evidence on the association between metabolic syndrome (diabetes, hypertension, and hyperlipidaemia) and exposure to antipsychotic polypharmacy in schizophrenia.We searched five electronic databases (...) , complemented by reference screening, to find systematic reviews that investigated the association of antipsychotic polypharmacy in schizophrenia with hypertension, diabetes, or hyperlipidaemia. Selection of reviews, data extraction and review quality were conducted independently by two people and disagreements resolved by discussion. Results were synthesised narratively.We included 12 systematic reviews, which reported heterogeneous results, mostly with narrative syntheses and without pooled data

2018 BMC Psychiatry

65. Polypharmacy in older people: lessons from 10 years of experience with the REPOSI register. Full Text available with Trip Pro

Polypharmacy in older people: lessons from 10 years of experience with the REPOSI register. As a consequence of population aging, we have witnessed in internal medicine hospital wards a progressive shift from a population of in-patients relatively young and mainly affected by a single ailment to one of ever older and more and more complex patients with multiple chronic diseases, followed as out-patients by many different specialists with poor integration and inevitably treated with multiple (...) medications. Polypharmacy (defined as the chronic intake of five or more drugs) is associated with increased risks of drug-drug interactions and related adverse effects, prescription and intake errors, poor compliance, re-hospitalization and mortality. With this background, the Italian Society of Internal Medicine chose to start in 2008 a prospective register called REPOSI (REgistro POliterapie SIMI, Società Italiana di Medicina Interna) in internal medicine and geriatric hospital wards. The country wide

2018 Internal and emergency medicine

66. Association of Polypharmacy With Mild Cognitive Impairment and Cognitive Ability: A Nationwide Survey in Taiwan. (Abstract)

Association of Polypharmacy With Mild Cognitive Impairment and Cognitive Ability: A Nationwide Survey in Taiwan. Polypharmacy, defined as the concomitant use of 5 or more medications, has a documented negative association with cognitive impairment such as delirium and is associated, potentially, with a higher risk of dementia. However, whether polypharmacy contributes to increased risk of mild cognitive impairment (MCI) or decreased cognitive capacity requires further investigation (...) . This nationwide population survey investigated the association among polypharmacy, MCI, and dementia.Through random sampling based on the proportion of all Taiwan counties, subjects were recruited and received in-person interviews between December 2011 and March 2013. Demographic data and clinical information included medical histories, medication use, and mental status measured by the Taiwanese Mini-Mental State Examination (TMSE) and Clinical Dementia Rating (CDR). Data on lifestyle and habits were

2018 Journal of Clinical Psychiatry

67. Factors related to excessive polypharmacy (≥15 medications) in an outpatient population from Colombia. (Abstract)

Factors related to excessive polypharmacy (≥15 medications) in an outpatient population from Colombia. To determine the frequency of excessive polypharmacy (≥15 medications) in an outpatient population from Colombia and the variables associated with this condition.A cross-sectional study using a systematised database of 6.2 million affiliates of the Colombian Health System. All patients treated uninterruptedly with 15 or more medications for 3 months (January-March 2017) were included (...) . Sociodemographic, pharmacological, potential drug interactions, and prescribers' variables were identified.A total of 264 patients with prescriptions of ≥15 medications were identified; with an estimated prevalence of excessive polypharmacy of 108.4 per 100 000 people. The mean age was 67.7 ± 17.8 years and 60.6% were females. The mean number of medications per patient was 20.1 ± 4.5 and 48.9% (n = 129) had 20 or more. The most used were antiulcer medications (89.0%; n = 235), antihypertensives (85.6%; n = 226

2018 International journal of clinical practice

68. Trends in Polypharmacy in Japan: A Nationwide Retrospective Study. (Abstract)

Trends in Polypharmacy in Japan: A Nationwide Retrospective Study. To describe and examine trends in polypharmacy according to age in Japan from 2010 to 2016.Retrospective observational study.Outpatient settings.Japanese individuals aged 20 and older.We analyzed pharmacy claims data that the Japanese Ministry of Health, Labor, and Welfare provided in the Survey of Medical Care Activities in Public Health Insurance from 2010 to 2016. The use of 5 or more oral prescription medications per month (...) was defined as polypharmacy and of 10 or more as excessive polypharmacy. Regression analysis was used to estimate trends in polypharmacy with annual percentage changes. Using number of medications (polypharmacy vs excessive polypharmacy), trends in polypharmacy and crude and age-adjusted rates of polypharmacy per 1,000 persons were calculated according to year and age group (20-34, 35-49, 50-64, 65-79, ≥ 80).We analyzed 240 million pharmacy claims data. The age-adjusted monthly prevalence rate

2018 Journal of the American Geriatrics Society

69. A transdisciplinary team approach to scoping reviews: the case of pediatric polypharmacy. Full Text available with Trip Pro

A transdisciplinary team approach to scoping reviews: the case of pediatric polypharmacy. Polypharmacy can be either beneficial or harmful to children. We conducted a scoping review to examine the concept of pediatric polypharmacy: its definition, prevalence, extent and gaps in research. In this manuscript, we report our transdisciplinary scoping review methodology.After establishing a transdisciplinary team, we iteratively developed standard operating procedures for the study's search strategy

2018 BMC medical research methodology

70. Trends of Polypharmacy and Prescription Patterns of Antidepressants in Asia. (Abstract)

Trends of Polypharmacy and Prescription Patterns of Antidepressants in Asia. Little is known regarding the trend of polypharmacy in Asia. We used data from 5 Asian countries to examine the patterns of antidepressant (AD) prescription and trends of psychotropic polypharmacy over time.We used the cross-sectional, pharmacoepidemiological data from 2004 and 2013 REAP-AD (Research on Asian Psychotropic Prescription Patterns for Antidepressants) to examine the patterns of AD prescriptions in clinical (...) settings in China, Japan, Korea, Singapore, and Taiwan. We compared the trend in polypharmacy (ie, concomitant use of ≥2 classes of psychotropic) among individuals receiving AD prescriptions in 2004 and 2013 using multivariable logistic regression models in different diagnostic categories.The proportion of patients with psychotropic polypharmacy decreased from 2004 to 2013 in all 3 diagnostic categories, including mood disorders (adjusted odds ratio [aOR], 0.44 [0.35-0.56]; P < 0.001), anxiety

2018 Journal of Clinical Psychopharmacology

71. The association between polypharmacy and medication regimen complexity and antibiotic use in bronchiectasis Full Text available with Trip Pro

The association between polypharmacy and medication regimen complexity and antibiotic use in bronchiectasis Background Polypharmacy is associated with an increased risk of adverse drug events, inappropriate prescribing and medication errors. People with bronchiectasis have frequent pulmonary exacerbations that require antibiotic therapy. Objective This study aimed to measure polypharmacy and medication regimen complexity in bronchiectasis patients and to explore associations between (...) these factors and oral and intravenous (IV) antibiotic use for suspected pulmonary exacerbations. Setting Patients were sampled from the Regional Bronchiectasis Clinic at the Belfast Health and Social Care Trust, Northern Ireland. Method Data on medicines were collected from patients' records and used to measure polypharmacy using three thresholds (≥ 4, ≥ 10, and ≥ 15 medicines'). Medication regimen complexity was calculated using the medication regimen complexity index (MRCI). Data analysis investigated

2018 International journal of clinical pharmacy

72. Are the kind of medications and patient's background associated with improving polypharmacy in elderly? Full Text available with Trip Pro

Are the kind of medications and patient's background associated with improving polypharmacy in elderly? Polypharmacy is associated with negative outcomes in older population. Managing polypharmacy is important but there is no definite method for regulating it. Our aim was to evaluate what medications and patient's background are associated with reducing polypharmacy.A prospective, single-center, cohort study was conducted from June to October in 2016. Participants were 65 and older hospitalized (...) of the kinds and the number of medications prescribed might not be changed during hospitalization despite those were probably the causes of admission. The factor associated with improvements in polypharmacy was length of hospital stay.

2018 Journal of General and Family Medicine

73. Polypharmacy and Medication-Related Problems in Hemodialysis Patients: A Call for Deprescribing Full Text available with Trip Pro

Polypharmacy and Medication-Related Problems in Hemodialysis Patients: A Call for Deprescribing Polypharmacy is a common problem among hemodialysis patients. It is associated with increased hospital admissions, morbidity, mortality, Medication-Related Problems (MRPs), and expenditures. There is a paucity of data on the prevalence of polypharmacy in our setting. This study aims to determine the prevalence of polypharmacy and MRPs and to assess its predictors. We conducted a cross-sectional study (...) in the outpatient hemodialysis unit. A pharmacy resident assessed electronic prescribing records to identify MRPs and discussed therapeutic interventions to enhance effective therapeutic regimens over a three months period. Eighty-three patients were included. The median age was 63 (Interquartile range; IQR = 22), 50% were males, and the mean number of co-morbidities was 3.14 ± 1.64. The prevalence of polypharmacy was 97.6% with a 95% CI (91.6%⁻99.7%). Medication use without indication, was the highest

2018 Pharmacy: Journal of Pharmacy Education and Practice

74. Influence of Education Level of Older Patients on Polypharmacy, Potentially Inappropriate Medications Listed in Beer’s Criteria, and Unplanned Hospitalization: A Cross-Sectional Study in Lahore, Pakistan Full Text available with Trip Pro

Influence of Education Level of Older Patients on Polypharmacy, Potentially Inappropriate Medications Listed in Beer’s Criteria, and Unplanned Hospitalization: A Cross-Sectional Study in Lahore, Pakistan Objective: To evaluate influence of education level of older patients on polypharmacy, potentially inappropriate medications (PIMs) listed in Beer's Criteria, and unplanned hospitalization. Methods: A cross-sectional study was conducted among older people aged ≥65 years between 1 December (...) 2017 and 28 February 2018. For data analysis, descriptive statistics and logistic regression analysis were employed. Results: Among 385 older patients, 88.8% were prescribed PIMs and 56.4% underwent PIMs associated unplanned hospitalization. Older people were less exposed to polypharmacy or excessive polypharmacy as their education levels increased (no formal education vs. primary vs. secondary vs. tertiary, 74% vs. 69.8% vs. 60.5% vs. 58.1%). Patients having higher education were also accompanied

2018 Medicina

75. A healthy lifestyle attenuates the effect of polypharmacy on total and cardiovascular mortality: a national prospective cohort study Full Text available with Trip Pro

A healthy lifestyle attenuates the effect of polypharmacy on total and cardiovascular mortality: a national prospective cohort study This work examines whether the increased all-cause and cardiovascular disease (CVD) mortality associated with polypharmacy could be offset by a healthy lifestyle. We included a prospective cohort of 3,925 individuals representative of the Spanish population aged ≥60 years, who were recruited in 2000-2001 and followed up through 2014. Polypharmacy was defined (...) as treatment with ≥5 medications. The following lifestyle behaviors were considered healthy: not smoking, eating a healthy diet, being physically active, moderate alcohol consumption, low sitting time, and adequate sleep duration. Individuals were classified into three lifestyle categories s: unfavorable (0-2), intermediate (3-4) favorable (5-6). Over a median 13.8-y follow-up, 1,822 all-cause and 675 CVD deaths occurred. Among individuals with polypharmacy, intermediate and favorable lifestyles were

2018 Scientific reports

76. Polypharmacy and medication deprescribing: A survey among multimorbid older adults in Denmark Full Text available with Trip Pro

Polypharmacy and medication deprescribing: A survey among multimorbid older adults in Denmark Polypharmacy is common among multimorbid adults and associated with increased morbidity and mortality. Excessive polypharmacy (ie, ≥10 medicine) is strongly associated with inappropriate medication use, but little is known about attitudes toward deprescribing in patients with excessive polypharmacy. We surveyed 100 Danish individuals aged 65 years and above with ≥10 prescribed medications, using (...) of tablets and capsules, 62 (62%) of participants reported that they would be comfortable taking fewer medications than they did. Forty-two (42%) participants had experience with stopping a regular medication. Almost all participants (92%) wanted to receive follow-up by various means if a medication was discontinued. Forty-one (41%) participants were interested in a consultation at an outpatient clinic specializing in polypharmacy. Overall, the answers to the PATD questionnaire suggest that our cohort

2018 Pharmacology research & perspectives

77. Risk factors for polypharmacy in older adults in a primary care setting: a cross-sectional study Full Text available with Trip Pro

Risk factors for polypharmacy in older adults in a primary care setting: a cross-sectional study Polypharmacy (PP) is a clinical challenge in older adults. Therefore, assessment of daily drug consumption (DDC) and its relationships is important. First-line health services have a crucial role in monitoring and preventing PP. In this study, we aimed to assess DDC and investigate the risk factors for higher DDC among older adults in a primary care setting.A total of 1,000 patients aged ≥65 years

2018 Clinical interventions in aging

78. From Oxidative Stress to Ageing via Lifestyle, Nutraceuticals, Polypharmacy, and Neuropsychological Factors Full Text available with Trip Pro

From Oxidative Stress to Ageing via Lifestyle, Nutraceuticals, Polypharmacy, and Neuropsychological Factors 30363930 2018 12 11 2018 12 11 1942-0994 2018 2018 Oxidative medicine and cellular longevity Oxid Med Cell Longev From Oxidative Stress to Ageing via Lifestyle, Nutraceuticals, Polypharmacy, and Neuropsychological Factors. 6352689 10.1155/2018/6352689 Peluso Ilaria I 0000-0002-6210-5241 Research Center for Food and Nutrition, Council for Agricultural Research and Economics (CREA-AN), Rome (...) . Enzymoics, 7 Peterlee Place, Hebersham, NSW 2770, Australia. Novel Global Community Educational Foundation, Australia. eng Editorial Introductory Journal Article 2018 09 30 United States Oxid Med Cell Longev 101479826 1942-0994 0 Antioxidants IM Aging Animals Antioxidants chemistry metabolism Carotid Intima-Media Thickness Dietary Supplements Humans Life Style Oxidative Stress Polypharmacy 2018 09 09 2018 09 10 2018 10 27 6 0 2018 10 27 6 0 2018 12 12 6 0 epublish 30363930 10.1155/2018/6352689

2018 Oxidative medicine and cellular longevity

79. Building interpretable models for polypharmacy prediction in older chronic patients based on drug prescription records Full Text available with Trip Pro

Building interpretable models for polypharmacy prediction in older chronic patients based on drug prescription records Multimorbidity presents an increasingly common problem in older population, and is tightly related to polypharmacy, i.e., concurrent use of multiple medications by one individual. Detecting polypharmacy from drug prescription records is not only related to multimorbidity, but can also point at incorrect use of medicines. In this work, we build models for predicting polypharmacy (...) ). Reducing complexity of the model by 65% and 48% for CVD and T2D, resulted in 3% and 4% lower AUC, and 4% and 5% lower AUPRC values, respectively. Calibration plots for our models showed that we can achieve moderate calibration with reducing the models' complexity without significant loss of predictive performance.In this study, we found that it is possible to use drug prescription data to build a model for polypharmacy prediction in older population. In addition, the study showed that it is possible

2018 PeerJ

80. Pharmacogenomic Approaches for Automated Medication Risk Assessment in People with Polypharmacy Full Text available with Trip Pro

Pharmacogenomic Approaches for Automated Medication Risk Assessment in People with Polypharmacy Medication regimen may be optimized based on individual drug efficacy identified by pharmacogenomic testing. However, majority of current pharmacogenomic decision support tools provide assessment only of single drug-gene interactions without taking into account complex drug-drug and drug-drug-gene interactions which are prevalent in people with polypharmacy and can result in adverse drug events (...) or insufficient drug efficacy. The main objective of this project was to develop comprehensive pharmacogenomic decision support for medication risk assessment in people with polypharmacy that simultaneously accounts for multiple drug and gene effects. To achieve this goal, the project addressed two aims: (1) development of comprehensive knowledge repository of actionable pharmacogenes; (2) introduction of scoring approaches reflecting potential adverse effect risk levels of complex medication regimens

2018 AMIA Summits on Translational Science Proceedings

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