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Polypharmacy

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81. 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

82. 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

83. 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

84. 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

85. Polypharmacy Among Headache Patients: A Cross-Sectional Study Full Text available with Trip Pro

Polypharmacy Among Headache Patients: A Cross-Sectional Study Polypharmacy can appropriately treat multiple chronic conditions, but it can also increase potential harm. Polypharmacy information for primary headaches is minimal, despite drugs being the main tools to manage headaches.The aim was to evaluate the prevalence, characteristics and risk factors of polypharmacy in patients with primary headaches and examine whether these variables differ between episodic and chronic headache patients.We (...) analysed polypharmacy (simultaneous use of five or more medications), medication type, comorbidity, and risk factors in 300 patients (mean age 42.81 ± 13.21 years) with primary headaches, divided into episodic and chronic, afferent to a headache centre.Patients took an average of 4.37 medications. Polypharmacy was common in 40.7% of patients, and among chronic patients, it reached 58.8%. Most patients used medications (mainly nonsteroidal anti-inflammatory drugs; 73.5%) to treat acute headaches

2018 CNS drugs

86. Is Excessive Polypharmacy a Transient or Persistent Phenomenon? A Nationwide Cohort Study in Taiwan Full Text available with Trip Pro

Is Excessive Polypharmacy a Transient or Persistent Phenomenon? A Nationwide Cohort Study in Taiwan Objectives: Target populations with persistent polypharmacy should be identified prior to implementing strategies against inappropriate medication use, yet limited information regarding such populations is available. The main objectives were to explore the trends of excessive polypharmacy, whether transient or persistent, at the individual level. The secondary objectives were to identify (...) the factors associated with persistently excessive polypharmacy and to estimate the probabilities for repeatedly excessive polypharmacy. Methods: Retrospective cohort analyses of excessive polypharmacy, defined as prescription of ≥ 10 medicines at an ambulatory visit, from 2001 to 2013 were conducted using a nationally representative claims database in Taiwan. Survival analyses with log-rank test of adult patients with first-time excessive polypharmacy were conducted to predict the probabilities

2018 Frontiers in pharmacology

87. Polypharmacy through Phage Display: Selection of Glucagon and GLP-1 Receptor Co-agonists from a Phage-Displayed Peptide Library Full Text available with Trip Pro

Polypharmacy through Phage Display: Selection of Glucagon and GLP-1 Receptor Co-agonists from a Phage-Displayed Peptide Library A promising emerging area for the treatment of obesity and diabetes is combinatorial hormone therapy, where single-molecule peptides are rationally designed to integrate the complementary actions of multiple endogenous metabolically-related hormones. We describe here a proof-of-concept study on developing unimolecular polypharmacy agents through the use of selection

2018 Scientific reports

88. The epidemiology of polypharmacy in older adults: register-based prospective cohort study Full Text available with Trip Pro

The epidemiology of polypharmacy in older adults: register-based prospective cohort study Polypharmacy is the concomitant use of several drugs by a single person, and it increases the risk of adverse drug-related events in older adults. Little is known about the epidemiology of polypharmacy at the population level. We aimed to measure the prevalence and incidence of polypharmacy and to investigate the associated factors.A prospective cohort study was conducted using register data with national (...) coverage in Sweden. A total of 1,742,336 individuals aged ≥65 years at baseline (November 1, 2010) were included and followed until death or the end of the study (December 20, 2013).On average, individuals were exposed to 4.6 (SD =4.0) drugs at baseline. The prevalence of polypharmacy (5+ drugs) was 44.0%, and the prevalence of excessive polypharmacy (10+ drugs) was 11.7%. The incidence rate of polypharmacy among individuals without polypharmacy at baseline was 19.9 per 100 person-years, ranging from

2018 Clinical epidemiology

89. Multimorbidity patterns in relation to polypharmacy and dosage frequency: a nationwide, cross-sectional study in a Japanese population Full Text available with Trip Pro

Multimorbidity patterns in relation to polypharmacy and dosage frequency: a nationwide, cross-sectional study in a Japanese population In the present study, we aimed to identify multimorbidity patterns in a Japanese population and investigate whether these patterns have differing effects on polypharmacy and dosage frequency. Data was collected on 17 chronic health conditions via nationwide cross-sectional survey of 3,256 adult Japanese residents. Factor analysis was performed to identify (...) multimorbidity patterns, and associations were determined with excessive polypharmacy [concurrent use of ≥ 10 prescription or over-the-counter (OTC) medications] and higher dosage frequency ( ≥ 3 doses per day). Secondary outcomes were the number of concurrent prescription medications and the number of concurrent OTC medications. We used a generalized linear model to adjust for individual sociodemographic characteristics. Five multimorbidity patterns were identified: cardiovascular/renal/metabolic

2018 Scientific reports

90. Medications & Polypharmacy Influence on Recurrent Fallers in Community: a Systematic Review Full Text available with Trip Pro

Medications & Polypharmacy Influence on Recurrent Fallers in Community: a Systematic Review The purpose of this systematic review is to summarize information about the impact different classes of medications and polypharmacy have on recurrent falls, defined as two or more falls in a 12-month period, in community-dwelling older adults. After adjustment for confounders such as age, gender, weight or depression symptoms, the reviewed studies suggested that older adults who use antidepressants (...) , sedatives or hypnotics and anti-epileptics were more likely to experience recurrent falls than non-users. Polypharmacy (use of four or more prescription medications daily) caused 1.5-2 times higher possibility of recurrent falls in older adults. As a high-risk group, recurrent fallers require meaningful intervention. Medications are believed to be a modifiable risk factor in falls prevention; hence, special consideration should be taken to balance the benefit and harm in initiating, continuing

2018 Canadian Geriatrics Journal

91. Using a Polypharmacy Simulation Exercise to Increase Empathy in Pharmacy Students Full Text available with Trip Pro

Using a Polypharmacy Simulation Exercise to Increase Empathy in Pharmacy Students Objective. To assess whether the Jellybean Polypharmacy Simulation Exercise (JPSE) improved empathy in pharmacy students. Methods. The JPSE was given to all third-professional year pharmacy students in a required Special Populations course with pre- and post-scores on the Kiersma-Chen Empathy Scale (KCES) assessed, and open-ended questions on lessons learned from the exercise. Results. Pharmacy students showed (...) a statistically significant increase in KCES scores after completing the JPSE. Open-ended question responses reflected personal growth and appreciation for patients managing difficult medication regimens. Conclusion. This polypharmacy simulation showed the ability to increase empathy in pharmacy students, as well as mimic a realistic experience in managing a multi-drug, multi-dose medication regimen.

2018 American journal of pharmaceutical education

92. Examining patterns of multimorbidity, polypharmacy and risk of adverse drug reactions in chronic obstructive pulmonary disease: a cross-sectional UK Biobank study. Full Text available with Trip Pro

Examining patterns of multimorbidity, polypharmacy and risk of adverse drug reactions in chronic obstructive pulmonary disease: a cross-sectional UK Biobank study. This study aims: (1) to describe the pattern and extent of multimorbidity and polypharmacy in UK Biobank participants with chronic obstructive pulmonary disease (COPD) and (2) to identify which comorbidities are associated with increased risk of adverse drug reactions (ADRs) resulting from polypharmacy.Cross-sectional.Community (...) cohort.UK Biobank participants comparing self-reported COPD (n=8317) with no COPD (n=494 323).Multimorbidity (≥4 conditions) and polypharmacy (≥5 medications) in participants with COPD versus those without. Risk of ADRs (taking ≥3 medications associated with falls, constipation, urinary retention, central nervous system (CNS) depression, bleeding or renal injury) in relation to the presence of COPD and individual comorbidities.Multimorbidity was more common in participants with COPD than those without

2018 BMJ open

93. A modified Delphi study to determine the level of consensus across the European Union on the structures, processes and desired outcomes of the management of polypharmacy in older people. Full Text available with Trip Pro

A modified Delphi study to determine the level of consensus across the European Union on the structures, processes and desired outcomes of the management of polypharmacy in older people. Inappropriate use of multiple medicines (inappropriate polypharmacy) is a major challenge in older people with consequences of increased prevalence and severity of adverse drug reactions and interactions, and reduced medicines adherence. The aim of this study was to determine the levels of consensus amongst key (...) stakeholders in the European Union (EU) in relation to aspects of the management of polypharmacy in older people.Forty-six statements were developed on aspects of healthcare structures, processes and desired outcomes, with consensus defined at ≥ 80% agreement. Panel members were strategists (e.g. directors, leading clinicians and commissioners) from each of the 28 EU member states, with a target recruitment of five per member state. Three Delphi rounds were conducted via email, with panel members being

2017 PLoS ONE

94. Analysis of polypharmacy effects in older patients using Japanese Adverse Drug Event Report database. Full Text available with Trip Pro

Analysis of polypharmacy effects in older patients using Japanese Adverse Drug Event Report database. Population aging is a global phenomenon, and choosing appropriate medical care for the elderly is critical. Polypharmacy is suspected to increase the risk of adverse events (AEs) in older patients. We examined the AE profiles associated with polypharmacy and aging using the Japanese Adverse Drug Event Report (JADER) database. We attempted to mitigate the effect of patient-related factors using (...) a multiple-logistic regression technique and data subsetting. We selected case reports for AEs as specified in the Medical Dictionary for Regulatory Activities (MedDRA). The association between polypharmacy and "renal disorder" or "hepatic disorder" was evaluated using reporting odds ratio (ROR) and adjusted for covariates using multiple-logistic regression. For renal disorder, advanced polypharmacy showed higher adjusted RORs, because the value of administered drugs group [1.82 (1.76-1.88), ≥ 10

2017 PLoS ONE

95. Kidney Function, Polypharmacy, and Potentially Inappropriate Medication Use in a Community-Based Cohort of Older Adults. Full Text available with Trip Pro

Kidney Function, Polypharmacy, and Potentially Inappropriate Medication Use in a Community-Based Cohort of Older Adults. Chronic kidney disease (CKD) afflicts many older adults and increases the risk for medication-related adverse events.The aim of this study was to assess the prevalence and associated morbidity and mortality of polypharmacy (use of several medications concurrently), and potentially inappropriate medication (PIM) use in older adults, looking for differences by CKD status.We (...) quantified medication and PIM use (from Beers criteria, the Screening Tool of Older People's Prescriptions, and Micromedex®) by level of estimated glomerular filtration rate (eGFR) for participants aged 65 years or older attending a baseline study visit in the Atherosclerosis Risk in Communities study (n =6392). We used zero-inflated negative binomial and Cox proportional hazards regressions to assess the relationship between baseline polypharmacy, PIM use, and subsequent hospitalization and death.Mean

2018 Drugs & Aging

96. Changes in prescribed medicines in older patients with multimorbidity and polypharmacy in general practice. Full Text available with Trip Pro

Changes in prescribed medicines in older patients with multimorbidity and polypharmacy in general practice. Treatment complexity rises in line with the number of drugs, single doses, and administration methods, thereby threatening patient adherence. Patients with multimorbidity often need flexible, individualised treatment regimens, but alterations during the course of treatment may further increase complexity. The objective of our study was to explore medication changes in older patients (...) with multimorbidity and polypharmacy in general practice.We retrospectively analysed data from the cluster-randomised PRIMUM trial (PRIoritisation of MUltimedication in Multimorbidity) conducted in 72 general practices. We developed an algorithm for active pharmaceutical ingredients (API), strength, dosage, and administration method to assess changes in physician-reported medication data during two intervals (baseline to six-months: ∆1; six- to nine-months: ∆2), analysed them descriptively at prescription

2018 BMC Family Practice

97. Polypharmacy among patients with diabetes: a cross-sectional retrospective study in a tertiary hospital in Saudi Arabia. Full Text available with Trip Pro

Polypharmacy among patients with diabetes: a cross-sectional retrospective study in a tertiary hospital in Saudi Arabia. ObjectivesPatients with diabetes are at high risk for polypharmacy (ie, use of multiple medications) for treatment of diabetes, associated comorbidities and other coexisting conditions. This study aims to estimate the prevalence of polypharmacy and factors associated with polypharmacy among adult patients with diabetes.A cross-sectional retrospective observational study (...) of adults with diabetes, who visited the outpatient clinic of a tertiary teaching hospital in Saudi Arabia, was conducted. Data were extracted from the Electronic Health Record database for a period of 12 months (January-December 2016). Polypharmacy was defined as the cumulative use of five or more medications. Polypharmacy among adults with diabetes was measured by calculating the average number of medications prescribed per patient. A multivariable logistic regression model was used to examine

2018 BMJ open

98. Association of Polypharmacy With 1-Year Trajectories of Cognitive and Physical Function in Nursing Home Residents: Results From a Multicenter European Study. (Abstract)

Association of Polypharmacy With 1-Year Trajectories of Cognitive and Physical Function in Nursing Home Residents: Results From a Multicenter European Study. To test the association between polypharmacy and 1-year change in physical and cognitive function among nursing home (NH) residents.Longitudinal multicenter cohort study based on data from the Services and Health for Elderly in Long TERm care (SHELTER) study.NH in Europe (n = 50) and Israel (n = 7).3234 NH older residents.Participants were (...) assessed through the interRAI long-term care facility instrument. Polypharmacy was defined as the concurrent use of 5 to 9 drugs and excessive polypharmacy as the use of ≥10 drugs. Cognitive function was assessed through the Cognitive Performance Scale (CPS). Functional status was evaluated through the Activities of Daily Living (ADL) Hierarchy scale. The change in CPS and ADL score, based on repeated assessments, was the outcome, and their association with polypharmacy was modeled via linear mixed

2018 Journal of the American Medical Directors Association

99. The prevalence and determinants of polypharmacy at age 69: a British birth cohort study. Full Text available with Trip Pro

The prevalence and determinants of polypharmacy at age 69: a British birth cohort study. To describe the development of polypharmacy and its components in a British birth cohort in its seventh decade and to investigate socioeconomic and gender differences independent of disease burden.Data from the MRC National Survey for Health and Development were analysed to determine the prevalence and composition of polypharmacy at age 69 and changes since ages 60 to 64. Multinomial regression was used (...) to test associations between gender, education and occupational social class and total, cardiological and non-cardiological polypharmacy controlling for disease burden.At age 69, 22.8% of individuals were taking more than 5 medications. There was an increase in the use of 5 to 8 medications (+ 2.3%) and over 9 medications (+ 0.8%) between ages 60-64 and 69. The greatest increases were found for cardiovascular (+ 13.4%) and gastrointestinal medications (+ 7.3%). Men experienced greater cardiological

2018 BMC Geriatrics

100. Polypharmacy among HIV positive older adults on anti-retroviral therapy attending an urban clinic in Uganda. Full Text available with Trip Pro

Polypharmacy among HIV positive older adults on anti-retroviral therapy attending an urban clinic in Uganda. Polypharmacy has not been investigated in patients living with HIV in developing countries. The aims of this study were to determine the prevalence of polypharmacy, the factors associated with polypharmacy and whether polypharmacy was associated with adverse effects among older adults on anti-retroviral therapy (ART).Cross-sectional study in older adults aged 50 and over on ART attending (...) an outpatient HIV/AIDS care centre in Uganda. Demographic and clinical data collected on number and type of medications plus supplements, possible medication related side-effects, comorbidity, frailty, cognitive impairment, current CD4 count and viral load.Of 411 participants, 63 (15.3, 95% C.I. 11.9, 18.8) had polypharmacy (≥ 4 non- HIV medications). In multivariate analyses, polypharmacy was associated with one or more hospitalisations in the last year (Prevalence Ratio PR = 1.8, 95% C.I. 1.1, 3.1, p

2018 BMC Geriatrics

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