0000000001071333

AUTHOR

Marta Molaro

showing 8 related works from this author

Choice and Outcomes of Rate Control versus Rhythm Control in Elderly Patients with Atrial Fibrillation: A Report from the REPOSI Study

2018

Background: Among rate-control or rhythm-control strategies, there is conflicting evidence as to which is the best management approach for non-valvular atrial fibrillation (AF) in elderly patients. Design: We performed an ancillary analysis from the ‘Registro Politerapie SIMI’ study, enrolling elderly inpatients from internal medicine and geriatric wards. Methods: We considered patients enrolled from 2008 to 2014 with an AF diagnosis at admission, treated with a rate-control-only or rhythm-control-only strategy. Results: Among 1114 patients, 241 (21.6%) were managed with observation only and 122 (11%) were managed with both the rate- and rhythm-control approaches. Of the remaining 751 patie…

MaleAnti-Arrhythmia Agents/therapeutic useantiarrhythmic agentComorbidityAged; Aged 80 and over; Anti-Arrhythmia Agents; Atrial Fibrillation; Comorbidity; Diabetes Mellitus; Female; Heart Failure; Heart Rate; Hospitalization; Humans; Male; Odds Ratio; Polypharmacy; Prevalence; Geriatrics and Gerontology; Pharmacology (medical)030204 cardiovascular system & hematologyanticoagulant agentDiabetes Mellitus/drug therapy0302 clinical medicineHeart RateAtrial Fibrillation80 and overOdds RatioPrevalencePharmacology (medical)030212 general & internal medicineLS4_4Aged 80 and overantiarrhythmic agent anticoagulant agent antithrombocytic agent calcium channel blocking agent digoxinHeart Rate/drug effectsDiabetes MellituAtrial fibrillationantithrombocytic agentdigoxinHospitalizationAnti-Arrhythmia AgentFemaleAnti-Arrhythmia AgentsHumanmedicine.medical_specialtySocio-culturale-Geriatrics and Gerontology; Pharmacology (medical)03 medical and health sciencesInternal medicineDiabetes mellitusHeart rateantiarrhythmic agent; anticoagulant agent; antithrombocytic agent; calcium channel blocking agent; digoxinmedicineDiabetes MellitusHumansAgedPolypharmacyHeart Failurebusiness.industryAtrial Fibrillation/drug therapyOdds ratiomedicine.diseaseHeart Failure/drug therapyComorbidityConfidence intervalcalcium channel blocking agentHeart failurePolypharmacyAged; Aged 80 and over; Anti-Arrhythmia Agents; Atrial Fibrillation; Comorbidity; Diabetes Mellitus; Female; Heart Failure; Heart Rate; Hospitalization; Humans; Male; Odds Ratio; Polypharmacy; PrevalenceGeriatrics and Gerontologybusiness
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Adherence to antibiotic treatment guidelines and outcomes in the hospitalized elderly with different types of pneumonia.

2015

none 22 no Background: Few studies evaluated the clinical outcomes of Community Acquired Pneumonia (CAP), Hospital-Acquired Pneumonia (HAP) and Health Care-Associated Pneumonia (HCAP) in relation to the adherence of antibiotic treatment to the guidelines of the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) in hospitalized elderly people (65 years or older). Methods: Data were obtained from REPOSI, a prospective registry held in 87 Italian internal medicine and geriatric wards. Patients with a diagnosis of pneumonia (ICD-9 480-487) or prescribed with an antibiotic for pneumonia as indication were selected. The empirical antibiotic regimen was defined t…

MaleAntibiotic regimenGuidelines adherenceSettore MED/09 - Medicina InternaAntibioticsLogistic regressionElderlyCommunity-acquired pneumoniaAntibiotics80 and overElderly peopleAge FactorHospital MortalityAged 80 and overTreatment regimenMedicine (all)Age FactorsOptimal managementAntibiotics; Elderly; Guidelines adherence; Mortality; Pneumonia; Re-hospitalization; Age Factors; Aged; Aged 80 and over; Anti-Bacterial Agents; Female; Hospital Mortality; Humans; Logistic Models; Male; Pneumonia; Practice Guidelines as Topic; Treatment Outcome; Guideline Adherence; Hospitalization; Internal Medicine; Medicine (all)Anti-Bacterial AgentsHospitalizationTreatment OutcomePractice Guidelines as TopicFemaleGuideline AdherenceHumanmedicine.medical_specialtyLogistic Modelmedicine.drug_classSocio-culturaleantibiotic treatment; guidelines; pneumonia; elderly;Internal medicineRe-hospitalizationAnti-Bacterial AgentmedicineInternal MedicineHumanselderly pmeumonia antibiotics guidelines adherence mortality re-hospitalizationpmeumoniaMortalityIntensive care medicineAntibiotics; Elderly; Guidelines adherence; Mortality; Pneumonia; Re-hospitalization; Age Factors; Aged; Aged 80 and over; Anti-Bacterial Agents; Female; Hospital Mortality; Humans; Logistic Models; Male; Pneumonia; Practice Guidelines as Topic; Treatment Outcome; Guideline Adherence; Hospitalization; Internal MedicineAgedbusiness.industrySettore MED/09 - MEDICINA INTERNAAntibioticPneumoniamedicine.diseasePneumoniaAntibiotics; Elderly; Guidelines adherence; Mortality; Pneumonia; Re-hospitalizationLogistic ModelsAntibiotics; Elderly; Guidelines adherence; Mortality; Pneumonia; Re-hospitalization; Age Factors; Aged; Aged 80 and over; Anti-Bacterial Agents; Female; Hospital Mortality; Humans; Logistic Models; Male; Pneumonia; Practice Guidelines as Topic; Treatment Outcome; Guideline Adherence; Hospitalizationbusiness
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Hospital Care of Older Patients With COPD: Adherence to International Guidelines for Use of Inhaled Bronchodilators and Corticosteroids

2019

Abstract Objectives We aimed to analyze the prevalence and impact of COPD in older patients hospitalized in internal medicine or geriatric wards, and to investigate adherence to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, associated clinical factors, and outcomes. Design Data were obtained from REgistro POliterapie SIMI (REPOSI), a prospective multicenter observational registry that enrolls inpatients aged ≥65 years. Setting and Participants Older hospitalized patients enrolled from 2008 to 2016 with a diagnosis of COPD. Measures We evaluated adherence to the 2018 GOLD guidelines at admission and discharge, by examining the prescription of inhaled bronchodi…

Malemajor clinical eventmajor clinical eventsPulmonary Disease Chronic Obstructive0302 clinical medicineOlder patientsAdrenal Cortex Hormones80 and over030212 general & internal medicineLS4_4adherenceProspective StudiesGeneral NursingNursing (all)2901 Nursing (miscellaneous)Aged 80 and overCOPDHealth PolicyGeneral MedicineCOPD guidelines adherence major clinical events older patientsolder patientsObstructive lung diseaseBronchodilator Agentsguidelines adherenceHospitalizationInhalationCOPD; guidelines adherence; major clinical events; older patients; Administration Inhalation; Adrenal Cortex Hormones; Aged; Aged 80 and over; Bronchodilator Agents; Female; Humans; Male; Prospective Studies; Pulmonary Disease Chronic Obstructive; Guideline Adherence; HospitalizationAdministrationFemaleGuideline AdherenceCOPD guidelinesCOPD; guidelines adherence; major clinical events; older patients; Nursing (all)2901 Nursing (miscellaneous); Health Policy; Geriatrics and GerontologyChronic Obstructivemedicine.medical_specialtySocio-culturalePulmonary Disease03 medical and health sciencesolder patientInternal medicineAdministration InhalationmedicineHumansCOPDMedical prescriptionAgedPolypharmacybusiness.industrySettore MED/09 - MEDICINA INTERNAOdds ratiomedicine.diseaseConfidence intervalrespiratory tract diseasesCOPD; guidelines adherence; major clinical events; older patientsObservational studyGeriatrics and Gerontologybusiness030217 neurology & neurosurgery
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Heart failure and chronic kidney disease in a registry of internal medicine wards

2014

Background: The aim of the present study was to evaluate the association between heart failure (HF) and chronic kidney disease (CKD) in tertiary care centers using the clinical records of patients enrolled in internal medicine departments.Patients and methods: We used the clinical records of 1380 elderly patients to identify patients with a history of HF and CKD using admission ICD codes and glomerular filtration rate (GFR) formulas. Magnitude and strength of such associations were investigated by univariable and multivariable analysis.Results: Of the 1380 patients enrolled, 27.9% had HF (age 80 ± 7, BMI 27 ± 6 kg/m2) and 17.4% CKD (age 81 ± 7, BMI 26.8 ± 6 kg/m2). Both groups were signific…

medicine.medical_specialtyChronic kidney disease; Elderly; Heart failure; REPOSI; Gerontology; Geriatrics and GerontologyHeart failure; Elderly; Chronic kidney disease; REPOSIChronic kidney disease; Elderly; Heart failure; REPOSI; Humans; Sleep Apnea Syndromes; Noninvasive Ventilation; Gerontology; Geriatrics and GerontologyChronic kidney disease; Elderly; Heart failure; REPOSIRenal functionHeart failure; chronic kidney disease; elderly; registry; REPOSIHeart failureregistryTertiary careSleep Apnea SyndromeElderlySleep Apnea SyndromesInternal medicineChronic kidney diseaseEpidemiologymedicineHumansNoninvasive Ventilationbusiness.industryREPOSIChronic kidney disease; Elderly; Heart failure; REPOSI; Humans; Sleep Apnea Syndromes; Noninvasive Ventilation; Geriatrics and Gerontology; Gerontologymedicine.diseaseHeart failureHeart failure Elderly Chronic kidney disease REPOSIIcd codesGeriatrics and GerontologybusinessClinical recordBody mass indexGerontologyKidney diseaseHuman
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Brain and kidney, victims of atrial microembolism in elderly hospitalized patients? Data from the REPOSI study

2015

Abstract Background It is well known that atrial fibrillation (AF) and chronic kidney disease (CKD) are associated with a higher risk of stroke, and new evidence links AF to cognitive impairment, independently from an overt stroke (CI). Our aim was to investigate, assuming an underlying role of atrial microembolism, the impact of CI and CKD in elderly hospitalized patients with AF. Methods We retrospectively analyzed the data collected on elderly patients in 66 Italian hospitals, in the frame of the REPOSI project. We analyzed the clinical characteristics of patients with AF and different degrees of CI. Multivariate logistic analysis was used to explore the relationship between variables an…

MaleSettore MED/09 - Medicina InternaREPOSI studyKidneyDisability EvaluationRetrospective StudieRisk Factorshospitalized patientAtrial Fibrillation80 and overOdds RatioLS4_4Renal InsufficiencyChronicMultivariate AnalysiStrokeAged 80 and overMedicine (all)BrainAtrial fibrillationStrokeFemaleatrial microembolismHumanGlomerular Filtration Ratemedicine.medical_specialtySocio-culturaleRenal functionelderlyCognition DisorderInternal medicineThromboembolismmedicineInternal MedicineHumansRenal insufficiency chronicHeart AtriaIntensive care medicineAged; Anticoagulants; Atrial fibrillation; Dementia; Renal insufficiency chronic; Stroke; Aged; Aged 80 and over; Anticoagulants; Atrial Fibrillation; Brain; Cognition Disorders; Dementia; Disability Evaluation; Female; Glomerular Filtration Rate; Heart Atria; Humans; Kidney; Male; Multivariate Analysis; Odds Ratio; Renal Insufficiency Chronic; Retrospective Studies; Risk Factors; Stroke; ThromboembolismAgedRetrospective Studiesbusiness.industryRisk FactorSettore MED/09 - MEDICINA INTERNAAnticoagulantAnticoagulantsRetrospective cohort studyOdds ratiomedicine.diseaseAtrial fibrillationBlood pressureHeart failureMultivariate AnalysisAged Anticoagulants Atrial fibrillation Dementia Renal insufficiency chronic Stroke.Aged; Anticoagulants; Atrial fibrillation; Dementia; Renal insufficiency chronic; Strokeatrial microembolism; elderly; hospitalized patients; REPOSI study;DementiabusinessCognition DisordersKidney diseaseAged; Anticoagulants; Atrial fibrillation; Dementia; Renal insufficiency chronic; Stroke; Aged; Aged 80 and over; Anticoagulants; Atrial Fibrillation; Brain; Cognition Disorders; Dementia; Disability Evaluation; Female; Glomerular Filtration Rate; Heart Atria; Humans; Kidney; Male; Multivariate Analysis; Odds Ratio; Renal Insufficiency Chronic; Retrospective Studies; Risk Factors; Stroke; Thromboembolism; Internal Medicine; Medicine (all)
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The stigma of low opioid prescription in the hospitalized multimorbid elderly in Italy.

2015

The primary aim of this study was to evaluate the prevalence of opioid prescriptions in hospitalized geriatric patients. Other aims were to evaluate factors associated with opioid prescription, and whether or not there was consistency between the presence of pain and prescription. Opioid prescriptions were gathered from the REgistro POliterapie Societa` Italiana di Medicina Interna (REPOSI) data for the years 2008, 2010 and 2012. 1,380 in-patients, 65+ years old, were enrolled in the first registry run, 1,332 in the second and 1,340 in the third. The prevalence of opioid prescription was calculated at hospital admission and discharge. In the third run of the registry, the degree of pain was…

RegistrieMalePoison controlOlder personComorbidityPractice PatternsDrug PrescriptionOlder persons Pain Analgesic opioids80 and overRegistriesPractice Patterns Physicians'Pain MeasurementAged 80 and overAnalgesicsAnalgesic opioids; Older persons; Pain; Emergency Medicine; Internal MedicineAnalgesics OpioidHospitalizationItalyEmergency MedicineFemaleTramadolHumanmedicine.drugmedicine.medical_specialtyAttitude of Health PersonnelAnalgesicPainOpioidelderlyDrug PrescriptionsInjury preventionmedicineInternal MedicineHumansAnalgesic opioidsMedical prescriptionAgedPhysicians'business.industryCodeineSettore MED/09 - MEDICINA INTERNAAnalgesic opioidmedicine.diseaseComorbidityOlder persons Pain Analgesic opioidsOpioidOlder personsEmergency medicinebusinessAnalgesic opioids; Older persons; Pain; Aged; Aged 80 and over; Analgesics Opioid; Comorbidity; Drug Prescriptions; Female; Humans; Italy; Male; Pain; Pain Measurement; Practice Patterns Physicians'; Registries; Attitude of Health Personnel; Hospitalization; Internal Medicine; Emergency MedicineAnalgesic opioids; Older persons; Pain; Aged; Aged 80 and over; Analgesics Opioid; Comorbidity; Drug Prescriptions; Female; Humans; Italy; Male; Pain; Pain Measurement; Practice Patterns Physicians'; Registries; Attitude of Health Personnel; Hospitalization; Emergency Medicine; Internal Medicine
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Adherence to antithrombotic therapy guidelines improves mortality among elderly patients with atrial fibrillation: insights from the REPOSI study

2016

Background: Atrial fibrillation (AF) is associated with a substantial risk of thromboembolism and mortality, significantly reduced by oral anticoagulation. Adherence to guidelines may lower the risks for both all cause and cardiovascular (CV) deaths. Methods: Our objective was to evaluate if antithrombotic prophylaxis according to the 2012 European Society of Cardiology (ESC) guidelines is associated to a lower rate of adverse outcomes. Data were obtained from REPOSI; a prospective observational study enrolling inpatients aged ≥65 years. Patients enrolled in 2012 and 2014 discharged with an AF diagnosis were analysed. Results: Among 2535 patients, 558 (22.0 %) were discharged with a diagnos…

Antithrombotic therapy; Atrial fibrillation; Elderly; Guidelines; Outcomes; Cardiology and Cardiovascular MedicineMaleRegistrieTime Factorsantithrombotic therapy; atrial fibrillation; elderly; guidelines; outcomesAtrial fibrillation (AF)Practice PatternsKaplan-Meier Estimate030204 cardiovascular system & hematologyGuidelineoutcomesCoronary artery disease0302 clinical medicineElderlyRisk FactorsAtrial FibrillationAntithrombotic80 and overAge Factor030212 general & internal medicineRegistriesguidelinesAntithrombotic therapy Atrial fibrillation Elderly Guidelines OutcomesPractice Patterns Physicians'OutcomeAged 80 and overFibrinolytic AgentAge FactorsAtrial fibrillationGeneral MedicineTreatment OutcomeItalyAtrial fibrillation (AF) thromboembolism antithrombotic prophylaxisPractice Guidelines as TopicCardiologyFemaleGuideline AdherenceCardiology and Cardiovascular MedicineHumanAntithrombotic therapy; Atrial fibrillation; Elderly; Guidelines; Outcomes; Age Factors; Aged; Aged 80 and over; Atrial Fibrillation; Chi-Square Distribution; Female; Fibrinolytic Agents; Guideline Adherence; Humans; Italy; Kaplan-Meier Estimate; Logistic Models; Male; Practice Patterns Physicians'; Proportional Hazards Models; Registries; Risk Assessment; Risk Factors; Thromboembolism; Time Factors; Treatment Outcome; Practice Guidelines as Topic; Cardiology and Cardiovascular Medicinemedicine.medical_specialtyLogistic ModelTime FactorSocio-culturaleLower riskRisk Assessment03 medical and health sciencesFibrinolytic AgentsInternal medicineThromboembolismmedicineHumansProportional Hazards ModelsAgedAntithrombotic therapyPhysicians'Chi-Square Distributionbusiness.industryProportional hazards modelRisk FactorSettore MED/09 - MEDICINA INTERNAGuidelinethromboembolismmedicine.diseaseAtrial fibrillationLogistic ModelsProportional Hazards Modelantithrombotic prophylaxisbusinessChi-squared distributionFibrinolytic agent
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Polypharmacy in older people: lessons from 10 years of experience with the REPOSI register

2018

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 …

Malemedicine.medical_specialtyPopulation ageingDeprescribing; Inappropriate prescription; Medication reconciliation; Multimorbidity; PolypharmacyPopulationSocio-culturale030204 cardiovascular system & hematology03 medical and health sciences0302 clinical medicineDeprescribingRisk Factors80 and overDeprescribing; Inappropriate prescription; Medication reconciliation; Multimorbidity; Polypharmacy; Internal Medicine; Emergency MedicineInternal MedicinemedicineDeprescribing Inappropriate prescription Medication reconciliation Multimorbidity PolypharmacyHumansMultimorbidityRegistries030212 general & internal medicineMedical prescriptionAdverse effecteducationAgedAged 80 and overPolypharmacyGeriatricseducation.field_of_studybusiness.industryMultimorbidityPatient DischargeHospitalizationDeprescribing; Inappropriate prescription; Medication reconciliation; Multimorbidity; Polypharmacy; Aged; Aged 80 and over; Female; Geriatrics; Hospitalization; Humans; Italy; Male; Multimorbidity; Patient Discharge; Registries; Risk Factors; PolypharmacyItalyGeriatricsFamily medicinePolypharmacyEmergency MedicineMedication reconciliationFemaleDeprescribingbusinessDeprescribing; Inappropriate prescription; Medication reconciliation; Multimorbidity; Polypharmacy;Inappropriate prescriptionInternal and Emergency Medicine
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