Search results for " polypharmacy"
showing 10 items of 22 documents
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…
Polypharmacy in people with dementia: Associations with adverse health outcomes
2018
Polypharmacy has been linked to higher risks of hospitalisation and death in community samples. It is commonly present in people with dementia but these risks have rarely been studied in this population. We aimed to investigate associations between polypharmacy and emergency department attendance, any and unplanned hospitalisation, and mortality in patients with dementia. Using a large mental health care database in South London, linked to hospitalisation and mortality data, we assembled a retrospective cohort of patients diagnosed with dementia. We ascertained number of medications prescribed at the time of dementia diagnosis and conducted multivariate Cox regression analyses. Of 4668 pati…
Polypharmacy in elderly patients with type 2 diabetes receiving oral antidiabetic treatment
2016
Aim: Polypharmacy in older diabetics can have detrimental effects linked to poor adherence and the risk of drug interaction or more serious/frequent side effects. The aim of this study was to identify the characteristics associated with polypharmacy in a cohort of elderly diabetic patients being treated with oral hypoglycemic agents. Methods: The study population consisted of 1342 diabetic patients consecutively enrolled in 57 diabetes centers in Italy participating in the METABOLIC Study. Patients meeting the following inclusion criteria were enrolled: diagnosis of type 2 diabetes mellitus, age ≥65 years, and receiving oral antidiabetic treatment. Data concerning diabetes duration and comp…
Multimorbidity and polypharmacy in the elderly: Lessons from REPOSI
2014
none 10 no The dramatic demographic changes that are occurring in the third millennium are modifying the mission of generalist professionals such as primary care physicians and internists. Multiple chronic diseases and the related prescription of multiple medications are becoming typical problems and present many challenges. Unfortunately, the available evidence regarding the efficacy of medications has been generated by clinical trials involving patients completely different from those currently admitted to internal medicine: much younger, affected by a single disease and managed in a highly controlled research environment. Because only registries can provide information on drug effectiven…
The relationship between Polypharmacy and Trajectories of Cognitive Decline in People with Dementia: a large representative cohort study
2019
Polypharmacy, defined through the number of medications prescribed, has been linked to a range of adverse health outcomes in people with dementia. It is however unclear whether a numerical threshold of concurrently prescribed drugs is a suitable predictor for cognitive decline. We aimed to test associations between polypharmacy and both short-term (six months) and long-term (three years) cognitive trajectories in patients with incident dementia. Using data from a large mental health and dementia care database in South London, a cohort of 12,148 patients (mean age = 80.7 years, 61.1% female, mean MMSE = 18.6) clinically diagnosed with dementia was identified. We determined the number of medi…
Taste loss in hospitalized multimorbid elderly subjects
2013
ED Toffanello,1 EM Inelmen,1 A Imoscopi,1 E Perissinotto,2 A Coin,1 F Miotto,1 LM Donini,3 D Cucinotta,4 M Barbagallo,5 E Manzato,1 G Sergi11Department of Medical and Surgical Sciences, Geriatrics Division and University of Padova, Padova, 2Department of Environmental Medicine and Public Health, University of Padua, Padua, Italy; 3Department of Medical Physiopathology (Food Science Section), University of Roma, La Sapienza, Roma, 4S Orsola Malpighi Hospital, Bologna, 5Geriatric Unit, Department of Internal Medicine and Emerging Diseases, University of Palermo, Palermo, ItalyBackground: Loss of the sense of taste is common among older people. Morbidities and polypharmacy may contribute to th…
Pattern of in-hospital changes in drug use in the older people from 2010 to 2016
2017
Purpose: To assess the pattern of in-hospital changes in drug use in older patients from 2010 to 2016. Methods: People aged 65 years or more acutely hospitalized in those internal medicine and geriatric wards that did continuously participate to the REgistro POliterapie Società Italiana di Medicina Interna register from 2010 to 2016 were selected. Drugs use were categorized as 0 to 1 drug (very low drug use), 2 to 4 drugs (low drug use), 5 to 9 drugs (polypharmacy), and 10 or more drugs (excessive polypharmacy). To assess whether or not prevalence of patients in relation to drug use distribution changed overtime, adjusted prevalence ratios (PRs) was estimated with log-binomial regression mo…
Association between clusters of diseases and polypharmacy in hospitalized elderly patients: results from the REPOSI study.
2011
BACKGROUND: Although the association between multimorbidity and polypharmacy has been clearly documented, no study has analyzed whether or not specific combinations of diseases influence the prescription of polypharmacy in older persons. We assessed which clusters of diseases are associated with polypharmacy in acute-care elderly in-patients. METHODS: This cross-sectional study was held in 38 Italian internal medicine and geriatric wards participating in the Registro Politerapie SIMI (REPOSI) study during 2008. The study sample included 1155 in-patients aged 65 years or older. Clusters of diseases, defined as two or more co-occurring specific chronic diseases, were identified using the odds…
PROGNOSTIC VALUE OF ESTIMATED GLOMERULAR FILTRATION RATE IN HOSPITALIZED ELDERLY PATIENTS
2013
A multicenter observational study, REPOSI (REgustri POliterapie Società Italiana di Medicina Interna), was conducted to assess the prognostic value of glomerular filtration rate (eGFR) on in-hospital mortality, hospital readmission and death within 3 months, in a sample of elderly patients (n=1,363) admitted to 66 internal medicine and geriatric wards. Bases on eGFR, calculated by the new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula, subjects at hostpital admission were classified into three groups: group 1 with normal eGFR (60 ml/min/1.73m2, reference group), group 2 with moderately reduced eGFR (30-59 ml/min/1.73 m2) and group 3 with severely reduced eGFR (<30 ml/m…