Potentially Inappropriate Prescribing in Older People Living With HIV: A Scoping Review.

Background: Antiretroviral therapy has transformed HIV from a progressive and often fatal infection to a chronic disease. Currently, people living with HIV (PLHIV) have near-normal life expectancy; however, they face accelerated ageing and a rise in non-AIDS-defining HIV-associated conditions. Comorbidities increase the number of prescribed drugs and, therefore, the risk of polypharmacy and prescribing potentially inappropriate medications (PIMs).

[Spanish version of the STOPP/START 3 criteria: Advances in the detection of inappropriate prescribing medication in the older people].

The STOPP/START criteria are explicit physiologic systems-based criteria that summarize evidence on clinically relevant prescribing problems related to the use of potentially inappropriate medications (STOPP criteria) and potential prescribing omissions (START criteria). The two previous versions of the STOPP/START criteria were published in 2008 and 2015, and their Spanish versions in 2009 and 2015. Version3 of these criteria has just been published in 2023.

COVID-19 pandemic and mortality in nursing homes across USA and Europe up to October 2021.

Purpose: We compared the prevalence of COVID-19 and related mortality in nursing homes (NHs) in 14 countries until October 2021. We explored the relationship between COVID-19 mortality in NHs with the average size of NHs and with the COVID-19 deaths at a population level.

Methods: The total number of COVID-19 cases and COVID-19-related deaths in all NHs as well as the total number of NHs and NH beds were provided by representatives of 14 countries.

Proactive Geriatric Comanagement of Nursing Home Patients by a New Hospital-Based Liaison Geriatric Unit: A New Model for the Future.

During the SARS-CoV-2 pandemic, hospital-based liaison geriatric units (LGUs) were created in Spanish hospitals with the aim to improve health care coordination between nursing homes (NHs) and hospitals. Our university hospital created a comprehensive, proactive LGU serving 31 public and private NHs of different sizes and characteristics to offer support to more than 2500 residents. In the first 3 months of 2021, this LGU performed 1252 assessments (81% as outpatients, 12% at the emergency department, and 7% during hospitalization), avoiding an estimated 49 hospital transfers and 29 hospitalizations.

Peripheral IL-6 Levels but not Sarcopenia Are Predictive of 1-Year Mortality After Hip Fracture in Older Patients.

Background: Sarcopenic patients may have an increased risk of poor outcomes after a hip fracture. The objective of this study was to determine whether sarcopenia and a set of biomarkers were potential predictors of 1-year-mortality in older patients after a hip fracture.

Methods: About 150 patients at least 80 years old were hospitalized for the surgical treatment of a hip fracture.

Prevention of adverse drug reactions in hospitalized older patients with multi-morbidity and polypharmacy: the SENATOR* randomized controlled clinical trial.

Background: Multi-morbidity and polypharmacy increase the risk of non-trivial adverse drug reactions (ADRs) in older people during hospitalization. Despite this, there are no established interventions for hospital-acquired ADR prevention.

Methods: We undertook a pragmatic, multi-national, parallel arm prospective randomized open-label, blinded endpoint (PROBE) controlled trial enrolling patients at six European medical centres.

Biomarkers of sarcopenia in very old patients with hip fracture.

Background: Hip fracture is both a cause and a consequence of sarcopenia. Older persons with sarcopenia have an increased risk of falling, and the prevalence of sarcopenia may be increased in those who suffer a hip fracture. The aim of this study was to explore potential biomarkers (neuromuscular and peripheral pro-inflammatory and oxidative stress markers) that may be associated with sarcopenia in very old persons with hip fracture.

[Prevalence of sarcopenia and characteristics of sarcopenic subjects in patients over 80 years with hip fracture].

Aim: to estimate the prevalence of sarcopenia in very old patients admitted to an Orthogeriatric Unit for the treatment of a hip fracture (HF), and to compare characteristics of patients with and without sarcopenia. Methods: one hundred and fifty consecutive patients ≥ 80 years old admitted with HF were included. Sarcopenia was diagnosed with low muscle mass (bioimpedance, using two different cut-off points, Janssen and Masanés) and low grip strength (Jamar's dynamometer).

[Ten recommendations to improve undergraduate training in Geriatric Medicine].

Introduction: Population ageing and scientific progress have made specific training in Geriatrics essential for any medical students. There are different international recommendations on the teaching of Geriatric Medicine at undergraduate level, but they are still far from being offered systematically. The aim of this work was to develop a National list of recommendations in order to improve training in Geriatric Medicine at the undergraduate level.

[Inappropriate drug use in palliative care: SPANISH version of the STOPP-Frail criteria (STOPP-Pal)].

Multiple medication and inappropriate drug prescription are prevalent and challenging problems in older patients in end-of-life situations, and increases both preventable adverse events and health care costs. Recent literature recommends de-prescribing some drugs in patients with short life expectancy, when the aim of drug treatments is not prevention or cure, but symptom control. Recently, a list of explicit criteria (STOPP-Frail) intended to guide prescribing physicians in decision making on the use of drugs in older patients with terminal conditions.

How clinical practitioners assess frailty in their daily practice: an international survey.

Introduction: Various operational definitions have been proposed to assess the frailty condition among older individuals. Our objective was to assess how practitioners measure the geriatric syndrome of frailty in their daily routine.

Methods: An online survey was sent to national geriatric societies affiliated to the European Union Geriatric Medicine Society (EUGMS) and to members of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO).

Technology-induced errors associated with computerized provider order entry software for older patients.

Background The introduction of new technologies in the prescribing process has seen the emergence of new types of medication errors. Objective To determine the prevalence and consequences of technology-induced prescription errors associated with a computerized provider order entry (CPOE) system in hospitalized older patients. Setting Patients 65 years or older admitted to the Departments of Internal Medicine, General Surgery, and Vascular Surgery of a tertiary hospital.

Further psychometric validation of the GAH scale: Responsiveness and effect size.

Objectives: The purpose of this study was to assess the responsiveness of the newly developed Geriatric Assessment in Hematology (GAH) scale to clinical change in older patients diagnosed with hematologic malignancies.

Methods: A prospective observational study conducted in 164 patients aged ≥65years and diagnosed with myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML), multiple myeloma (MM), or chronic lymphocytic leukemia (CLL). Responsiveness of the GAH scales was studied by means of the Eastern Cooperative Oncology Group (ECOG) score, the Karnofsky performance status (KPS) score, the visual analog scale (VAS), and the physician's subjective assessment, used as clinical anchors to identify whether patients had changed clinically (either improved or worsened) or not since the baseline visit.

Agreement between the 2009 STOPP Criteria and the 2003 Beers Criteria at the time of hospital admission.

Unlabelled: Potentially inappropriate prescription in elderly patients can be evaluated by different methods. The STOPP Criteria and Beers Criteria stand out among the explicit criteria most widely used.

Objective: The main objective of this study is to identify the agreement in the detection of potentially inappropriate prescribing between the STOPP criteria and the Beers Criteria, in elderly patients assessed at the time of hospital admission.

[Analysis of palliative sedation in hospitalised elderly patients: Effectiveness of a protocol].

Objective: To measure changes in the practice of palliative sedation during agony in hospitalised elderly patients before and after the implementation of a palliative sedation protocol.

Material And Methods: A retrospective before-after study was performed in hospitalised patients over 65 years old who received midazolam during hospital admission and died in the hospital in two 3-month periods, before and after the implementation of the protocol. Non-sedative uses of midazolam and patients in intensive care were excluded.

Potentially inappropriate prescribing detected by STOPP-START criteria: are they really inappropriate?

Background: the STOPP-START criteria were developed to detect potentially inappropriate prescribing (PIP) in older people. The reasons why multidisciplinary geriatric teams decide not to follow STOPP-START criteria have not been studied.

Objective: to analyse compliance with the recommendations of the STOPP-START criteria in older inpatients.

[Geriatric teaching at undergraduate level: are Spanish Medical Schools following European recommendations?].

Objectives: To compare the learning objectives proposed by the European Union of Medical Specialists Geriatric section (UEMS-GS) with those approved in Spain for undergraduate teaching.

Material And Methods: Learning objectives included in the European Undergraduate Curriculum in Geriatric Medicine developed by the UEMS-GS in 2013 were compared with those listed in different Spanish official documents: Boletín Oficial del Estado (BOE, Spanish State Gazette), white book on Medicine of the Spanish Accreditation Agency (ANECA), and list of learning objectives of Spanish Medical Schools.

Results: the European curriculum recommends to teach 42 competencies divided in 10 sections, while the BOE mentions 37 general competencies and some other specific competencies, and the ANECA mentions 23 generic and 34 specific competencies (similar to the 37 of the BOE), and a list of common contents in which Geriatrics is included.