Publications by authors named "Johannes Heck"

Acute care of patients in the emergency department (ED) can be very challenging when patients attend EDs without their important medical information. This is especially problematic for multimorbid patients under polypharmacy. The aim of this study was to assess systematically the frequency and clinical relevance of incomplete medical data upon ED admission.

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  • * Researchers analyzed medication records of 153 patients with AUD at a university hospital in Germany, finding that the prevalence of potential alcohol-medication interactions (pAMIs) increased from 67.3% before treatment to 91.5% afterward.
  • * The findings indicate a significant rise in both alcohol-medication and drug-drug interactions during withdrawal treatment, suggesting a need for better prescribing practices, particularly concerning antihypertensives and opioids.
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  • * A study evaluated the impact of anticholinergic burden on both motor and non-motor symptoms in patients with Parkinson's disease and atypical Parkinsonian syndromes using two scoring systems (ADS and GABS).
  • * Results indicated that while the anticholinergic burden was higher in Parkinson's patients, its correlation with various clinical symptoms was weak, and the GABS may overestimate this burden due to its inclusion of anti-parkinsonian drugs.
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  • Janus kinase inhibitors (JAKi) have recently been approved alongside tumor necrosis factor inhibitors (TNFi) and interleukin-17 inhibitors (IL-17i) as treatment options for axial spondyloarthritis (axSpA), yet their real-world drug survival is under-studied.
  • A retrospective analysis of 1,222 axSpA patients, focusing on treatment initiation timing from January 2015 to October 2023, reveals median drug survival rates of 31 months for TNFi, 25 months for IL-17i, and 18 months for JAKi.
  • Higher discontinuation rates were seen for JAKi and IL-17i compared to TNFi, with
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  • Treatment options for psoriatic arthritis have expanded to include various biologic DMARDs and Janus kinase inhibitors, but real-world data on their persistence in patients is limited.
  • A study analyzed 1352 prescriptions and found that the 5-year survival rates were highest for IL-17 inhibitors (67.8%) and lowest for IL-12/23 inhibitors (46.0%), with JAKi showing a higher likelihood of discontinuation.
  • The findings suggest that patients in Germany may stick with TNFi and IL-17i longer than IL-12/23i or JAKi, potentially influenced by disease severity and other health conditions like osteoarthritis.
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Background: Older patients with alcohol use disorder are at particular risk of developing adverse drug reactions due to multimorbidity, polypharmacy, and altered organ function.

Objectives: In this study, we investigated the frequency and characteristics of potentially serious alcohol-medication interactions, potentially inappropriate medications (PIMs) for older adults, and potential drug-drug interactions (pDDIs) in a population of older patients with alcohol use disorder over a 10-year period.

Design: Retrospective monocentric cohort study.

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  • Multiple system atrophy (MSA) is a serious disease that affects movement and is hard to treat.
  • Researchers studied MSA patients to see what other health problems they have and how many medications they take.
  • They found that MSA patients have more health issues, especially related to the bladder and kidneys, and take more medications, which can lead to dangerous drug interactions.
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Introduction: Older patients are frequently affected by infectious diseases and adverse drug reactions (ADRs) of consecutively prescribed antibiotics. Particularly within geriatric psychiatry, high rates of potentially inappropriate prescriptions (PIPs) have been described, significantly complicating pharmacological treatment. Therefore, this study aimed to investigate the frequency and characteristics of antibiotic PIPs in geriatric psychiatry.

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  • Progressive supranuclear palsy (PSP) patients, typically older adults, have a distinct pattern of health comorbidities and often take multiple medications compared to those without neurodegenerative diseases.
  • The study analyzed data from over 600 patients, revealing higher rates of circulatory and nervous system diseases in PSP patients, alongside increased occurrences of conditions like diabetes and polyneuropathies.
  • The PSP group showed significantly more polypharmacy, leading to a higher risk of severe drug interactions, highlighting the need for careful management of treatment in these patients.
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Background: Post-exposure prophylaxis (PEP) is an effective tool to prevent infection with HIV. Patients seeking PEP after potential HIV exposure usually present to the emergency department (ED). Our study sought to determine the concordance of ED physicians' decisions on HIV-PEP with national guidelines (primary objective) and to assess the clinical relevance of drug-drug interactions (DDIs) between the HIV-PEP regimen and patients' concomitant medication (secondary objective).

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Purpose: This study sought to analyze the medication knowledge and awareness of medication adjustment options during intercurrent illness (sick day rules) of patients ≥ 70 years treated at a hospital for geriatric medicine in northern Germany.

Methods: The study was designed as a cross-sectional, interview-based pilot study, was approved by the Ethics Committee of Hannover Medical School (No. 10274_BO_K_2022; date of approval: 11 March 2022), and enrolled a convenience sample of 100 patients between May and December 2022.

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Antidepressants, in particular selective serotonin reuptake inhibitors (SSRIs), are the most commonly prescribed psychopharmacological drug group. Thus, a precise knowledge of the expected adverse drug reactions is indispensable. The increased risk of bleeding events is well documented, especially in patients treated with SSRIs.

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Objective: Psychiatric patients in general, and elderly psychiatric patients in particular, are at risk of adverse drug reactions due to comorbidities and inappropriate polypharmacy. Interdisciplinary and clinical-pharmacologist-led medication reviews may contribute to medication safety in the field of psychiatry. In this study, we reported the frequency and characteristics of clinical-pharmacological recommendations in psychiatry, with a particular focus on geriatric psychiatry.

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Background: Differentiating depression and dementia in elderly patients represents a major clinical challenge for psychiatrists. Pharmacological and non-pharmacological treatment options for both conditions are often used cautiously due to fear of adverse effects. If a clinically indicated therapy is not initiated due to fear of adverse effects, the quality of life of affected patients may significantly be reduced.

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Introduction: QT prolongation carries the risk of ventricular tachyarrhythmia (Torsades de Pointes) and sudden cardiac death. Psychotropic drugs can affect ventricular repolarization and thus prolong the QT interval. The present study sought to investigate the risk factors (pharmacological and non-pharmacological) of severe QT prolongation in gerontopsychiatric patients.

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Objective: To investigate the frequency and characteristics of adverse drug reactions (ADRs) that occurred on the gerontopsychiatric ward of Hannover Medical School over a 6-year period.

Design: Retrospective monocentric cohort study.

Results: Six hundred thirty-four patient cases (mean age 76.

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Background: This study sought to investigate the frequency and characteristics of duplicate prescriptions (DPs) in elderly psychiatric inpatients using a novel categorisation of DPs that differentiates between appropriate duplicate prescriptions (ADPs) and potentially inappropriate duplicate prescriptions (PIDPs).

Methods: The study was conducted as a monocentric retrospective cross-sectional pilot study on the gerontopsychiatric ward of the Department of Psychiatry, Social Psychiatry and Psychotherapy of Hannover Medical School, a large university hospital in northern Germany. The outcome measures were the nature and frequency of PIDPs compared with the frequency of ADPs.

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Objective: Geriatric patients account for a significant proportion of the collective treated by psychiatric consultation service in hospitals. In the Emergency Department (ED), psychotropic drugs are frequently recommended, notwithstanding their extensive side-effect profiles. This study sought to investigate medication safety of geriatric patients referred to psychiatric consultation service in the ED.

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Purpose: To determine the nature and frequency of duplicate prescriptions (DPs) in the emergency department (ED) by utilization of a novel categorization of DPs which differentiates between appropriate DPs (ADPs) and potentially inappropriate DPs (PIDPs).

Methods: In this retrospective cohort study, adult patients who presented to the ED for internal medicine of a large university hospital in northern Germany in 2018 and 2019 were screened for the presence of DPs. Descriptive statistical methods were used to characterize the nature and frequency of PIDPs compared to the frequency of ADPs.

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Drug information centers (DICs) are institutions dedicated to provide objective, independent, and up-to-date information on drugs and their rational use. To overcome the lack of recent DIC reports from central Europe, we analyzed all queries (n = 594) submitted to the DIC run by the Institute for Clinical Pharmacology of Hannover Medical School between October 2018 and April 2022. Approximately one in three queries (31.

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Apart from Alzheimer's disease (AD), no biomarkers for the differential diagnosis of dementia have been established to date. Inflammatory processes contribute to the pathogenesis of dementia subtypes, e.g.

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Objective: In addition to teaching theoretical and clinical-practical skills, the development of individual moral competence should be another core concern in medical school. However, research suggests that moral competence in students of human medicine stagnates or even declines during the course of medical school. Therefore, the present cross-sectional study investigated the moral competence of medical students at the beginning of their studies and during their practical year, as well as the effects of testosterone as a neurohormone on moral judgment.

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  • The COVID-19 pandemic increased the need for clinical trial support from medical students, highlighting the importance of adhering to Good Clinical Practice (GCP) despite challenges in training due to social-distancing regulations.
  • An interdisciplinary expert panel from Germany and the Netherlands created a comprehensive "Students' guide to documentation in clinical trials" to set a common quality standard for student involvement.
  • The guide includes roles in clinical trials, GCP principles, documentation practices, a trilingual medical dictionary, and further reading recommendations, serving as a self-training resource rather than a replacement for practical training courses.
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