Medication Assessment in an Older Population during Acute Care Hospitalization and Its Effect on the Anticholinergic Burden: A Prospective Cohort Study.

(1) Background: Anticholinergic and sedative drugs (ASDs) contribute to negative health outcomes, especially in the frail population. In this study, we aimed to assess whether frailty increases with anticholinergic burden and to evaluate the effects of medication reviews (MRs) on ASD regimens among patients attending an acute care for the elderly (ACE) unit. (2) Methods: A cohort study was conducted between June 2019 and October 2020 with 150 consecutive patients admitted to our ACE unit.

Potential Risk of Overtreatment in Patients with Type 2 Diabetes Aged 75 Years or Older: Data from a Population Database in Catalonia, Spain.

Aim: To assess the potential risk of overtreatment in patients with type 2 diabetes (T2DM) aged 75 years or older in primary care. Methods: Electronic health records retrieved from the SIDIAP database (Catalonia, Spain) in 2016. Variables: age, gender, body mass index, registered hypoglycemia, last HbA1c and glomerular filtration rates, and prescriptions for antidiabetic drugs.

Improving individualized prescription in patients with multimorbidity through medication review.

Background: Older patients tend to have multimorbidity, represented by multiple chronic diseases or geriatric conditions, which leads to a growing number of prescribed medications. As a result, pharmacological prescription has become a major concern because of the increased difficulties to ensure appropriate prescription in older adults. The study's main objectives were to characterize a cohort of older adults with multimorbidity, carry out a medication review and compare the pharmacological data before and after the medication review globally and according to the frailty index.

Individualized Medication Review in Older People with Multimorbidity: A Comparative Analysis between Patients Living at Home and in a Nursing Home.

(1) Background: aging is associated with complex and dynamic changes leading to multimorbidity and, therefore, polypharmacy. A periodic medication review (MR) in frail older people leads to optimizing medication use. The aims of the study were to perform a comparative analysis of the impact of place of residence (own home versus nursing home) in a cohort of older patients on the characteristics of the baseline therapeutic plan and characteristics of the therapeutic plan after an MR; (2) Methods: Study with paired pre- and post-MR data based on person-centred prescription, with a follow-up assessment at three months.

Factors Associated with the Detection of Inappropriate Prescriptions in Older People: A Prospective Cohort.

(1) Background: Ageing is associated with complex and dynamic changes leading to multimorbidity and, therefore, polypharmacy. The main objectives were to study an older community-dwelling cohort, to detect inappropriate prescriptions (IP) applying the Patient-Centred Prescription model, and to evaluate the most associated factors. (2) Methods: This was a prospective, descriptive, and observational study conducted from June 2019 to October 2020 on patients ≥ 65 years with multimorbidity who lived in the community.

Factors Associated with Medication Non-Adherence among Patients with Multimorbidity and Polypharmacy Admitted to an Intermediate Care Center.

Identifying determinants of medication non-adherence in patients with multimorbidity would provide a step forward in developing patient-centered strategies to optimize their care. Medication appropriateness has been proposed to play a major role in medication non-adherence, reinforcing the importance of interdisciplinary medication review. This study examines factors associated with medication non-adherence among older patients with multimorbidity and polypharmacy.

Association between anticholinergic burden and oropharyngeal dysphagia among hospitalized older adults.

Background: Oropharyngeal dysphagia is an emerging age-related disorder that affects 23% of inpatients leading to malnutrition, dehydration, or aspiration pneumonia. Anticholinergic drugs can cause reduced peristalsis and dry mouth, both related to dysphagia.

Aim: To determine the association between anticholinergic burden and oropharyngeal dysphagia in older inpatients.

Medication regimen complexity on hospital admission in patients with advanced chronic conditions in need of palliative care.

Objectives: To evaluate characteristics of the medication complexity, risk factors associated with high medication complexity and their clinical consequences in patients with advanced chronic conditions.

Methods: A 10-month cross-sectional study was performed in an acute-hospital care Geriatric Unit. Patients with advanced chronic conditions were identified by the NECPAL test.

Potentially inappropriate medication in palliative care patients according to STOPP-Frail criteria.

Background: Potentially inappropriate medications (PIMs) are common in palliative care patients, but no specific tools have been used to determine these PIMs.

Objective: To evaluate the prevalence of PIMs according to specific tool 'STOPP-Frail', related factors with its existence and clinical consequences.

Methods: This is a post hoc analysis from a 10-month prospective cross-sectional study.

Patient-Centered Prescription Model to improve therapeutic adherence in patients with multimorbidity.

To date, interventions to improve medication adherence in patients with multimorbidity have shown modest and inconsistent efficacy among  available studies. Thereby, we should define new approaches aimed at improving medication adherence tailored to effective prescribing, with a multidisciplinary approach and patient-centered.In this regard, the Patient-Centered Prescription Model has shown its usefulness on improving appropriateness of drug treatments in patients with clinical complexity.

Prevalence, risk factors and adverse outcomes of anticholinergic burden in patients with advanced chronic conditions at hospital admission.

Aim: To evaluate the anticholinergic burden (ACB), the risk factors associated with its onset and the clinical consequences for patients with advanced chronic conditions.

Methods: A 10-month cross-sectional study was carried out in an acute hospital care geriatric unit. Patients with advanced chronic conditions were identified by the NECessity of PALliative care (NECPAL) test.

Frail-VIG index: a concise frailty evaluation tool for rapid geriatric assessment.

Background: Demographic changes have led to an increase in the number of elderly frail persons and, consequently, systematic geriatric assessment is more important than ever. Frailty Indexes (FI) may be particularly useful to discriminate between various degrees of frailty but are not routinely assessed due, at least in part, to the large number of deficits assessed (from 30 to 70). Therefore, we have developed a new, more concise FI for rapid geriatric assessment (RGA)-the Frail-VIG index ("VIG" is the Spanish/Catalan abbreviation for Comprehensive Geriatric Assessment), which contains 22 simple questions that assess 25 different deficits.

Potentially inappropriate medication at hospital admission in patients with palliative care needs.

Background Potentially inappropriate medications (PIMs) are common in older patients with polypharmacy, and are related to negative clinical results. Little information is available on the characteristics and consequences of PIMs in patients with advanced chronic conditions and palliative care needs. Objective To evaluate, for this population: (i) the prevalence of PIMs; (ii) the possible risk factors associated with its onset; and (iii) the related clinical consequences.

[Patient-centred prescription model to improve adequate prescription and therapeutic adherence in patients with multiple disorders].

Patients with multiple disorders and on multiple medication are often associated with clinical complexity, defined as a situation of uncertainty conditioned by difficulties in establishing a situational diagnosis and decision-making. The patient-centred care approach in this population group seems to be one of the best therapeutic options. In this context, the preparation of an individualised therapeutic plan is the most relevant practical element, where the pharmacological plan maintains an important role.

[Frail-VIG index: Design and evaluation of a new frailty index based on the Comprehensive Geriatric Assessment].

Introduction: Frailty is closely linked to health results. Frailty indexes (FI) and the Comprehensive Geriatric Assessment (CGA) are multidimensional tools. FI serve to quantitatively measure frailty levels.

Adverse drug events in patients with advanced chronic conditions who have a prognosis of limited life expectancy at hospital admission.

Purpose: Adverse drug events (ADEs) lead to adverse clinical outcomes such as hospitalization. There is little information about the characteristics of ADEs in patients with advanced chronic conditions and have a prognosis of limited life expectancy. This study aimed to evaluate (i) the prevalence of ADEs at the time of admission to hospital, (ii) the causality, severity, and preventability of the ADEs, and (iii) the clinical and pharmacological characteristics associated with the ADEs.

[Topics and considerations on reducing hospital admission: from evidence to practice].

Demographic changes and the economic situation of the recent years have conditioned a turning point in health policies, which have decided to progressively prioritize chronicity care programs. Given that hospital costs were concentrated in attention to patients with chronic diseases, reduction on admissions is now a priority target. Meanwhile, we state that among the obviously community handling paradigmatic aim for those patients and the current care situation, there is a long way to do that should be done gradually.