Medication changes implemented during medication reviews and factors related to deprescribing: Posthoc analyses of a randomized clinical trial in geriatric outpatients with polypharmacy.

Aims: To provide posthoc analyses of a clinical trial that reported beneficial effects of medication reviews on health-related quality of life. Specifically, to describe the medication changes with a focus on deprescribing and to explore patient- and medication-related factors that may identify patients most likely to benefit from medication reviews.

Methods: Posthoc analyses of data from a pragmatic, nonblinded, randomized clinical trial investigating a medication review intervention (NCT03911934) in 408 geriatric outpatients treated with ≥9 medicines.

Effects of a comprehensive medication review intervention on health-related quality of life and other clinical outcomes in geriatric outpatients with polypharmacy: A pragmatic randomized clinical trial.

Aim: To investigate the effects of a comprehensive medication review intervention on health-related quality of life (HRQoL) and clinical outcomes in geriatric outpatients exposed to polypharmacy.

Methods: Pragmatic, nonblinded, randomized clinical trial with follow-up after 4 and 13 months. Participants were geriatric outpatients taking ≥9 medicines.

Polypharmacy and medication deprescribing: A survey among multimorbid older adults in Denmark.

Polypharmacy is common among multimorbid adults and associated with increased morbidity and mortality. Excessive polypharmacy (ie, ≥10 medicine) is strongly associated with inappropriate medication use, but little is known about attitudes toward deprescribing in patients with excessive polypharmacy. We surveyed 100 Danish individuals aged 65 years and above with ≥10 prescribed medications, using the validated Patients' Attitudes Towards Deprescribing (PATD) instrument.

Psychotropic medication in a randomly selected group of citizens receiving residential or home care.

Introduction: Treatment with one or more psychotropic medications (PMs), especially in the elderly, is associated with risk, and the effects of treatment are poorly validated. The aim of this article was to describe the use of PM in a population of citizens receiving either residential care or home care with focus on the prevalence of drug use, the combination of different PMs and doses in relation to current recommendations.

Methods: The medication lists of 214 citizens receiving residential care (122) and home care (92) were collected together with information on age, gender and residential status.

Independent valine and leucine isotope labeling in Escherichia coli protein overexpression systems.

The addition of labeled α-ketoisovalerate to the growth medium of a protein-expressing host organism has evolved into a versatile tool to achieve concomitant incorporation of specific isotopes into valine- and leucine- residues. The resulting target proteins represent excellent probes for protein NMR analysis. However, as the sidechain resonances of these residues emerge in a narrow spectral range, signal overlap represents a severe limitation in the case of high-molecular-weight NMR probes.

Iridium dihydroxybipyridine complexes show that ligand deprotonation dramatically speeds rates of catalytic water oxidation.

We report highly active iridium precatalysts, [Cp*Ir(N,N)Cl]Cl (1-4), for water oxidation that are supported by recently designed dihydroxybipyridine (dhbp) ligands. These ligands can readily be deprotonated in situ to alter the electronic properties at the metal; thus, these catalyst precursors have switchable properties that are pH-dependent. The pKa values in water of the iridium complexes are 4.

Is a targeted intensive intervention effective for improvements in hypertension control? A randomized controlled trial.

Background: High blood pressure (BP) is one of the most important risk factors for stroke, and antihypertensive therapy significantly reduces the risk of cardiovascular morbidity and mortality. However, achieving a regulated BP in hypertensive patients is still a challenge.

Objective: To evaluate the impact of an intervention targeting GPs' management of hypertension.

Multi-dose drug dispensing is a challenge across the primary-secondary care interface.

Introduction: Multi-dose drug dispensing (MDDD) signifies that the patient's medicine is packed in disposable bags corresponding to the dose that should be taken. The purpose of the present study was to investigate how a hospital MDDD instruction was followed.

Material And Methods: All patients receiving MDDD on admission to the acute medical admission ward at Bispebjerg Hospital in the period from 1 January to 30 June 2010 were prospectively included in the study.

[Medication errors after hospitalisation due to multi-dose drug dispensing in the primary sector].

Multi-dose drug dispensing (MDDD) was introduced in Denmark in 2001 in order to minimize medication errors. In May 2010 44.500 Danish citizens received MDDD.

Treatment of 5413 hypertensive patients: a cross-sectional study.

Background: Most hypertensive patients are managed in primary care in Denmark, but previous studies have shown that only 21-43% of hypertensive patients achieve optimal blood pressure (BP) control. Antihypertensive drug treatment, risk factors and cardiovascular disease (CVD) are some of the important factors to consider when optimizing the individual treatment strategy in hypertensive patients.

Objective: To examine treatment of BP according to Danish guidelines (BP < 140/90 mmHg generally and <130/80 mmHg for diabetics) in a population from general practice in relation to risk factors, CVD and diagnosis of diabetes.

Inhibition of fibroblast growth factor receptor 1: influence on tympanic membrane wound healing in rats.

An animal model of chronic tympanic membrane (TM) perforation is needed for experiments on supporting healing of TM perforations. The basic fibroblast growth factor is important in TM wound healing. The object of this study was to investigate the efficacy of fibroblast growth factor receptor 1 (FGFR1) inhibition to arrest wound healing of experimental TM perforation.

Influence of glycemic control on tympanic membrane healing in diabetic rats.

Objectives/hypothesis: It is generally assumed that glycemic control in diabetic patients is important in optimizing wound healing. The goal of this study was to examine tympanic membrane (TM) wound healing in spontaneously diabetic rats depending on the diabetic metabolic state compared to nondiabetic control animals.

Study Design: Prospective controlled study in experimental animals.

The influence of inhibition of the epidermal growth factor receptor on tympanic membrane wound healing in rats.

Recently, a report on a bilateral tympanic membrane (TM) perforation in a patient after long-term treatment with erlotinib was published. The object of this study was to investigate the destructive potential of topical applied epidermal growth factor receptor (EGFR) inhibitors on wound healing of experimental TM perforation in rats by evaluating closure rates and histology. In 12 rats, erlotinib (10 mg/ml) was applied to one TM of each animal and cetuximab (5 mg/ml) to the other side daily for 12 consecutive days.

[Changing clinicians' prescription patterns].

In 2005 the Central Drug Committee in co-operation with the hospitals in the county of Copenhagen (H:S) focused on the increasing use of and expenditure derived from three tumour necrosis factor alpha (TNF-alpha) inhibitors. While the three inhibitors are estimated to be equivalent regarding efficacy and safety, eternacept and adalimumab are twice as expensive as infliximab. With a little effort, the Central Drug Committee succeeded in changing clinicians' prescription pattern in a cost-effective manner.

[Patient information leaflets seen through the eyes of patients in a general practice].

Introduction: The objective was to investigate patients' perception of patient information leaflets, including their readability, comprehensibility and their impact on adherence.

Material And Methods: A 14-item questionnaire was prepared and answered by unselected patients in a general practice in Copenhagen.

Results: A total of 111 patients were included.

[Application of the medicine profile in an ambulatory setting].

Introduction: A person with a digital signature can access his or her own personal electronic medicinal profile (PEM) which can also be accessed by the person's prescribing doctors. The PEM provides an overview and contains an overview of the prescription medicine sold to the patient over the previous two years.

Materials And Methods: Randomly-selected geriatric ambulatory patients were included.

Delay of tympanic membrane wound healing in rats with topical application of a tyrosine kinase inhibitor.

An animal model of chronic tympanic membrane (TM) perforation is needed for experiments on supporting wound healing of TM perforations. The epidermal growth factor receptor (EGFR) has been implicated in the regulation of wound healing. The object of this study was to investigate the efficacy of topical EGFR-inhibitor (erlotinib) to arrest wound healing of experimental TM perforation in rats.

[Combination therapy with acetylsalicylic acid and non-aspirin nonsteroidal anti-inflammatory drugs].

Patients may require both low-dose aspirin (ASA) and a nonsteroidal anti-inflammatory drug (NSAID). This raises the questions of whether NSAIDs may inhibit the cardioprotective effects of low-dose ASA; whether the cardioprotective effect of low-dose ASA can be obtained by NSAIDs: and whether the combination of low-dose ASA and NSAIDs increases the risk of adverse effects. This review attempts to answer these questions.

Thiopurine methyltransferase (TPMT) genotype distribution in azathioprine-tolerant and -intolerant patients with various disorders. The impact of TPMT genotyping in predicting toxicity.

Objective: To study the distribution of the thiopurine methyltransferase (TPMT) genotype among azathioprine (Aza)-tolerant and -intolerant patients with various disorders, and to investigate a possible relationship with the Aza metabolite levels.

Methods: Forty-six Aza-tolerant and six Aza-intolerant patients had the TPMT genotype distribution determined using a polymerase chain reaction (PCR) assay and the forty-six Aza-tolerant patients had the Aza metabolite levels determined using a high-pressure liquid chromatography (HPLC) analysis.

Results: One non-functional TPMT mutant allele was demonstrated in 2 of the 46 Aza-tolerant patients (4.

Pharmacological monitoring of azathioprine therapy.

Background: Studies on azathioprine (Aza) treatment in Crohn disease have indicated a positive correlation between clinical remission and a concentration in erythrocytes of the metabolites 6-thioguanine nucleotides (E-6-TGN) above 230 pmol/8 x 10(8) RBC. A concentration of the methylated Aza metabolites (E-6-MMP) above 5000 pmol/8 x 10(8) RBC has been correlated to hepatotoxicity. Thiopurine methyltransferase (TPMT) is responsible for the formation of methylated metabolites and lower E-TGN levels, and TPMT genotyping has been proposed as guidance for dosage.

[Drug-induced seizures].

Numerous drugs have been suspected to be associated with the occurrence of epileptic seizures. Our information retrieval, however, shows that drug-induced seizures are relatively rare. The risk of seizure seems to be increased, also in patients who are not predisposed to seizure, when taking clozapine, enflurane, theophylline, foscarnet, ganciclovir, and ritonavir.

Thiopurine methyltransferase genotype distribution in patients with Crohn's disease.

Background: Inter-individual response to azathioprine is partly due to inter-individual variation in the thiopurine methyltransferase (TPMT) activity. The TPMT genotype, which reflects the TPMT activity, has previously been studied in healthy Caucasians, with the most common variant allele being TPMT*3A. TPMT genotyping in adult patients with Crohn's disease has never been performed systematically.