Efficacy and safety of antidepressants for pain in older adults: A systematic review and meta-analysis.

Aims: In many countries, pain is the most common indication for use of antidepressants in older adults. We reviewed the evidence from randomized controlled trials on the efficacy and safety of antidepressants, compared to all alternatives for pain in older adults (aged ≥65 years).

Methods: Trials published from inception to 1 February 2024, were retrieved from 13 databases.

Opioid analgesics for nociceptive cancer pain: A comprehensive review.

Pain is one of the most burdensome symptoms in people with cancer, and opioid analgesics are considered the mainstay of cancer pain management. For this review, the authors evaluated the efficacy and toxicities of opioid analgesics compared with placebo, other opioids, nonopioid analgesics, and nonpharmacologic treatments for background cancer pain (continuous and relatively constant pain present at rest), and breakthrough cancer pain (transient exacerbation of pain despite stable and adequately controlled background pain). They found a paucity of placebo-controlled trials for background cancer pain, although tapentadol or codeine may be more efficacious than placebo (moderate-certainty to low-certainty evidence).

Preventability of venous thromboembolism in hospitalised patients.

Background: Hospital-acquired venous thromboembolism (VTE) is a major cause of morbidity and mortality.

Aims: To determine the proportion of patients with hospital-acquired VTE that are preventable.

Methods: This was a retrospective study of patients in two tertiary care hospitals in Sydney, Australia.

Persistent postoperative opioid use after total hip or knee arthroplasty: A systematic review and meta-analysis.

Purpose: To identify the proportion of patients with continued opioid use after total hip or knee arthroplasty.

Methods: This systematic review and meta-analysis searched Embase, MEDLINE, the Cochrane Central Register of Controlled Trials, and International Pharmaceutical Abstracts for articles published from January 1, 2009, to May 26, 2021. The search terms (opioid, postoperative, hospital discharge, total hip or knee arthroplasty, and treatment duration) were based on 5 key concepts.

Dose equivalence between metaraminol and norepinephrine in critical care.

Aims: The aim of this study was to determine the conversion dose ratio between continuous infusion metaraminol and norepinephrine in critically ill patients with shock.

Methods: A retrospective cohort study was conducted in adult patients with shock admitted to an intensive care unit from 29 October 2018 to 30 October 2019 and who transitioned from metaraminol monotherapy to norepinephrine monotherapy. Mean arterial pressure (MAP) and infusion doses for both drugs were collected at hourly intervals; 2 hours before to 5 hours after switching from metaraminol monotherapy to norepinephrine monotherapy.

Comparison of opioid prescribing upon hospital discharge in patients receiving tapentadol versus oxycodone following orthopaedic surgery.

Background The changing of opioids during the transition of care from hospital to home may be associated with harm. Objective To compare patients receiving tapentadol IR versus oxycodone IR following orthopaedic surgery during hospitalisation with regard to the changing of opioids at hospital discharge. Setting A major metropolitan tertiary referral hospital in Australia.

Proposed guidance on cost-avoidance studies in pharmacy practice.

Purpose: Cost-avoidance studies of pharmacist interventions are common and often the first type of study conducted by investigators to quantify the economic impact of clinical pharmacy services. The purpose of this primer is to provide guidance for conducting cost-avoidance studies pertaining to clinical pharmacy practice.

Summary: Cost-avoidance studies represent a paradigm conceptually different from traditional pharmacoeconomic analysis.

Methods used to attribute costs avoided from pharmacist interventions in acute care: A scoping review.

Purpose: Cost-avoidance studies are common in pharmacy practice literature. This scoping review summarizes, critiques, and identifies current limitations of the methods that have been used to determine cost avoidance associated with pharmacists' interventions in acute care settings.

Methods: An Embase and MEDLINE search was conducted to identify studies that estimated cost avoidance from pharmacist interventions in acute care settings.

Gastrointestinal Adverse Events in Hospitalized Patients Following Orthopedic Surgery: Tapentadol Immediate Release Versus Oxycodone Immediate Release.

Background: Tapentadol has relatively less effect on mu-opioid receptors compared with other opioids. This has the potential to reduce the occurrence of gastrointestinal (GI) adverse drug events (ADEs).

Objectives: To compare the GI ADEs during hospitalization between tapentadol immediate release (IR) and oxycodone IR following orthopedic surgeries.

Predictive Performance of Bayesian Vancomycin Monitoring in the Critically Ill.

Objectives: It is recommended that therapeutic monitoring of vancomycin should be guided by 24-hour area under the curve concentration. This can be done via Bayesian models in dose-optimization software. However, before these models can be incorporated into clinical practice in the critically ill, their predictive performance needs to be evaluated.

Effect of mannitol plus hypertonic saline combination versus hypertonic saline monotherapy on acute kidney injury after traumatic brain injury.

Purpose: To compare the effect of mannitol plus hypertonic saline combination (MHS) versus hypertonic saline monotherapy (HS) on renal function in patients with traumatic brain injury (TBI).

Materials And Methods: This was a secondary analysis of data from the Resuscitation Outcomes Consortium Hypertonic Saline Trial Shock Study and Traumatic Brain Injury Study. The study cohort included a propensity matched subset of patients with TBI who received MHS or HS.

Adherence to Antiretroviral Regimens in Australia: A Nationwide Cohort Study.

The lifetime use of combination antiretroviral therapy (cART) highlights the need to understand patterns of and factors associated with adherence to cART. In this cohort study using a 10% random sample of dispensing claims data for eligible Australians, we identified 2042 people dispensed cART between January 2016 and December 2017 (mean age 48.0 ± 12.

Efficacy and Safety of Tapentadol Immediate Release for Acute Pain: A Systematic Review and Meta-Analysis.

Objective: Tapentadol (TAP) immediate release (IR) is a newer opioid option for acute pain. The aim of this systematic review was to examine the efficacy and safety of TAP IR compared with other opioids for acute pain.

Methods: A systematic literature search as conducted using the Cochrane Library, Embase, International Pharmaceutical Abstracts, MEDLINE, PubMed, and Web of Science.

Missing data reporting in clinical pharmacy research.

Purpose: This study aimed to document the ways by which missing data were handled in clinical pharmacy research to provide an insight into the amount of attention paid to the importance of missing data in this field of research.

Methods: Our cross-sectional descriptive report evaluated 10 journals affiliated with pharmacy organizations in the United States, Canada, the United Kingdom, and Australia. Randomized controlled trials, cohort studies, case-control studies, and cross-sectional studies published in 2018 were included.

Cannabinoids for drug-resistant seizures in a critically ill patient-Case report and literature review.

What Is Known And Objective: Drug-resistant seizures are life-threatening and contribute to sustained hospitalization. We present the case of a critically ill 28-year-old male with Lennox-Gastaut syndrome who had approximately 30 seizures/day in the intensive care unit.

Case Description: Patient required mechanical ventilation and pharmacologically induced thiopentone coma.

Anticholinergic medicines use among older adults before and after initiating dementia medicines.

Aims: We investigated anticholinergic medicines use among older adults initiating dementia medicines.

Methods: We used Pharmaceutical Benefits Scheme dispensing claims to identify patients who initiated donepezil, rivastigmine, galantamine or memantine between 1 January 2013 and 30 June 2017 (after a period of ≥180 days with no dispensing of these medicines) and remained on therapy for ≥180 days (n = 4393), and dispensed anticholinergic medicines in the 180 days before and after initiating dementia medicines. We further examined anticholinergic medicines prescribed by a prescriber other than the one initiating dementia medicines.

Anticipating the effects of restricting high-dose preparations of strong opioids in Australia: A population-based analysis to inform the current policy debate.

Purpose: Countries worldwide are developing a variety of strategies to combat the opioid epidemic, such as restricting access to high-strength opioid formulations. We aimed to examine the dispensing patterns of strong opioids by dose units (DUs), age, and sex.

Methods: We used Australian population-level dispensing data from January 2003 to December 2015 and categorised strong opioids by DU: very low, low, moderate, and high, corresponding to total daily doses of less than or equal to 25, 26 to 50, 51 to 100, and greater than 100 morphine milligramme equivalents, respectively.

Population-based study examining the utilization of preventive medicines by older people in the last year of life.

Aim: To examine the patterns of preventive medicines (PM) use in the last year of life of older adults.

Methods: This study cohort included individuals (n = 99 809) aged ≥75 years who were in their last year of life. PM examined in this study included low-dose aspirin (≤325 mg/day), clopidogrel, dipyridamole, warfarin, dabigatran, statins and bisphosphonates.

Potentially inappropriate medications in community-dwelling older adults undertaken as a comprehensive geriatric risk assessment.

Purpose: The prescription of potentially inappropriate medications (PIMs) is associated with an increase in adverse events, prescribing cascades, high health-care costs, morbidity, and mortality in the elderly. The overarching objective of this study is to examine the prevalence of PIMs in the elderly, applying the 2012 American Geriatrics Society Beers criteria for the study period 2012-2014, and the updated 2015 Beers criteria for 2015.

Methods: The study population (N = 70,479) included a continuously recruited national cohort of community-dwelling older (aged ≥ 65 years) New Zealanders who had undertaken the International Resident Assessment Instrument-Home Care (interRAI-HC) assessments between September 2012 and October 2015.

Evaluation of the National Minimum Data Set for Neurological Conditions in Older Adults.

Aim: To evaluate the National Minimum Data Set (NMDS) against the International Resident Assessment Instrument-Home Care (interRAI-HC) in diagnosing dementia or Parkinson disease (PD).

Method: The NMDS data were matched with interRAI-HC for all older individuals in New Zealand. Dementia or PD was compared within 90 and 180 days and 1 to 4 years preceding and subsequent to the date of diagnosis in interRAI-HC.

Development and validation of a Medicines Comorbidity Index for older people.

Purpose: An index for estimating multimorbidity based on prescription claims data is important for predicting health outcomes for older people in pharmacoepidemiological studies. We aimed to develop a Medicines Comorbidity Index (MCI) based on nationwide prescription claims data and evaluate its performance in predicting adverse outcomes in older individuals.

Methods: The index was developed on a retrospective cohort comprising of all individuals aged ≥ 65 years old, captured in the claims dataset from 1st January to 31st December 2012.

Discontinuation of Preventive Medicines in Older People with Limited Life Expectancy: A Systematic Review.

Background: In the presence of multimorbidity and limited life expectancy (LLE), the need for continued use of preventive medicines becomes uncertain as they may neither improve health nor confer continued health benefits.

Objective: Our objective was to systematically review the literature to examine the discontinuation of preventive medicines in older people with LLE.

Methods: A systematic literature search was conducted using the Ovid MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Central Register databases.

An overview of pharmacoepidemiology in New Zealand: medical databases, registries and research achievements.

Pharmacoepidemiology is an eclectic blend of epidemiology, clinical pharmacology and biostatistics. In New Zealand there have been recent advances in pharmacoepidemiology to examine drug utilisation, monitor adverse drug events and complement pharmacovigilance. This paper attempts to describe the past, present and future of pharmacoepidemiology, particularly in the area of translational research with a particular focus on medicine use and safety.