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An Educational Intervention to Promote Central Nervous System-Active Deprescribing in Dementia: A Pilot Study.
Drugs Aging
January 2025
Center for Clinical Management Research, VA Ann Arbor Healthcare System, NCRC 016-308E, 2800 Plymouth Rd, Ann Arbor, MI, 48109, USA.
Background: Central nervous system (CNS)-active polypharmacy (defined as concurrent exposure to three or more antidepressant, antipsychotic, antiseizure, benzodiazepine, opioid, or nonbenzodiazepine benzodiazepine receptor agonists) is associated with significant potential harms in persons living with dementia (PLWD).We conducted a pilot trial to assess a patient nudge intervention's implementation feasibility and preliminary effectiveness to prompt deprescribing conversations between PLWD experiencing CNS-active polypharmacy and their primary care clinicians ("clinicians").
Methods: We used the electronic health record to identify PLWD prescribed CNS-active polypharmacy in primary care clinics from two health systems.
Use of Hallway Beds, Radiology Studies, and Patients in Pain on Arrival to the Emergency Department Are Associated With Patient Experience.
Ann Emerg Med
January 2025
Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN; Center for Health Services Research, The William M. Tierney Center for Health Services Research, Regenstrief Institute, Indianapolis, IN.
Study Objective: Patient experience is an essential measure of patient-centered emergency care. However, emergency department (ED) patient experience scores may be influenced by patient demographics as well as clinical and operational characteristics unrelated to actual patient-centeredness of care. This study aimed to determine whether there are characteristics associated with patient experience scores that have not yet been proposed for risk adjustment by the Centers for Medicare and Medicaid Services (CMS).
View Article and Find Full Text PDFPatterns of Maternal Single and Polysubstance Use in the US: A Latent Class Analysis.
J Stud Alcohol Drugs
January 2025
Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States.
Objective: Substance use patterns vary considerably in the general population, yet little is known about patterns before and during pregnancy. The purpose of this study was to describe single substance and polysubstance use (PSU) before and during pregnancy among recent births in the United States (US) and compare exposure patterns.
Methods: We used data from the Pregnancy and Risk Assessment Monitoring System (PRAMS) postpartum survey for 2016-2018 to estimate the prevalence and identify patterns of substance use by participants one to three months before and during pregnancy.
Evaluation of acute substance abuse patients admitted to the ICU by different scoring system.
Toxicol Res (Camb)
February 2025
Department of Forensic Medicine and Clinical Toxicology, Champollion street, Faculty of Medicine, University of Alexandria, Alexandria, 21517, Egypt.
Drug abuse poisoning is a significant public health problem in many countries all over the world. The recent study aimed to assess the applicability of NEWS II and APACHE II scores as predictors of the ICU admission of acute intoxication by substance abuse. The study enrolled 98 patients admitted to the Alexandria Poison Center of the Main University Hospital (APC-AMUH) with a history of acute intoxication with substance abuse.
View Article and Find Full Text PDFDopaminergic and Glutamatergic Mechanisms in Addiction: Assessing the Therapeutic Promise of Memantine and Galantamine for Maintenance Treatment: A Review.
Alpha Psychiatry
November 2024
Old Age Psychiatry, Lancashire & South Cumbria NHS Foundation Trust, Preston, United Kingdom.
Addiction comes in various forms and can be related to substances like cocaine, opioids, alcohol, cannabis, amphetamine, and nicotine, as well as behaviors like gambling or sex addiction. The impact of addiction places increased economic and medical burdens on society. Currently, the management of addiction is more focused on symptomatic relief rather than targeting the reinforcing mechanisms of dependence on addictive substances and behaviors.
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