Polypharmacy is accentuated in our fast-growing population. Polypharmacy is associated with adverse drug reactions, interactions, non-compliance, and increased risk of geriatric syndroms (falls, incontinence, malnutrition, cognitive impairment, delirium). There is a dilemma between clinical practice guidelines and pragmatism in the treatment of elderly patients in the last ten years of life. Reducing polypharmacy is a challenge and we present some instruments for reducing polypharmacy.
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http://dx.doi.org/10.1024/1661-8157/a002347 | DOI Listing |
BMC Psychiatry
January 2025
Department of Psychiatry, Kitasato University, School of Medicine, 1-15-1 Kitasato, Minami-Ku, Sagamihara, Kanagawa, 252-0374, Japan.
Background: Pro re nata (PRN) medication is used "as needed" for symptoms such as agitation and insomnia, in addition to regular daily pharmacotherapy of mental disorders. However, there is no high-quality evidence on the effectiveness of psychotropic PRN medications and concerns have been raised about their potential to contribute to polypharmacy. This study introduced a psychotropic PRN prescription-monitoring programme for psychiatric inpatients with the aim of examining the change before and after the implementation of the programme.
View Article and Find Full Text PDFCureus
December 2024
Department of Osteopathic Principles and Practice, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Tampa, USA.
Both Irritable Bowel Syndrome (IBS) and Gastroesophageal Reflux Disease (GERD) pose significant healthcare burdens on the general population of America. Though first-line medications are available, concomitant burdens of polypharmacy, side effects, and inadequate control exist. Osteopathic Manipulative Treatment (OMT) is a hands-on, physical manipulation technique that offers a personalized and direct approach to modifying the body's neuromuscular and viscerosomatic activity leading to decreased symptomatic burden with minimal side effects.
View Article and Find Full Text PDFJ Formos Med Assoc
January 2025
Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan. Electronic address:
Controlling hypertension has become an important issue in the elderly population in whom neurological comorbidities are highly prevalent. Most of the large-scale trials focusing on hypertension management in older populations have excluded patients with comorbid neurological disorders. However, this population requires special considerations, as the benefits of antihypertensive agents are mostly uncertain and there is a higher risk of adverse events.
View Article and Find Full Text PDFJ Arrhythm
February 2025
Department of Cardiology and Clinical Examination, Faculty of Medicine Oita University Yufu Oita Japan.
Background: The prevalence rates of heart failure (HF) and hyperpolypharmacy have increased with the aging population. While a negative impact of hyperpolypharmacy on HF clinical outcomes has already been reported, the effects of hyperpolypharmacy on patients with advanced HF with reduced ejection fraction (HFrEF) undergoing cardiac resynchronization therapy (CRT) remain unclear.
Methods: We retrospectively evaluated data from 147 patients with advanced HFrEF who underwent CRT between March 2004 and June 2020.
BMC Health Serv Res
January 2025
Health Systems Transformation Platform (HSTP), AISF Building, First Floor, Kalka Devi Marg, Lajpat Nagar IV, New Delhi, 110024, India.
Background: Multimorbidity is associated with significant out-of-pocket expenditures (OOPE) and catastrophic health expenditure (CHE), especially in low- and middle-income countries like India. Despite this, there is limited research on the financial burden of multimorbidity in outpatient and inpatient care, and cross-state comparisons of CHE are underexplored.
Methods: We conducted a cross-sectional analysis using nationally representative data from the National Sample Survey 75th Round 'Social Consumption in India: Health (2017-18)', focusing on patients aged 30 and above in outpatient and inpatient care in India.
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