Purpose: The aims of this study were to compare the application of three geriatric medication screening tools to the Beers Criteria alone for potentially inappropriate medication quantification and to determine feasibility of a pharmacist-led polypharmacy assessment in a geriatric oncology clinic.
Methods: Adult patients with cancer aged 65 and older underwent a comprehensive geriatric assessment. A polypharmacy assessment was completed by a pharmacist and included a review of all drug therapies. Potentially inappropriate medications were screened using the Beers Criteria, Screening Tool to Alert doctors to Right Treatment/Screening Tool of Older Persons' Prescriptions, and the Medication Appropriateness Index. Deprescribing occurred after discussion with the pharmacist, geriatric oncologist, patient, and caregiver.
Results: Data were collected for 26 patients. The mean number of medications was 12. The Beers Criteria alone identified 38 potentially inappropriate medications compared to 119 potentially inappropriate medications with the three-tool assessment; a mean of 5 potentially inappropriate medications were identified per patient. After the application of the three-tool assessment, 73% of potentially inappropriate medications identified were deprescribed, resulting in a mean of 3 medications deprescribed per patient. Approximately two thirds of patients reported a reduction in symptoms after the deprescribing intervention. Healthcare expenditures of $4282.27 per patient were potentially avoided as a result of deprescribing.
Conclusions: Our three-tool assessment identified three times more potentially inappropriate medications than the Beers Criteria alone. Pharmacist-led deprescribing interventions are feasible and may lead to improved patient outcomes and cost savings. This three-tool assessment process should be incorporated into interdisciplinary assessments of older patients with cancer and validated in future studies.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6204077 | PMC |
| http://dx.doi.org/10.1007/s00520-018-4281-3 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Ingenuity in treating malunion after inappropriate open reduction and internal fixation of symphyseal mandibular fractures with bicondylar fractures.
J Dent Sci
January 2025
Department of Oral and Maxillofacial Surgery, Kobe City Medical Center General Hospital, Kobe, Japan.
Disseminated Chickenpox Following Live Varicella Vaccination in a Crohn's Disease Patient on Combination Immunosuppression.
Case Rep Gastrointest Med
January 2025
Department of Gastroenterology and Hepatology, Michigan Medicine, Ann Arbor, Michigan, USA.
Novel therapeutics used in the treatment of inflammatory bowel disease pose an increased risk of viral reactivation in patients. We present a case of a patient with refractory Crohn's disease (CD) who developed primary varicella (chickenpox) of a vaccine-viral strain after receiving combination immunosuppression with high-dose corticosteroids, tumor necrosis factor inhibitor (TNFi), and a Janus kinase inhibitor (JAKi) in the hospital. While this patient recovered and did not experience long term adverse effects, her case provides an opportunity for improvement.
View Article and Find Full Text PDFAddressing the overuse of hospital emergency departments in the Portuguese NHS: a new paradigm.
Front Public Health
January 2025
Portuguese National Health Service Executive Board, Porto, Portugal.
The escalating trend of inappropriate visits to Emergency Departments (ED) has led to significant concerns, including resource misallocation, compromised patient care, and an increased burden on healthcare workers. Portugal faces a notable challenge, reporting one of the highest ED visit rates, with an annual average of approximately 6 million ED visits from 2013 to 2023. In response, the "Call First, Save Lives" pilot project was launched by the Portuguese NHS Executive Board, in 2023, at the Local Health Unit (LHU) of Póvoa de Varzim/Vila do Conde.
View Article and Find Full Text PDFPharmacokinetics and pharmacodynamics of ciprofol after continuous infusion in elderly patients.
BMC Anesthesiol
January 2025
Department of Anesthesiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, 310006, China.
Background: Ciprofol, a novel intravenous anesthetic, which has primarily been used for the induction and maintenance of general anesthesia in adults, is characterized by rapid onset, short duration of action, and quick and smooth recovery. However, the pharmacokinetic characteristics of continuous infusions and the correlation between the plasma concentration and the bispectral index (BIS) in elderly patients are still unknown.
Method: In this randomized, controlled study, thirty elderly patients (62-78 years old) undergoing elective gastrointestinal tumor resection were treated with propofol (N = 15) or ciprofol (N = 15) as sedatives during anesthesia.
Impact of potentially inappropriate medications on emergency ambulance admissions in geriatric patients after discharge.
Pharmazie
December 2024
Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Tokyo, Japan.
This study aimed to determine the risk of emergency admission by ambulance in patients taking potentially inappropriate medications (PIMs). We included 273,932 patients aged over 75 years of age admitted between January 1, 2019, and December 31, 2019, using the Japan Medical Data Center medical insurance database containing anonymized patient data. We excluded patients without a history of admission.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!