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Pharmacologic Management of Heart Failure with Preserved Ejection Fraction (HFpEF) in Older Adults.
Drugs Aging
January 2025
Program for the Care and Study of the Aging Heart, Department of Medicine, Weill Cornell Medicine, 420 East 70th St, New York, NY, LH-36510063, USA.
There are several pharmacologic agents that have been touted as guideline-directed medical therapy for heart failure with preserved ejection fraction (HFpEF). However, it is important to recognize that older adults with HFpEF also contend with an increased risk for adverse effects from medications due to age-related changes in pharmacokinetics and pharmacodynamics of medications, as well as the concurrence of geriatric conditions such as polypharmacy and frailty. With this review, we discuss the underlying evidence for the benefits of various treatments in HFpEF and incorporate key considerations for older adults, a subpopulation that may be at higher risk for adverse drug events.
View Article and Find Full Text PDFImpact of psychotropic pro re nata prescription-monitoring programme on prescriptions for inpatients with psychiatric disorders: a retrospective observational study.
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 PDFUsing Osteopathic Manipulative Therapy to Treat Irritable Bowel Syndrome and Severe Refractory Gastroesophageal Reflux Disease: A Case Report.
Cureus
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 PDFPrescription opioid dispensing rates in the 12-months post-discharge after acute spinal cord injury: An observational study.
J Spinal Cord Med
January 2025
The Hopkins Centre, Griffith University, Brisbane, Australia.
Objectives: To determine rates of opioid and concomitant antidepressant, anticonvulsant and benzodiazepine dispensing in the post-discharge period, after acute spinal cord injury (SCI).
Design: Single-center prospective cohort study with 12-month linked pharmaceutical data.
Setting: Community pharmaceutical dispensing.
Impact of polypharmacy on clinical outcomes in patients with advanced heart failure undergoing cardiac resynchronization therapy.
J 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.
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