Objectives: This study aimed to identify the prevalence of potentially inappropriate medication use (PIMU) in adults above the age of 65 with chronic kidney disease (CKD) according to the American Geriatric Society Beers Criteria (Beers), Screening Tool of Older People's Potentially Inappropriate Prescriptions Criteria (STOPP) and medication appropriateness index (MAI) 30 criteria and to compare them to justify their use in this specific patient group.
Materials And Methods: This was a retrospective and descriptive study conducted between October 1, 2019 and March 18, 2020 at Ibni Sina Hospital, Nephrology Department, Faculty of Medicine, Ankara University.
Results: Among 269 patients discharged from the hospital during the study period, 100 of them were eligible for the study. The mean age was 73.3 ± 6.9 years and 51.9% of them were male. The prevalence of 35 PIMU was 91%, 42%, and 70% according to the Beers, STOPP, and MAI criteria, respectively. There was a statistically significant difference in terms of prevalence among 3 criteria (<0.001). Beer detected more PIMU (11.3% vs. 6.4%) and had higher sensitivity among older adults with CKD (0.97 vs. 0.56) compared to the STOPP criteria. Most patients had at least one drug-drug interaction (DDIs) in their discharge prescription (93%) and DDI was one of the main contributors of PIMU. Proton pump inhibitors were the most common medication associated with PIMU in all 3 criteria.
Conclusion: The prevalence of PIMU was high among older adults with CKD at discharge according to these criteria. To improve the prescriptions after hospital discharge, it is considered appropriate to use Beers criteria under guidance of a clinical pharmacist.
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http://dx.doi.org/10.4274/tjps.galenos.2021.94556 | DOI Listing |
Alzheimers Dement
December 2024
Columbia University Irving Medical Center, New York, NY, USA.
Background: Genetic studies indicate a causal role for microglia, the innate immune cells of the central nervous system (CNS), in Alzheimer's disease (AD). Despite the progress made in identifying genetic risk factors, such as CD33, and underlying molecular changes, there are currently limited treatment options for AD. Based on the immune-inhibitory function of CD33, we hypothesize that inhibition of CD33 activation may reverse microglial suppression and restore their ability to resolve inflammatory processes and mitigate pathogenic amyloid plaques, which may be neuroprotective.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Greifswald, Germany.
Background: Previous trials reported that collaborative Dementia Care Management (cDCM) could be effective for patients and caregivers and cost-effective for healthcare systems in the short term. However, long-term evidence is lacking. Therefore, the study's objective was to determine the long-term efficacy and cost-effectiveness of cDCM compared with usual care.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
University of Calgary, Calgary, AB, Canada.
Background: The overuse of antipsychotics in persons with dementia in long-term care (LTC) has been a source of clinical concern, public attention, and policy intervention for over 30 years. Targeted quality improvement, broader awareness of risks, and other initiatives have resulted in substantial reductions in antipsychotic use in LTC settings in North America and elsewhere. Limited evidence suggests that reductions in antipsychotic use may be resulting in unintended consequences, such as substitution with alternate, but similarly harmful, psychotropic medications.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
University of Pennsylvania, Philadelphia, PA, USA.
Background: Best practice recommendations suggest a person close to a patient with mild cognitive impairment (MCI) or dementia be involved in their care. This person is often referred to as a "caregiver," though the term "care partner" has increasingly been used in research and care instead of "caregiver." Unlike "caregiver," "care partner" suggests a collaborative relationship between the patient and their support person, in which the patient actively participates rather than passively receives help.
View Article and Find Full Text PDFBackground: Harmful care including the prescribing of high-risk and potentially inappropriate medications for older people is widespread among older adults, including people living with dementia (PLWD). Integrated Memory Care (IMC) is a comprehensive dementia care model where patients and their family caregivers access dementia-sensitive geriatric primary care.
Methods: We conducted a retrospective observational study of adult patients of IMC, Cognitive Neurology (CN), and Primary Care (PC) clinics aged 65 and older with a diagnosis of dementia in 2019-2021.
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