Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia.
Published: May 2024
AI Article Synopsis
Article Abstract
Objective: Deprescribing opportunities may differ across health care systems, nursing home settings, and prescribing cultures. The objective of this study was to compare the prevalence of STOPPFrail medications according to frailty status among residents of nursing homes in Australia, China, Japan, and Spain.
Design: Secondary cross-sectional analyses of data from 4 cohort studies.
Setting And Participants: A total of 1142 residents in 31 nursing homes.
Methods: Medication data were extracted from resident records. Frailty was assessed using the FRAIL-NH scale (non-frail 0-2; frail 3-6; most-frail 7-14). Chi-square tests and prevalence ratios (PRs) were used to compare STOPPFrail medication use across cohorts.
Results: In total, 84.7% of non-frail, 95.6% of frail, and 90.6% of most-frail residents received ≥1 STOPPFrail medication. Overall, the most prevalent STOPPFrail medications were antihypertensives (53.0% in China to 73.3% in Australia, P < .001), vitamin D (nil in China to 52.7% in Australia, P < .001), lipid-lowering therapies (11.1% in Japan to 38.9% in Australia, P < .001), aspirin (13.5% in Japan to 26.2% in China, P < .001), proton pump inhibitors (2.1% in Japan to 32.0% in Australia, P < .001), and antidiabetic medications (12.3% in Japan to 23.5% in China, P = .010). Overall use of antihypertensives (PR, 1.15; 95% CI, 1.06-1.25), lipid-lowering therapies (PR, 1.78; 95% CI, 1.45-2.18), aspirin (PR, 1.31; 95% CI, 1.04-1.64), and antidiabetic medications (PR, 1.31; 95% CI, 1.00-1.72) were more prevalent among non-frail and frail residents compared with most-frail residents. Antihypertensive use was more prevalent with increasing frailty in China and Japan, but less prevalent with increasing frailty in Australia. Antidiabetic medication use was less prevalent with increasing frailty in China and Spain but was consistent across frailty groups in Australia and Japan.
Conclusions And Implications: There were overall and frailty-specific variations in prevalence of different STOPPFrail medications across cohorts. This may reflect differences in prescribing cultures, application of clinical practice guidelines in the nursing home setting, and clinician or resident attitudes toward deprescribing.
Background: acquired exotropia mostly manifests as an intermittent form, and very few cases show constant exotrpia. However, the differences in the clinical features of the constant and intermittent exotropia patients has not been clear yet.
Methods: We retrospectively evaluated 6159 patients with exotropia from 2012 to 2022 in Farabi Eye Hospital, Tehran, Iran.
Purpose: To examine the acute effects of forehand drive (FD) preconditioning with or without blood-flow restriction (BFR) on subsequent forehand performance and muscle recruitment in tennis.
Methods: On separate visits, 12 well-trained tennis players participated in 4 randomized trials. Each visit included pretests (maximal muscle-activation capacity or FD performance), a preconditioning phase, and posttests after 5 minutes of rest (ie, similar to pretests).
Introduction: Lumbar transcutaneous spinal cord stimulation (TSS) evokes synchronized muscle responses, termed spinally evoked motor response (sEMR). Whether the structures TSS activates to evoke sEMRs differ when TSS intensity and waveform are varied is unknown.
Methods: In 15 participants (9F:6M), sEMRs were evoked by TSS over L1-L3 (at sEMR threshold and suprathreshold intensities) using conventional (one 400-µs biphasic pulse) or high-frequency burst (ten 40-µs biphasic pulses at 10 kHz) stimulus waveforms in vastus medialis (VM), tibialis anterior (TA) and medial gastrocnemius (MG) muscles.
Background: Physiological-based cord clamping (PBCC) in preterm infants is beneficial for cardiovascular transition at birth and may optimize placental transfusion. Whether PBCC can improve clinical outcomes is unknown. The aim of the Aeration, Breathing, Clamping (ABC3) trial was to test whether PBCC results in improved intact survival in very preterm infants.
