Prevalence and predictors of inappropriate prescribing according to the Screening Tool of Older People's Prescriptions and Screening Tool to Alert to Right Treatment version 2 criteria in older patients discharged from geriatric and internal medicine ward

2018 ◽  
Vol 19 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Mario Bo ◽  
Maddalena Gibello ◽  
Enrico Brunetti ◽  
Edoardo Boietti ◽  
Matteo Sappa ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Older Patients ◽  
Screening Tool ◽  
Inappropriate Prescribing ◽  
Internal Medicine Ward

scholarly journals Assessment of Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward According to the 2019 Beers Criteria

2020 ◽  
Vol 03 (02) ◽  
Author(s):  
Cátia Pereira ◽  
Ana Guiomar ◽  
Alexandra Cunha ◽  
Catarina Alves Cunha ◽  
José Pedro Barbosa ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Elderly Patients ◽  
Inappropriate Prescribing ◽  
Beers Criteria ◽  
Internal Medicine Ward

scholarly journals Letter to the Editor Regarding the Article: “Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward”

2019 ◽  
Vol 32 (3) ◽  
pp. 249
Author(s):  
Mariana Alves ◽  
Marco Ribeiro Narciso ◽  
Teresa Fonseca ◽  
João Gorjão Clara
Keyword(s):  
Internal Medicine ◽  
Elderly Patients ◽  
Inappropriate Prescribing ◽  
Internal Medicine Ward ◽  
Letter To The Editor

N/a.

scholarly journals Multimorbidity patterns in chronic older patients, potentially inappropriate prescribing and adverse drug reactions: protocol of the multicentre prospective cohort study MoPIM

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e033322
Author(s):  
Marisa Baré ◽  
Susana Herranz ◽  
Rosa Jordana ◽  
Maria Queralt Gorgas ◽  
Sara Ortonobes ◽  
...  
Keyword(s):  
Cohort Study ◽  
Adverse Drug Reactions ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Older Patients ◽  
Screening Tool ◽  
Inappropriate Prescribing ◽  
Fatal Outcome ◽  
Potentially Inappropriate Prescribing ◽  
Drug Reactions

IntroductionMultimorbidity is a major challenge for current healthcare systems and professionals. From the different approaches that have been proposed to analyse this issue, the hypothesis of the existence of association patterns of different chronic conditions is gaining visibility. In addition, multimorbidity can be associated to polypharmacy, which can lead to a higher risk of potentially inappropriate prescribing (PIP) and consequently to adverse drug reactions (ADRs). The general objective of this novel study is to identify the association between PIP, multimorbidity patterns, polypharmacy and the presence of ADRs in older patients admitted for exacerbation of chronic diseases.Methods and analysisThe MoPIM (morbidity, potentially inappropriate medication) study is a multicentre prospective cohort study of an estimated sample of 800 older (≥65 years) patients admitted to five general hospitals in Spain due to an exacerbation of a chronic disease. Patients referred to home hospitalisation, admitted due to an acute process or with a fatal outcome expected at the time of admission are excluded. Sociodemographic data, chronic morbidities and geriatric syndromes, number of chronic prescribed medications, PIP at admission to hospital and on discharge, according to the newest screening tool of older screening tool of older person's potentially inappropriate prescriptions/screening tool to alert doctors to right treatment criteria, and ADRs during hospitalisation are being collected. Multimorbidity patterns will be identified using cluster analyses techniques, and the frequency of polypharmacy, PIP and ADRs will be calculated. Finally, the possible relationship between those indicators will be identified through bivariate and multivariate analyses.Ethics and disseminationThe project has been approved by the clinical research ethics committees of each centre: Comité Ético de investigación Clínica del Parc Taulí, Comitè Ètic d'Investigació Clínica Osona per a la Recerca i Educació Sanitàries (FORES), Comité de Ètica de la Investigación con Medicamentos (CEIm)-Parc de Salut MAR, Comité Ético de Investigación Clínica de Euskadi, Comité de Ética de Investigación del Hospital Universitario de Canarias. The results will be actively and mainly disseminated through publication in peer-reviewed journals and communications in scientific conferences.Trial registration numberNCT02830425.

scholarly journals Prescription of Potentially Inappropriate Medication in Older Inpatients of an Internal Medicine Ward: Concordance and Overlap Among the EU(7)-PIM List and Beers and STOPP Criteria

2021 ◽  
Vol 12 ◽  
Author(s):  
Carla Perpétuo ◽  
Ana I. Plácido ◽  
Daniela Rodrigues ◽  
Jorge Aperta ◽  
Maria Piñeiro-Lamas ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Older Patients ◽  
Inappropriate Medication ◽  
Circulatory System ◽  
Beers Criteria ◽  
Internal Medicine Ward ◽  
The Poor ◽  
Stopp Criteria ◽  
Older Inpatients ◽  
The Eu

Background: Age-related comorbidities prone older adults to polypharmacy and to an increased risk of potentially inappropriate medication (PIM) use. This work aims to analyze the concordance and overlap among the EU(7)-PIM list, 2019 Beers criteria, and Screening Tool of Older Person’s Prescriptions (STOPP) version 2 criteria and also to analyze the prevalence of PIM.Methods: A retrospective cohort study was conducted on older inpatients of an internal medicine ward. Demographic, clinical, and pharmacological data were collected, during March 2020. After PIM identification by the EU(7)-PIM list, Beers criteria, and STOPP v2 criteria, the concordance and overlap between criteria were analyzed. A descriptive analysis was performed, and all the results with a p-value lower than 0.05 were considered statistically significant.Results: A total of 616 older patients were included in the study whose median age was 85 (Q1–Q3) (78–89) years. Most of the older patients were male (51.6%), and the median (Q1–Q3) number of days of hospitalization was 17 (13–22) days. According to the EU(7)-PIM list, Beers criteria, and STOPP criteria, 79.7, 92.0, and 76.5% of older adults, respectively, used at least one PIM. A poor concordance (<63.4%) among criteria was observed. An association between PIM and the number of prescribed medicines was found in all applied criteria. Moreover, an association between the number of PIMs and diagnoses of endocrine, nutritional, and metabolic diseases, mental, behavioral, and neurodevelopmental disorders, and circulatory system diseases and days of hospitalization was observed according to Beers criteria, and that with diseases of the circulatory system and musculoskeletal system and connective tissue was observed according to STOPP criteria.Conclusion: Despite the poor concordance between the EU(7)-PIM list, 2019 Beers, and STOPP v2 criteria, this work highlights the need for more studies in inpatients to develop strategies to facilitate the identification of PIM to decrease the high prevalence of PIM in hospitalized patients. The poor concordance among criteria also highlights the need to develop new tools adapting the existing criteria to medical ward inpatients.

scholarly journals Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward

2019 ◽  
Vol 32 (2) ◽  
pp. 141 ◽  
Author(s):  
Joana Urzal ◽  
Ana Bárbara Pedro ◽  
Inês Ferraz De Oliveira ◽  
Inês Romero ◽  
Miguel Achega ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Elderly Patients ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Inappropriate Prescribing ◽  
Inappropriate Drug ◽  
Published Data ◽  
Internal Medicine Ward ◽  
Medical Database ◽  
Increased Risk

Introduction: Polypharmacy is often observed in elderly patients and is associated with an increased risk of adverse drug reactions, side effects and interactions. Clinicians should be alert to inappropriate drug prescribing and reduce polypharmacy. Material and Methods: Observational, longitudinal, retrospective and descriptive study in an internal medicine ward in a Portuguese hospital. Polypharmacy was defined as the use of five or more different medicines. The purpose of this study was to describe the prevalence of polypharmacy and inappropriate prescribing at admission and discharge in an internal medicine ward, according to deprescribing.org guidelines/algorithms. A total of 838 consecutive patients were admitted between January and July 2017. All patients were aged under 65 years old, and those who died before discharge were excluded. Patients’ medications were reviewed from a medical database at hospital admission and discharge. We examined whether patients were taking anticoagulants, proton pump inhibitors, benzodiazepines, antipsychotics and/or antihyperglycemic medication.Results: A total of 483 patients were included, mean age was 79.2 ± 8.0 years, and 42% of patients were male. Median number of medications at admission and discharge was six. Polypharmacy was present in more than 70% of admitted patients. Proton pump inhibitors were the most common inappropriate prescription at discharge (17.2%). Discussion: This study demonstrated a low use of inappropriate medicine (11.2% - 17.2%) in older people discharged from hospital, when compared to other studies. Conclusion: Our study shows that polypharmacy is present in more than 70% of elderly admitted patients. Nevertheless, the drug inappropriateness rate was not significantly affected by polypharmacy at both admission and discharge, being overall lower than published data.

An open-label, single-center pilot study to test the effects of an amino acid mixture in older patients admitted to internal medicine wards

Nutrition ◽  
2020 ◽  
Vol 69 ◽  
pp. 110588 ◽  
Author(s):  
Francesco Bellanti ◽  
Aurelio Lo Buglio ◽  
Elena Di Stasio ◽  
Giorgia di Bello ◽  
Rosanna Tamborra ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Amino Acid ◽  
Pilot Study ◽  
Older Patients ◽  
Amino Acid Mixture ◽  
Acid Mixture ◽  
Single Center ◽  
Open Label ◽  
Internal Medicine Wards

scholarly journals Screening for atrial fibrillation during automated blood pressure measurement among patients admitted to internal medicine ward

2021 ◽  
Author(s):  
Giacomo Pucci ◽  
Edoardo Santoni ◽  
Valeria Bisogni ◽  
Camilla Calandri ◽  
Alberto Cerasari ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Adult Population ◽  
Blood Pressure Measurement ◽  
University Hospital ◽  
Daily Routine ◽  
Internal Medicine Ward ◽  
Clinical Conditions ◽  
Electrocardiogram Ecg

AbstractAtrial fibrillation (AF), the commonest sustained cardiac arrhythmia affecting the adult population, is often casually discovered among hospitalized people. AF onset is indeed triggered by several clinical conditions such as acute inflammatory states, infections, and electrolyte disturbance, frequently occurring during the hospitalization. We aimed to evaluate whether systematic AF screening, performed through an automated oscillometric blood pressure (BP) device (Microlife WatchBP Office AFIB, Microlife AG, Switzerland), is effective for detecting AF episodes in subjects admitted to an Internal Medicine ward. 163 patients consecutively hospitalized at the Unit of Internal Medicine of the “Santa Maria” Terni University Hospital between November 2019 and January 2020 (mean age ± standard deviation: 77 ± 14 years, men proportion: 40%) were examined. Simultaneously with BP measurement and AF screening, a standard 12-lead electrocardiogram (ECG) was performed in all subjects. AF was diagnosed by ECG in 29 patients (18%). AF screening showed overall 86% sensitivity and 96% specificity. False negatives (n = 4) had RR-interval coefficient of variation lower than true positives (n = 25, p < 0.01), suggesting a regular ventricular rhythm during AF. The repeated evaluation substantially confirmed the same level of agreement. AF screening was positive in all patients with new-onset AF (n = 6, 100%). Systematic AF screening in patients admitted to Internal Medicine wards, performed using the Microlife WatchBP Office AFIB, is feasible and effective. The opportunity to implement such technology in daily routine clinical practice to prevent undiagnosed AF episodes in hospitalized patients should be the subject of further research.

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