scholarly journals Potential and clinical relevant drug-drug interactions among elderly from nursing homes: a multicentre study in Murcia, Spain

2019 ◽  
Vol 24 (5) ◽  
pp. 1895-1902
Author(s):  
Carles Iniesta-Navalón ◽  
Juan Jose Gascón-Cánovas ◽  
Zenewton André da Silva Gama ◽  
José Francisco Sánchez-Ruiz ◽  
Erick Angelico Gutiérrez-Estrada ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Drug Interactions ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Complex Sampling ◽  
Inflammatory Drugs ◽  
Multi Level ◽  
Relevant Factors

Abstract This study purposes to determine the prevalence of potential and clinical relevant Drug-Drug-Interactions (pDDIs) in institutionalized older adults and to identify the pertinent factors associated. We conduct an observational, multicenter and cross-sectional study during the last quarter of 2010. We selected a sample of 275 subjects (aged ≥ 65 years) from 10 nursing homes of Murcia (Spain) by a two-stage complex sampling. pDDIs were identified using the College of Pharmacists Database. We only considered pDDIs of clinical relevance, and thereafter the relevant factors were identified through uni-level and multi-level regression analyses. A total of 210 pDDIs were identified, 120 of which were considered clinically relevant (57.1%), affecting a total of 70 elderly (25.8%). Eight pharmacological groups made up 70.2% of the clinically relevant pDDIs. More clinically relevant DDIs were found in people suffering several pathologies (OR = 2.3; 95%CI = 1.4-4.5), and also in people who take ten or more drugs daily (OR = 9.6; 95%CI = 4.8-19.1), and people who take anti-inflammatory drugs (OR = 3.9; 95%CI = 1.4-10.4). This study reveals that clinically relevant pDDIs are very common in institutionalized elderly people, and that caregivers should aim at improving their practice in order to reduce the prevalence of this phenomenon.

Non-Steroidal Anti-Inflammatory Drugs: Usage and Co-prescription with Other Potentially Interacting Drugs in Elderly: a Cross-sectional Study

2019 ◽  
Author(s):  
Nuru Abdu ◽  
Samuel Teweldemedhin ◽  
Asmerom Mosazghi ◽  
Luwam Asfaha ◽  
Makda Teshale ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Drug Interactions ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Protective Agents ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Abstract Introduction: Globally, non-steroidal anti-inflammatory drugs (NSAIDs) usage in the elderly with chronic pain has been reported as frequent. Though it is fundamental in maintaining their quality of life, the risk of polypharmacy, drug interactions and adverse effects is of paramount importance as the elderly usually require multiple medications for their co-morbidities. If prescriptions are not appropriately monitored and managed, they are likely to expose patients to serious drug interactions and potentially fatal adverse effects. Thus, the objective of the study was to assess the appropriateness of NSAIDs use and incidence of NSAIDs related potential interactions in elderly. Methods: A descriptive cross-sectional study was conducted among elderly out-patients (aged 60 and above) who visited three hospitals in Asmara between August 22 and September 29, 2018. The sampling design was two-stage random sampling and data was collected using a questionnaire, exit interview and by abstracting information from patients’ clinical cards. Descriptive and analytical statistics including chi-square test and logistic regression were employed using SPSS. Results: A total of 285 elderly respondents were enrolled in the study with similar male to female ratio. One in four of all respondents were chronic NSAIDs users, of which 74.6% were not prescribed prophylactic gastro-protective agents (GPAs). About 20% of the elderly were involved in polypharmacy and nearly all of the encountered potential NSAIDs related interactions (n=322) with prescribed drugs were moderate. Diabetes and hypertension were significantly associated with chronic NSAIDs use (OR=3, 95% CI: 1.54, 5.84; OR=9.99, 95% CI: 4.46, 22.38) and incidence of drug interactions (OR=3.95, 95%CI: 1.92, 8.13; OR=3.12, 95%CI: 1.81, 5.33) while diabetes and cardiac problem were significantly associated with incidence of polypharmacy (OR=4.33, 95% CI: 2.36, 7.96; OR=3.56, 95% CI: 1.05, 12.11). Conclusion: Though the overall reflection of prescription pattern of NSAIDs during the study period was almost satisfactory, gastro-protective agents were poorly prescribed as a prophylaxis.

scholarly journals Mechanical Restraint in Nursing Homes in Brazil: a cross-sectional study

2020 ◽  
Vol 73 (suppl 3) ◽  
Author(s):  
Romulo Delvalle ◽  
Rosimere Ferreira Santana ◽  
Ariana Kassiadou Menezes ◽  
Keila Mara Cassiano ◽  
Ana Carolina Siqueira de Carvalho ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Cross Sectional Study ◽  
International Studies ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mechanical Restraint ◽  
Alternative Interventions ◽  
Factors Associated ◽  
Restraint Use ◽  
Risk Of Falls

ABSTRACT Objective: to estimate the mechanical restraint prevalence in Nursing Homes in Brazil and the factors associated with its performance. Methods: this cross-sectional study was carried out in 14 institutions, with a final sample of 443 elderly people. Mechanical restraint was considered as a dependent variable. Results: there was a 7.45% prevalence of mechanical restraint considering bed rails and 3.84% without considering bed rails. Main justification for restraint use was risk of falls (66.7%), and restraint duration was 24 hours (84.8%). The factors associated with the dependent variable were: wandering (p=0.000); MMSE, with cognitive loss (p=0.000); Katz Index, with dependence for Activities of Daily Living (p=0.000); and Alzheimer’s comorbidity (p=0.001) Conclusion: prevalence was lower than international studies, but there was an association with worsening of wandering, dependence, cognitive worsening, and Alzheimer’s Disease, showing the need for alternative interventions to mechanical restraint.

scholarly journals Potential drug interactions and profile of antimicrobials prescribed for outpatient use in the interior of Bahia

2021 ◽  
Vol 10 (4) ◽  
pp. e44210414250
Author(s):  
Beatriz da Silva Santos ◽  
Manoela Santos da Silva ◽  
Isadora Oliveira e Pereira ◽  
Lucas Brasileiro Lemos ◽  
Gisele da Silveira Lemos
Keyword(s):  
Drug Interactions ◽  
Cross Sectional Study ◽  
Potential Drug ◽  
Sectional Study ◽  
Electronic Prescription ◽  
Cross Sectional ◽  
Version 2.0 ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
A Chain

This study aimed to analyze the profile of antimicrobials and potential drug interactions, involving these drugs, prescribed for outpatient use in the interior of Bahia. This is a cross-sectional study, carried out based on the analysis of 404 antimicrobial prescriptions listed in the DRC no. 20/2011, made available by the store of a chain of pharmacies, referring to the period of May 2018. The analysis of drug interactions (IM) was made using the MICROMEDEX® version 2.0 database (2011). The most prescribed class of antimicrobials was that of β-lactams (27.7%), followed by macrolides (25.3%) and fluoroquinolones (18.3%). As for the drugs prescribed in combination, there was a predominance of non-steroidal anti-inflammatory drugs (23.3%) and analgesics (19.8%). A total of 20 different drug interactions were observed, involving antimicrobials, most frequently for ciprofloxacin. After analyzing the interactions, it was possible to verify the risks related to drug associations that can be minimized with the analysis of the prescription by a pharmaceutical professional and alert systems in electronic prescription.

scholarly journals Factors Associated With Missed Nursing Care in Nursing Homes: A Multicentre Cross-sectional Study

2021 ◽  
Author(s):  
Sara Campagna ◽  
Alessio Conti ◽  
Marco Clari ◽  
Ines Basso ◽  
Veronica Sciannameo ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Nursing Care ◽  
Nursing Home Residents ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Basic Care ◽  
Clinical Conditions ◽  
Missed Nursing Care

Background: Despite its association with patient safety, few studies on missed nursing care have been conducted in nursing homes. We aimed to describe individual and environmental factors in a sample of registered nurses (RNs) reporting missed nursing care in nursing homes, and to explore the association between these factors and missed nursing care. Methods: In the present, multicentre cross-sectional study, 217 RNs from 43 nursing homes in Northern Italy reported all episodes of missed nursing care (ie, any aspect of required care that was omitted or delayed) that occurred in the 20 most dependent residents (according to RNs’ judgement; 860 residents in total) over 3 consecutive days. Multilevel multivariable logistic regression models were used to test possible explanatory factors of missed nursing care (individual, work-related, organisational, and work environment factors), which were entered in a step-wise manner. Results: Younger RNs (P=.026), freelance RNs (P=.046), RNs with a permanent contract (P=.035), and those working in publicly-owned nursing homes reported more episodes of missed nursing care (P<.012). Public ownership (odds ratio [OR]=9.88; 95% CI 2.22–44.03; P=.003), a higher proportion of residents with severe clinical conditions (OR=2.45; 95% CI 1.12–5.37; P=.025), a lower proportion of RNs (OR=2.24; 95% CI 1.10–4.54; P=.026), and perceived lack of time to care for residents (OR=2.33; 95% CI 1.04–5.26; P=.041) were statistically significantly associated with missed nursing care. Conclusion: Factors associated with missed nursing care are similar in hospitals and nursing homes, and include heavy workload and perceived lack of time for care. Because missed nursing care in nursing homes represents tasks performed specifically by RNs, missed nursing care in this setting should be measured in terms of these tasks. An optimal skill mix is crucial to guarantee not only comfort and basic care for nursing home residents, but also good outcomes for residents with severe clinical conditions.

Etiologies, Clinical Manifestations, and Factors Associated with Severe Symptomatic Hyponatremia among Hospitalized Hyponatremia Patients

2020 ◽  
Vol 103 (5) ◽  
pp. 465-471
Keyword(s):  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Hospitalized Patients ◽  
Sectional Study ◽  
Close Attention ◽  
Cross Sectional ◽  
Factors Associated ◽  
Present Cross Sectional Study ◽  
Important Health ◽  
Baseline Characteristics

Background: Hyponatremia is associated with unfavorable outcomes in many cases. The mainstay of hyponatremia treatment depends on its symptoms and etiology. However, etiologies, clinical manifestations, and factors associated with severe symptomatic hyponatremia have been rarely reported. Objective: To analyze and report etiologies, clinical manifestations, and factors associated with severe symptomatic hyponatremia. Materials and Methods: In the present cross-sectional study, the authors enrolled hospitalized patients with hyponatremia who had consulted a nephrologist between October 1, 2017, and October 31, 2018. Their baseline characteristics and clinical manifestations were recorded. Etiologies were confirmed by the attending nephrology staff. Factors associated with severe symptomatic hyponatremia were evaluated using logistic regression analysis. Results: One hundred patients were included in this study. The syndrome of inappropriate antidiuresis (SIAD), hypovolemia, and hydrochlorothiazide use were the leading hyponatremia etiologies. Hyponatremia etiologies differed between patients with community-acquired hyponatremia (n=50) and those with hospital-associated hyponatremia (n=50). Patients with communityacquired hyponatremia were older, presented with a higher frequency of severe symptomatic hyponatremia, and showed lower SNa-levels. Low SNa-levels were significantly associated with severe symptomatic hyponatremia (p=0.014). Conclusion: Hyponatremia remains an important health problem. SIAD, hypovolemia, and hydrochlorothiazide use are among the leading etiologies of hyponatremia. Low SNa-levels are associated with severe symptomatic hyponatremia; thus, physicians should pay close attention to low SNa-levels in hospitalized patients. Keywords: Hyponatremia, Symptomatic Hyponatremia, Community-acquired hyponatremia, Hospital-associated hyponatremia

Depression and Cognitive Impairment in Patients on Hemodialysis: A cross-sectional study

2020 ◽  
Vol 5 (15) ◽  
pp. 185-192
Author(s):  
Nor Jannah Nasution Raduan ◽  
Mohd Razali Salleh ◽  
Ghazali Ahmad ◽  
Zaleha Ismail
Keyword(s):  
Cognitive Impairment ◽  
Publishing House ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Education Level ◽  
Sectional Study ◽  
Contributing Factors ◽  
Cross Sectional ◽  
Factors Associated ◽  
Low Education

Depression and cognitive impairment are the most common complications of patients on hemodialysis. The objective of this study is to identify contributing factors to depression and cognitive impairment in hemodialysis patients. This is a cross-sectional study involving 110 hemodialysis patients in Hospital Kuala Lumpur. The samples were recruited through universal sampling. Patients were assessed with the Beck Depression Inventory and Montreal Cognitive Assessment. This study found that 18.2% of patients had depression, and 48.2% had cognitive impairment. Factors associated with depression were unmarried status, low education level, and cognitive impairment. Factors associated with cognitive impairment were low education level, depression, and unemployment. Keywords: hemodialysis, depression, cognitive, ESRD eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v5i15.2468.

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