Polypill therapy and frailty in elderly: Time to stop treating everything

2021 ◽  
Vol 12 (4) ◽  
pp. 39-42
Author(s):  
Sunil Kumar ◽  
Parth Godhiwala ◽  
Amrutha Garikapati ◽  
Shraddha Jain
Keyword(s):  
Observational Study ◽  
Elderly Patients ◽  
Prospective Observational Study ◽  
Related Condition ◽  
Medicine Department ◽  
Risk Of Death ◽  
Age Related ◽  
One Year ◽  
The Impact

Background: Frailty is a reversible age-related condition of increased vulnerability and risk of death or unplanned hospitalization. Frailty and polypill therapy are common in elderly, although little is known about the impact, they may have on each other. Aims and Objective: The study was a prospective observational study, designed with an aim to observe the six-month and one-year outcomes of elderly patients on polypill therapy. Material and Methods: Three hundred forty-two patients aged more than 60 years on polypill treatment were enrolled in this study, which were on regular follow up in our rural hospital at geriatric units of medicine department. Results: At the end of one year, 38.1% were in severe frailty (FIRE >0.7) category, out of which death happened at the end of one year were 41.6%. 47.6% required repeated hospitalisations that were on polypill therapy. Conclusions: A reduction of polypill therapy could be a cautious strategy to prevent and manage frailty. Further research is needed to confirm the possible benefits of reducing polypill in the development, reversion or delay of frailty.

scholarly journals The impact of non-steroidal anti-inflammatory drugs use in elderly cardiovascular patients: an observational study from tertiary care in South India

2019 ◽  
Vol 7 (5) ◽  
pp. 1787
Author(s):  
Sadhna Sharma ◽  
Biju Govind ◽  
Kondal Rao
Keyword(s):  
Observational Study ◽  
Elderly Patients ◽  
Tertiary Care ◽  
The Elderly ◽  
Left Ventricular ◽  
Risk Of Death ◽  
Increased Risk ◽  
High Prevalence ◽  
One Year ◽  
The Impact

Background: Long-term use of NSAIDs, by patients having cardiovascular conditions, has shown to increase the risk of cardiovascular events and increased risk of death. Hence, the study was conducted to determine the complications related to NSAID use by the elderly patients with cardiovascular disease (CVD).Methods: The study was a single-center prospective observational study conducted November 2017 to October 2018. Elderly patients (>60 years) suffering from various CVDs and reported NSAID intake daily for at least one month were included. A questionnaire included demographic, treatment related history and complete details of NSAIDs intake including nature, dose, indication, source etc. The same questionnaire was again filled at the end of one-year follow-up.Results: A total of 100 participants were included in the study. The mean age was 72±8.6 years. Majority of the patients (93%) had hypertension, and 69% of the patient had previous MI.  Five NSAIDs (diclofenac, ibuprofen, mefenamic acid, naproxen, and ketorolac) were used routinely. At least one over the counter NSAID used was reported by 86%, 57% were prescribed at least one NSAIDs by their orthopaedics and physicians. At the end of 1-year follow-up, authors found that 71% had MI (2% increase), 4% developed reinfarction, 20% had severe left ventricular failure (4% increase), 7% had atrial fibrillation (1% increase), and 2% patients died and 63% patients reported raise in systolic blood pressure by 5mmHg.Conclusions: High prevalence of concomitant NSAID use among elderly CVD patients, which might be contributing towards increase in CVS morbidity and mortality.

scholarly journals Safety of High-Dose Dabigatran in Elderly and Younger Patients with a Low Bleeding Risk: A Prospective Observational Study

Cardiology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Aharon Erez ◽  
Gregory Golovchiner ◽  
Robert Klempfner ◽  
Ehud Kadmon ◽  
Gustavo Ruben Goldenberg ◽  
...  
Keyword(s):  
Observational Study ◽  
Elderly Patients ◽  
Prospective Observational Study ◽  
Bleeding Risk ◽  
The Elderly ◽  
High Dose ◽  
World Population ◽  
Younger Patients ◽  
End Point

<b><i>Introduction:</i></b> In patients with atrial fibrillation (AF) at risk for stroke, dabigatran 150 mg twice a day (DE150) is superior to warfarin for stroke prevention. However, there is paucity of data with respect to bleeding risk at this dose in elderly patients (≥75 years). We aimed to evaluate the safety of DE150 in comparison to warfarin in a real-world population with AF and low bleeding risk (HAS-BLED score ≤2). <b><i>Methods:</i></b> In this prospective observational study, 754 consecutive patients with AF and HAS-BLED score ≤2 were included. We compared outcome of elderly patients (age ≥75 tears) to younger patients (age &#x3c;75 years). The primary end point was the combined incidence of all-cause mortality, stroke, systemic emboli, and major bleeding event during a mean follow-up of 1 year. <b><i>Results:</i></b> There were 230 (30%) elderly patients, 151 patients were treated with warfarin, and 79 were treated with DE150. Fifty-two patients experienced the primary endpoint during the 1-year follow-up. Among the elderly, at 1-year of follow-up, the cumulative event rate of the combined endpoint in the DE150 and warfarin was 8.9 and 15.9% respectively (<i>p</i> = 0.14). After adjustment for age and gender, patients who were treated with DE150 had a nonsignificant difference in the risk for the combined end point as patients treated with warfarin both among the elderly and among the younger population (HR 0.58, 95% C.I = 0.25–1.39 and HR = 1.12, 95% C.I 0.62–2.00, respectively [<i>p</i> for age-group-by-treatment interaction = 0.83). <b><i>Conclusions:</i></b> Our results suggest that Dabigatran 150 mg twice a day can be safely used among elderly AF patients with low bleeding risk.

scholarly journals ASSESSMENT OF MEDICATION ADHERENCE AMONG ELDERLY PATIENTS IN MYSURU CITY

2019 ◽  
pp. 41-46
Author(s):  
JAIDEV KUMAR ◽  
MAHENDRAPPA ◽  
PRAMOD KUMAR
Keyword(s):  
Medication Adherence ◽  
Observational Study ◽  
Elderly Patients ◽  
Prospective Observational Study ◽  
Research Study ◽  
Medical Condition ◽  
Good Adherence ◽  
Oral Feedback ◽  
One Year ◽  
Age Range

Objective: To assess medication adherence among patients with chronic diseases. Methods: This was a prospective observational study carried out over period of one year in mysuru city. The subjects who meet study criteria were enrolled in this research study. The enrolled subjects were administered with simplified medication adherence questionnaire. The criteria to establish adherent and non-adherent were calculated as per simplified medication adherence questionnaire directions. Results: The gender distribution of this research study was reflected with male accountable for 45.63 % followed by female 54.36%. Asper simplified medication adherence questionnaire88% were adherent and remaining 12% were non-adherent in this research study. Conclusion: Patients with good adherence in this research study showed that they have good literacy status as well as better awareness about the existing medical condition and more consciousness may be there among these patients, what will be going to happen if their medical condition is left untreated.46.29 % males and 59.58 % females were adherent in this research study followed by 59.24% were adherent in the age range of 60-70 y as they were more conscious and less forgetfulness about medications as per the directions given by patient consultant which was oral feedback taken by research investigators during medication review in subjects home.

scholarly journals Homeopathic treatment of elderly patients - a prospective observational study with follow-up over a two year period

2010 ◽  
Vol 10 (1) ◽  
Author(s):  
Michael Teut ◽  
Rainer Lüdtke ◽  
Katharina Schnabel ◽  
Stefan N Willich ◽  
Claudia M Witt
Keyword(s):  
Observational Study ◽  
Elderly Patients ◽  
Prospective Observational Study ◽  
Homeopathic Treatment

scholarly journals Use of Telemedicine for Chronic Liver Disease at a Single Care Center During the COVID-19 Pandemic: Prospective Observational Study (Preprint)

2020 ◽  
Author(s):  
Maria Guarino ◽  
Valentina Cossiga ◽  
Andrea Fiorentino ◽  
Giuseppina Pontillo ◽  
Filomena Morisco
Keyword(s):  
Health Care ◽  
Liver Disease ◽  
Observational Study ◽  
Chronic Liver Disease ◽  
Prospective Observational Study ◽  
Care Delivery ◽  
Care Center ◽  
Social Distancing ◽  
The Impact

BACKGROUND The COVID-19 outbreak has overwhelmed and altered health care systems worldwide, with a substantial impact on patients with chronic diseases. The response strategy has involved implementing measures like social distancing, and care delivery modalities like telemedicine have been promoted to reduce the risk of transmission. OBJECTIVE The aim of this study was to analyze the benefits of using telemedicine services for patients with chronic liver disease (CLD) at a tertiary care center in Italy during the COVID-19–mandated lockdown. METHODS From March 9 to May 3, 2020, a prospective observational study was conducted in the Liver Unit of the University Hospital of Naples Federico II to evaluate the impact of (1) a fully implemented telemedicine program, partially restructured in response to COVID-19 to include video consultations; (2) extended hours of operation for helpline services; and (3) smart-working from home to facilitate follow-up visits for patients with CLD while adhering to social distancing regulations. RESULTS During the lockdown in Italy, almost 400 visits were conducted using telemedicine; only patients requiring urgent care were admitted to a non–COVID-19 ward of our hospital. Telemedicine services were implemented not only for follow-up visits but also to screen patients prior to hospital admission and to provide urgent evaluations during complications. Of the nearly 1700 patients with CLD who attended a follow-up visit at our Liver Unit, none contracted COVID-19, and there was no need to alter treatment schedules. CONCLUSIONS Telemedicine was a useful tool for following up patients with CLD and for reducing the impact of the COVID-19 pandemic. This system of health care delivery was appreciated by patients since it gave them the opportunity to be in contact with physicians while respecting social distancing rules.

Elevated liver enzymes of newly-diagnosed pediatric celiac patients- a prospective-observational study

2021 ◽  
Author(s):  
Asaf Regev ◽  
Amir Ben-Tov ◽  
Anat Yerushalmy - Feler ◽  
Yael Weintraub ◽  
Hadar Moran Lev ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Newly Diagnosed ◽  
Laboratory Findings ◽  
Elevated Liver Enzymes ◽  
One Year ◽  
Elevated Transaminases

Abstract ObjectivesCeliac disease clinical presentation is constantly changing. We set to determine the prevalence of elevated transaminases in newly diagnosed celiac patients, and to evaluate this sub-group of patients for associated clinical and laboratory findings and assess their natural course of disease following therapeutic diet initiation.MethodsWe conducted a prospective-observational study of all newly-diagnosed pediatric celiac patients, between August 2016 – April 2018, in a pediatric gastroenterology clinic. Clinical data, anthropometrics and blood test results were recorded at diagnosis and at three, six and twelve months of follow-up. We compared patients with normal and elevated transaminases at diagnosis. ALT threshold was set at 24 U/l.ResultsOf 125 newly-diagnosed celiac patients, 31 (24.8%) had elevated ALT at diagnosis; two (1.6%) with over 3xULN. Patients with elevated ALT at diagnosis were significantly younger (mean age 5.5 (SD- 3.4) vs 7.3 (SD- 3.7) years, p < 0.01) and more commonly presented with diarrhea (32.3% vs. 14.9%, p = 0.03). 80% of patients with elevated ALT levels, normalized their ALT within 3 months and all within one year. Following gluten free diet initiation, patients with elevated ALT had similar clinical course, growth, serology normalization rate, and laboratory results, compared to patients with normal ALT over a one year follow up. A single patient was simultaneously co-diagnosed with celiac disease and auto-immune hepatitis.ConclusionsClinically significant ALT abnormalities are rare among newly diagnosed pediatric celiac patients. Significant elevations failing to normalize on gluten free diet, should raise concern of a concomitant primary liver disease and warrant further investigations.

Acute kidney injury and it's outcome following maternal near miss event: A prospective observational study from a tertiary care hospital

2021 ◽  
pp. 1753495X2110690
Author(s):  
Geetika Thakur ◽  
Aruna Singh ◽  
Vanita Jain ◽  
Pooja Sikka ◽  
Aashima Arora ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Near Miss ◽  
Care Hospital ◽  
One Year

Purpose Haemorrhage, preeclampsia and sepsis are the leading causes renal dysfunction in women with a maternal nearmiss(MNM) complication. The study aimed to assess the prevalence, pattern and follow up of these women. Methods This was a hospital based prospective observational study, conducted over one year. All women with a MNM leading to acute kidney injury (AKI) were analysed for fetomaternal outcomes and renal function at 1 year of followup. Results Incidence of MNM was 43.04 per 1000 livebirths. 18.2% women developed AKI. 51.1% women developed AKI in the puerperal period. Most common cause of AKI was haemorrhage seen in 38.3% women. Majority of women had s.creatinine between 2.1 to 5 mg/dl and 44.68% required dialysis. 80.8% women recovered fully when the treatment was initiated within 24 h. One patient underwent renal transplant. Conclusion Early diagnosis and treatment of AKI results in full recovery.

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