scholarly journals Identification of Different Class of Drugs causing Medication Related Problems in the Elderly Patients of Dakshina Kannada

2021 ◽  
Vol 8 (8) ◽  
pp. 668-672
Author(s):  
Abhishek Pradhan ◽  
Febin Benny ◽  
A.R Shabaraya
Keyword(s):  
Health Outcome ◽  
Drug Therapy ◽  
Elderly Patients ◽  
Related Problem ◽  
Elderly Population ◽  
The Elderly ◽  
Healthcare Outcomes ◽  
Microsoft Excel ◽  
Cardiovascular Agents ◽  
Patient Interview

Medication related problems (MRPs) can be defined as an event or situation involving drug therapy that potentially interferes with desired health outcome. The aim of the study was to identify the class of drugs that are commonly causing medication related problems in elderly patients. This study was conducted in 150 patients aged over 60 years for a duration of six months. The data were collected using a patient interview form and was analysed using Microsoft Excel 2016. Out of 150 patients participated in the study, 107 patients were identified with MRPs. And a total of 196 MRPs were identified from those 107 patients. The patients who were treated with cardiovascular agents where more prone to medication related problems and was found to be 57%. They were followed by endocrine agents (33%), gastro-protectants (21%), respiratory agents (17%) & others. This study concluded that, pharmacist can be helpful in identification and prevention of MRPs leading to a better healthcare outcomes. Keywords: Medication related problem, elderly population, class of drug.

scholarly journals Prevalence of Diseases in Elderly Patients with Medication Related Problems

2021 ◽  
Vol 8 (9) ◽  
pp. 228-233
Author(s):  
Abhishek Pradhan ◽  
Fathimath Kamila Thasneem ◽  
A R Shabaraya
Keyword(s):  
Drug Therapy ◽  
Elderly Population ◽  
The Elderly ◽  
Multiple Drug ◽  
Endocrine Disorders ◽  
World Population ◽  
Community Based ◽  
Patient Interview ◽  
The World ◽  
Targeted Approach

Introduction: The elderly population commonly known as geriatrics constitute nearly 21% of the world population. With the increasing age, the human body undergoes physiologic changes, leading to pharmacokinetic and pharmacodynamic alterations, hence making this sector of the patients more prone to medication related problems. Medication related problems are any unwanted events or circumstances that occur during the drug therapy which has the potential to interfere with the desired goals of health outcomes. Methods: A community based observational study was conducted in different places of Dakshina Kannada district for a duration of 6 months by enrolment of 150 patients aged above 60 years of either sex diagnosed with any disease except for cancer and bed ridden patients. The data was collected with the help of patient interview forms and was analysed. Results: Out of the 150 patients, 107 patients were identified with medication related problems. The total number of identified medication related problems were 196. From this study it was found that the medication related problems were more prevalent in cardiovascular disorders and endocrine disorders. As hypertension and diabetes mellitus are the most common diseases found among the elderly, the risk factors for developing medication related problems in such patients include the need of additional drug therapy or adequate monitoring of the clinical outcomes. Conclusion: It was found that the geriatrics suffering from multiple co-morbidities, undergoes multiple drug therapies thereby leading to medication related problems. Hence in order to ensure optimum care, a targeted approach is essential. Keywords: Medication related problems, Geriatrics, Hepler-Strand classification.

scholarly journals How to Treat Hepatocellular Carcinoma in Elderly Patients

2021 ◽  
Vol 14 (3) ◽  
pp. 233
Author(s):  
Piera Federico ◽  
Emilio Francesco Giunta ◽  
Annalisa Pappalardo ◽  
Andrea Tufo ◽  
Gianpaolo Marte ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Elderly Patients ◽  
Elderly Population ◽  
Primary Tumour ◽  
The Elderly ◽  
Chronic Liver Diseases ◽  
Old Patients ◽  
Choice Of Treatment ◽  
Definition Of ◽  
Optimal Treatment Strategy

Hepatocellular carcinoma (HCC) is the primary tumour of the liver with the greatest incidence, particularly in the elderly. Additionally, improvements in the treatments for chronic liver diseases have increased the number of elderly patients who might be affected by HCC. Little evidence exists regarding HCC in old patients, and the elderly are still underrepresented and undertreated in clinical trials. In fact, this population represents a complex subgroup of patients who are hard to manage, especially due to the presence of multiple comorbidities. Therefore, the choice of treatment is mainly decided by the physician in the clinical practice, who often tend not to treat elderly patients in order to avoid the possibility of adverse events, which may alter their unstable equilibrium. In this context, the clarification of the optimal treatment strategy for elderly patients affected by HCC has become an urgent necessity. The aim of this review is to provide an overview of the available data regarding the treatment of HCC in elderly patients, starting from the definition of “elderly” and the geriatric assessment and scales. We explain the possible treatment choices according to the Barcelona Clinic Liver Cancer (BCLC) scale and their feasibility in the elderly population.

scholarly journals 744. Effectiveness of 23-Valent Pneumococcal Polysaccharide Vaccine and Influenza Vaccine Against Pneumococcal Pneumonia Among Elderly Patients Aged 65 Years and Older in the Republic of Korea: A Case–Control Study

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S267-S267
Author(s):  
Jong Hun Kim ◽  
Byung Chul Chun ◽  
Joon Young Song ◽  
Hyo Youl Kim ◽  
In-Gyu Bae ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Elderly Population ◽  
Case Control Study ◽  
The Elderly ◽  
Case Control ◽  
Polysaccharide Vaccine ◽  
Vaccine Effectiveness ◽  
Pneumococcal Polysaccharide Vaccine ◽  
The Republic ◽  
Control Study

Abstract Background The national immunization program (NIP) of annual influenza vaccination to the elderly population (≥65 years of age) in the Republic of Korea (ROK) has been implemented since 1987. Recently, the 23-valent pneumococcal polysaccharide vaccine (PPV23) through the NIP has been provided to the elderly population in the ROK since May 2013. The aim of this study was to assess PPV23 and influenza vaccine (IV) effectiveness in preventing pneumococcal pneumonia (PP) among elderly patients ≥65 years of age. Methods A case–control study using a hospital-based cohort was conducted. Cases of PP including bacteremic PP and nonbacteremic PP were collected from 14 hospitals in the pneumococcal diseases surveillance program from March 2013 to October 2015. Controls matched by age and sex in the same hospital were selected. Demographic, clinical information, and vaccination histories were collected. Previous immunization was categorized into “vaccinated” if a patient had received vaccines as follows: PPV23 (4 weeks to 5 years) and IV (2 weeks to 6 months) prior to the diagnosis of PP for case patients and prior to the hospital admission for control patients. Adjusted odds ratio (OR) was calculated, controlling for underlying medical conditions. Vaccine effectiveness was defined as (1 – OR) × 100. Results During the study period, a total of 661 cases (104 bacteremic PP cases and 557 nonbacteremic PP cases) and 661 controls were enrolled for analyses. For overall patients ≥65 years of age, there was no significant vaccine effectiveness against PP. For young elderly patients with 65–74 years, IV alone (1.2%, [95% confidence interval (CI) −95.3% to 50.0%]) and PPV23 alone (21.9%, [95% CI −39.0% to 56.1%]) were not effective. However, significant vaccine effectiveness of PPV23 plus IV against PP was noted (54.4%, [95% CI 6.9–77.7%], P = 0.031). For older elderly patients ≥75 years of age, no significant vaccine effectiveness was observed. Conclusion Our study indicates that PPV23 plus IV may be effective in preventing PP among young elderly patients with 65–74 years, suggesting additive benefits of influenza plus PPV23 vaccination. Further studies are required to confirm the persistent additive protective effectiveness. Disclosures All authors: No reported disclosures.

scholarly journals Perioperative Multimodal Anesthesia Using Regional Techniques in the Aging Surgical Patient

2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
Diana Nordquist ◽  
Thomas M. Halaszynski
Keyword(s):  
Drug Therapy ◽  
Adverse Effects ◽  
Elderly Patients ◽  
Regional Anesthesia ◽  
Pain Control ◽  
The Elderly ◽  
Surgical Patient ◽  
Cochrane Central Register ◽  
Promising Alternative ◽  
Age Related

Background. Elderly patients have unique age-related comorbidities that may lead to an increase in postoperative complications involving neurological, pulmonary, cardiac, and endocrine systems. There has been an increase in the number of elderly patients undergoing surgery as this portion of the population is increasing in numbers. Despite advances in perioperative anesthesia and analgesia along with improved delivery systems, monotherapy with opioids continues to be the mainstay for treatment of postop pain. Reliance on only opioids can oftentimes lead to inadequate pain control or increase in the incidence of adverse events. Multimodal analgesia incorporating regional anesthesia is a promising alternative that may reduce needs for high doses and dependence on opioids along with any potential associated adverse effects. Methods. The following databases were searched for relevant published trials: Cochrane Central Register of Controlled Trials and PubMed. Textbooks and meeting supplements were also utilized. The authors assessed trial quality and extracted data. Conclusions. Multimodal drug therapy and perioperative regional techniques can be very effective to perioperative pain management in the elderly. Regional anesthesia as part of multimodal perioperative treatment can often reduce postoperative neurological, pulmonary, cardiac, and endocrine complications. Regional anesthesia/analgesia has not been proven to improve long-term morbidity but does benefit immediate postoperative pain control. In addition, multimodal drug therapy utilizes a variety of nonopioid analgesic medications in order to minimize dosages and adverse effects from opioids while maximizing analgesic effect and benefit.

Optimizing Antiepileptic Drug Therapy in the Elderly

2005 ◽  
Vol 39 (11) ◽  
pp. 1852-1860 ◽  
Author(s):  
William R Garnett
Keyword(s):  
Drug Therapy ◽  
Elderly Patients ◽  
Antiepileptic Drug ◽  
Age Groups ◽  
The Elderly ◽  
Complex Partial Seizures ◽  
Medline Search ◽  
Age Related ◽  
Epilepsy In The Elderly ◽  
Clonic Seizures

OBJECTIVE To review and evaluate the medical literature concerning antiepileptic drug (AED) therapy in elderly patients. DATA SOURCES A MEDLINE search (1982–December 2004) was conducted. Bibliographies of the articles identified were also reviewed, and an Internet search engine was used to identify additional pertinent references. STUDY SELECTION AND DATA EXTRACTION Clinical studies and reviews were evaluated, and relevant information was included. DATA SYNTHESIS The elderly have the highest incidence of seizures among all age groups. Complex partial seizures are the most common, followed by primary generalized tonic–clonic seizures. An accurate diagnosis may prove difficult because of a low suspicion of epilepsy in the elderly and other diseases that may mimic seizures. Most AEDs are approved for treatment of elderly patients who have partial and tonic–clonic seizures. However, a number of age-related variables should be addressed when selecting an appropriate AED. Age-dependent differences in pharmacokinetics and pharmacodynamics of AEDs must be taken into account. Drug–drug interactions must be considered since elderly people often take multiple medications. The ultimate factor that often determines AED selection is tolerability. CONCLUSIONS Numerous factors must be considered in treating elderly patients for seizures, but maximizing the ability of patients to tolerate drug therapy is often the basis for AED selection. Special consideration should be made along several lines, including elderly patients’ cognitive functioning and their tendency to respond to lower AED concentrations.

scholarly journals Displaced olecranon fractures in the elderly: outcomes after non-operative treatment – a narrative review

2020 ◽  
Vol 5 (7) ◽  
pp. 391-397
Author(s):  
Olga D. Savvidou ◽  
Panagiotis Koutsouradis ◽  
Angelos Kaspiris ◽  
Leon Naar ◽  
George D. Chloros ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Elderly Patients ◽  
Operative Treatment ◽  
Treatment Option ◽  
Gold Standard ◽  
Elderly Population ◽  
Standard Of Care ◽  
The Elderly ◽  
Small Series ◽  
Olecranon Fractures

Operative treatment with tension band wiring or plate is the gold standard of care for displaced olecranon fractures. In elderly patients, multiple comorbidities combine with increased intraoperative risks, and postoperative complications may yield poor results. There are small series in the literature that show promising results with non-operative treatment. Non-operative treatment may provide reasonable function and satisfaction in the elderly population and could be considered as a treatment option in this group, especially for those with comorbidities, to avoid postoperative complications and the need for re-operation. Cite this article: EFORT Open Rev 2020;5:391-397. DOI: 10.1302/2058-5241.5.190041

Evaluating anticoagulation sensitivity among elderly patients managed with an institution’s heparin protocol using initial anti-factor Xa levels

2020 ◽  
Vol 77 (Supplement_1) ◽  
pp. S13-S18
Author(s):  
Adley Lemke ◽  
Jean Kohs ◽  
Lynn Weber
Keyword(s):  
Elderly Patients ◽  
Retrospective Cohort ◽  
Elderly Population ◽  
Factor Xa ◽  
The Elderly ◽  
Target Level ◽  
P Values ◽  
Vein Thrombosis ◽  
Coronary Syndrome ◽  
Deep Vein

Abstract Purpose The purpose of this study was to assess an institution’s heparin protocols in elderly and nonelderly adult populations to see if a response difference was observed. Methods This was a retrospective cohort study of hospitalized adults who were prescribed unfractionated heparin due to surgery, acute coronary syndrome (ACS), or deep vein thrombosis/pulmonary embolism (DVT/PE) from February 11, 2016, through August 1, 2017. Patients were divided into nonelderly adults 18 to 69 years of age and elderly patients 70 years of age or older. The anti-factor Xa (anti-Xa) level after protocol initiation was compared to the institution’s goal range of 0.3 to 0.7 IU/mL. Outcomes of each protocol in the elderly population were compared to outcomes in their nonelderly counterparts to determine if there was a difference in heparin response. Results A total of 325 patients were included in the analysis, comprising 150 elderly and 175 nonelderly adults. Elderly patients had a higher initial anti-Xa levels than did their nonelderly adult counterparts in the ACS, DVT/PE, and surgery protocols, with P values of 0.02, <0.001, and 0.01, respectively. Only the ACS protocol demonstrated increased frequency of above-target-level anti-Xa levels in the elderly (P = 0.03). Conclusion Elderly patients had significantly higher initial anti-Xa levels than did nonelderly adult patients across all protocols. This study identifies the need to further study elderly patients’ increased heparin sensitivity to determine if a separate dosing protocol is needed.

Worldwide Experiences with Assisted Peritoneal Dialysis

2017 ◽  
Vol 37 (5) ◽  
pp. 503-508 ◽  
Author(s):  
Anna Giuliani ◽  
Akash Nayak Karopadi ◽  
Mario Prieto-Velasco ◽  
Sabrina Milan Manani ◽  
Carlo Crepaldi ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Elderly Patients ◽  
Elderly Population ◽  
Age Groups ◽  
The Elderly ◽  
Clinical Results ◽  
Social Barriers ◽  
Stage Renal Disease ◽  
End Stage ◽  
Assisted Peritoneal Dialysis

End-stage renal disease (ESRD) is common in the elderly population, and renal replacement therapy (RRT) is often required. However, in this particular subgroup of patients, the choice between hemodialysis (HD) and peritoneal dialysis (PD) is often not an easy decision to make. Published literature has adequately demonstrated that PD prevalence is significantly less than HD across all patient age groups despite several advantages. We also know that elderly patients are less likely to complete a PD assessment, due to both medical and social barriers. Additionally, elderly patients are often reluctant to go ahead with PD despite being eligible PD candidates, mainly due to the fear of performing self-therapy. Recently, many new assisted PD (asPD) programs have cropped up in several countries. The main aim of these programs is to overcome barriers to PD and to promote PD utilization among elderly and non-self-sufficient patients. Although asPD has proven to be associated with good clinical results, there still remain concerns about its greater use. In this review, we will first describe an ideal asPD model and then enumerate examples of strategies and outcomes associated with successful asPD programs worldwide.

P1339ARTERIOVENOUS FISTULA AND BASILIC VEIN TRANSPOSITION IN ELDERLY PATIENTS ON HEMODIALYSIS: AN OBSERVATIONAL STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Vinant Bhargava ◽  
Priti Meena ◽  
Ambrish Satwik ◽  
Apurv Srivastava ◽  
A K Bhalla ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Vascular Access ◽  
Elderly Population ◽  
The Elderly ◽  
Primary Patency ◽  
New Delhi ◽  
Secondary Patency ◽  
Basilic Vein ◽  
The Mean

Abstract Background and Aims With the increase in the line expectancy of chronic kidney disease in the older population (>60 years), the numbers requiring haemodialysis is progressively rising. The elderly population may be different from the younger in terms of non-suitable vessels for access creation, non-maturation, and vascular calcifications, and this may alter the outcomes of use of arteriovenous fistula (AVF). This study was conducted to analyse the outcomes of AVF in elderly patients (>60 years). Method Retrospective study was conducted in the Department of Nephrology at Sir Ganga Ram Hospital, New Delhi. Patients of more than 60 years of age in whom AVF was created from 1st January 2012 to 31st December 2016 were included in the study. Follow-up data of 3.5 years was analysed. The primary endpoint was to assess primary and secondary patency rates. Results A total of 300 patients were included in the study. The mean age was 63.8 years. Radiocephalic AVF (RCAVF) was the most common site of [69.8% (n = 210)], followed by brachiocephalic (BCAVF) in 25.2% (n = 75) and basilic vein transposition (BVT) in 5% (n = 15). At 12 months, overall survival of the AVF was 66.8%. At 42 months, the primary patency rate of RCAVF, BCAVF, and BVT was 50.6%, 52.6%, and 50.4% respectively. The commonest cause of access failure was thrombosis (20.4%) followed by non-maturation (9%). Vascular access abandonment was found least in BCAVF. Conclusion AVF remains the preferred vascular access for haemodialysis in the elderly population. Brachiocephalic AVF has higher primary and secondary patency rates. Thrombosis and failure of maturation are major concerns in the elderly AVF.

scholarly journals Noninvasive Testing for Diagnosis of Stable Coronary Artery Disease in the Elderly

2020 ◽  
Vol 21 (17) ◽  
pp. 6263
Author(s):  
Sergey G. Kozlov ◽  
Olga V. Chernova ◽  
Elena V. Gerasimova ◽  
Ekaterina A. Ivanova ◽  
Alexander N. Orekhov
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Elderly Patients ◽  
Elderly Population ◽  
The Elderly ◽  
The United States ◽  
Diagnostic Methods ◽  
Exercise Stress ◽  
Attractive Alternative ◽  
Artery Disease

Efficient diagnostic approaches to detect coronary artery disease (CAD) in elderly patients are necessary to ensure optimal and timely treatment. The population of suspected CAD patients older than 70 years is especially vulnerable and constantly growing. Finding the optimal diagnostic approach is challenging due to certain features of this population, such as high prevalence of comorbidities, existing contraindications to exercise tests or cognitive decline, which hinders correct assessment of the patient’s situation. Moreover, some symptoms of CAD can have variable significance in the elderly compared to younger adult groups. In this review, we present current recommendations of the United States (US) and European cardiologists’ associations and discuss their applicability for diagnostics in the elderly population. Exercise electrocardiogram (ECG) and exercise stress echocardiography (SE) tests are not feasible for a substantial proportion of elderly patients. Coronary computed tomography angiography (CTA) appears to be an attractive alternative for such patients, but is not universally applicable; for instance, it is problematic in patients with significant calcification of the vessels. Moreover, more studies are needed to compare the results delivered by CTA to those of other diagnostic methods. Future efforts should be focused on comparative studies to better understand the limits and advantages of different diagnostic methods and their combinations. It is possible that some of the currently used diagnostic criteria could be improved to better accommodate the needs of the elderly population.

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