Background Our goal was to determine (a) the prevalence of multimorbidity and polypharmacy in patients with cancer and (b) the prevalence, predictability, and preventability of adverse drug reactions (ADRs) causing/contributing to hospitalization. Materials and Methods We conducted a 12‐month prospective observational study of patients aged ≥16 years admitted to an oncology center. Older adults were aged ≥70 years. Results We enrolled 350 patients: 52.3% (n = 183) female, mean age 63.6 years (SD 12.1), 36.6% (n = 121) aged ≥70 years. Multimorbidity (≥2 conditions) was identified in 96.9%; 68% had ≥5 conditions. The median number of medications was 6 (interquartile range [IQR] 4–8); 47% were prescribed ≥6 medications and 11.4% ≥11 medications. Older adults had higher numbers of comorbid conditions (7 [IQR 5–10] vs. 5 [IQR 3–7]) and were prescribed more medications (median 7 [IQR 4–9] vs. 4 [IQR 2–7]). ADRs caused/contributed to hospitalization in 21.5% (n = 75): 35.8% (n = 72) of emergency admissions and 4.7% (n = 3) of elective admissions. The most common ADRs were neutropenia with infection (25.3%), dyspepsia/nausea/vomiting (20%), and constipation (20%). Causative medications included systemic anticancer therapies (SACTs; 53.3%), opioids (17.3%), corticosteroids (6.7%), and nonsteroidal anti‐inflammatory drugs (5.3%). ADR prevalence was similar in older and younger adults secondary to SACTs (8.3% vs. 13.1%), non‐cancer medications (10.7% vs. 8.3%), and both (0% vs. 1.3%). ADRs were predictable in 89.3% (n = 67), definitely avoidable in 29.3% (n = 22), and possibly avoidable in 33.3% (n = 25). No association was identified between ADRs and age, gender, daily medication number, length of stay, or death. No ADR predictor variables were identified by logistic regression. Conclusion More than 21% of admissions to an oncology service are ADR‐related. ADRs are caused by both SACTs and non‐cancer‐specific medications. The majority are predictable; ≥60% may be preventable. Patients with cancer have high levels of multimorbidity and polypharmacy, which require vigilance for related adverse outcomes. Implications for Practice A diagnosis of cancer often occurs in patients with multimorbidity and polypharmacy. Cancer can cause an altered physiological environment, placing patients at risk of drug‐drug interactions, drug‐disease interactions, and adverse drug reactions (ADRs). This study identified that ADRs caused or contributed to one in five hospital admissions of patients with cancer. ADRs were caused by systemic anticancer therapies (SACTs) in 53.3% of cases and non‐cancer medications in 45.4% of cases, and a combination of both in 1.3%. ADRs occurred in similar frequencies in older and younger patients secondary to SACTs (8.3% vs. 13.1%, p = .295), non‐SACTs (10.7% vs. 8.3%, p = .107), and a combination of both (0% vs. 1.3%, p = .240). The majority of ADRs were predictable (89.3%) and potentially preventable (62.6%). These findings support the need for increased awareness of medication‐related adversity in pa...

Purpose: This paper reports on results of a study to identify education needs of nurses in acute care environments regarding dementia care in Ireland. Method:As part of a multicentre study of dementia prevalence and in-hospital course, a survey was conducted with nurses (n = 151) in six acute hospitals in the south of Ireland. Data were analysed using descriptive statistics. Findings:Despite the availability of a national dementia education programme across all care services, 83% of acute hospital nursing staff perceived that they had insufficient training in dementia care, reflecting the known poor uptake of offered dementia education in acute hospitals. Over two thirds of nurses felt that education on dementia specific communication strategies was insufficient or unavailable. Nurses also reported insufficient knowledge with regard to pain assessment in patients with dementia, or alternatives to physical or chemical restraint. This lack of knowledge has implications for quality of care and may have consequences for safety of patients with dementia in acute hospitals in Ireland. Conclusion:With the expected growth in prevalence of dementia worldwide, more people with dementia will access acute hospital care. Education and training to improve dementia care needs to be prioritised in acute hospitals at senior level.

There appears to be a widespread and inappropriate use of PPIs in hospital practice.

The clinical and pathological features are described in a case of prolonged dementia in a 59 year old man with familial dementia and extrapyramidal disorder. Postmortem examination showed severe fronto-temporal and basal ganglia atrophy, with many “ballooned neurons” in the residual cortex most likely representing Pick's disease. The differential diagnosis is discussed and aspects of this rare condition are reviewed.

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