Advancement in telemedicine and teledentistry with virtual reality and metaverse

Dagli, Namrata

doi:10.4103/jioh.jioh_135_22

Cited by 39 publications

(47 citation statements)

References 6 publications

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“…97,98 Polypharmacy can lead to inappropriate medications being prescribed, drug-drug interactions, an increased risk of nonadherence and adverse drug reactions (ADRs) and is a particular problem in the elderly due to their altered metabolism, reduced drug clearance and therefore greater risk for ADRs. 99 ADRs can be multiple and non-specific, particularly in the elderly, and thus may be misinterpreted as either aging or underlying disease, resulting in further treatments, leading to a 'prescribing cascade'. 100 Elderly patients are also more likely to be prescribed antibiotics upon presenting with a respiratory viral infection, leading to the potential of ADRs, drug interactions and complications of underlying diseases.…”

Section: Polypharmacymentioning

confidence: 99%

Respiratory viral infections in the elderly

Watson

Wilkinson

2021

Ther Adv Respir Dis

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With the global over 60-year-old population predicted to more than double over the next 35 years, caring for this aging population has become a major global healthcare challenge. In 2016 there were over 1 million deaths in >70 year olds due to lower respiratory tract infections; 13–31% of these have been reported to be caused by viruses. Since then, there has been a global COVID-19 pandemic, which has caused over 2.3 million deaths so far; increased age has been shown to be the biggest risk factor for morbidity and mortality. Thus, the burden of respiratory viral infections in the elderly is becoming an increasing unmet clinical need. Particular challenges are faced due to the interplay of a variety of factors including complex multimorbidities, decreased physiological reserve and an aging immune system. Moreover, their atypical presentation of symptoms may lead to delayed necessary care, prescription of additional drugs and prolonged hospital stay. This leads to morbidity and mortality and further nosocomial spread. Clinicians currently have limited access to sensitive detection methods. Furthermore, a lack of effective antiviral treatments means there is little incentive to diagnose and record specific non-COVID-19 viral infections. To meet this unmet clinical need, it is first essential to fully understand the burden of respiratory viruses in the elderly. Doing this through prospective screening research studies for all respiratory viruses will help guide preventative policies and clinical trials for emerging therapeutics. The implementation of multiplex point-of-care diagnostics as a mainstay in all healthcare settings will be essential to understand the burden of respiratory viruses, diagnose patients and monitor outbreaks. The further development of novel targeted vaccinations as well as anti-viral therapeutics and new ways to augment the aging immune system is now also essential. The reviews of this paper are available via the supplemental material section.

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Section: Polypharmacymentioning

confidence: 99%

Respiratory viral infections in the elderly

Watson

Wilkinson

2021

Ther Adv Respir Dis

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“…Similarly, a study conducted by Callisaya et al, reported that increasing the daily dose of antihypertensives (one of the drugs at risk of falling), increases the risk of falling in the elderly (Zia et al 2017). With age, there is a decrease in liver and kidney function, an increase in total body fat, metabolic changes, a decrease in drug clearance, so that with polypharmacy there will be an increased risk of experiencing drug side effects or the risk of falling (Dagli and Sharma 2014;Ming et al 2021).…”

Section: The Accumulation Of Disturbance Conditions On Multiplementioning

confidence: 96%

Analysis of fall risk increasing drugs on Morse Fall Scale in geriatric patients (a study at geriatric outpatient clinic Airlangga University Teaching Hospital)

Yulistiani¹,

Utomo²,

Nugroho³

et al. 2023

PHAR

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Falls are the geriatric syndromes that become one of the main causes of injury, even death in the elderly. It is known that one of the risk factors for falling is the use of certain drugs that have the effect of orthostatic hypotension, sedation, balance disruptions, and other side effects. This study aims to examine the risk of falling based on Morse scale of geriatric patient that use fall-risk drug. Retrospective data were taken from e-prescriptions for geriatric patients and interviews with the patients to determine the risk of falling based on the Morse scale. The results showed that 115 patients who used the fall-risk drug had an average risk of falling from mild to moderate. The high fall-risk drug used by most patients was gabapentin (43%), the moderate fall-risk drug was candesartan (60%), and the low fall-risk drug was furosemide (9%). Patients with the total of 71% received a combination of two to four fall-risk drugs. Total MFRS of ≥6 was 53% patients, meaning that the patients’ using of drugs needed to be evaluated. From the results of statistical analysis, it was found that the number of fall risk drugs received by patients was not associated to the risk of falling in geriatric patients, while increasing the dose of high fall-risk drugs such as gabapentin, increased the fall risk level in geriatric patients. From the result of this study, it is known that fall-risk drugs are widely used by patients, hence it is necessary to increase the awareness of falling in geriatric patients.

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“…The presentation of ADRs in the elderly is often atypical and can imitate underlying disease processes such as global decline akin to frailty and dementia [ 32 ]. Furthermore, ADRs can also present as vague symptoms, including constipation, hallucinations, tremor, and falls, which are mistakenly attributed as primary diagnoses rather than secondary to medication [ 31 , 46 ]. The difficulty in recognising true ADRs creates a cycle where clinicians are often persuaded to treat vague symptoms with additional medications instead of accurately identifying and removing the culprit drug.…”

Section: Reviewmentioning

confidence: 99%

Limiting Factors in Implementing Pharmacovigilance Principles in the Elderly

Shah¹,

Nagi²,

Khare³

et al. 2023

Cureus

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The overarching aim of pharmacovigilance is to ensure the safe and effective usage of medication across the population and optimise medicines through holistic considerations. However, within the heterogeneous elderly population, several unique factors are at play, limiting the ability of clinicians to fulfil this aim. A matured physiology influencing the response and effects of drugs, increased polypharmacy enabling drugdrug interactions, and greater consumption of concurrent herbal medicines predispose patients to harmful drug events. This increasingly multimorbid subpopulation requires complex pharmaceutical regimens encouraging inappropriate prescribing and medicine non-adherence leading to suboptimal therapy. Furthermore, restrictive practices in clinical trials commonly exclude elderly patients creating disparities from expected findings within a real-world setting. These issues create an environment where elderly patients are at a heightened risk of adverse drug events and clinicians are forced to make significant decisions from limited information. With projections showing that this demographic will continue growing in size, the true burden of these limiting factors is yet to be realised.

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Advancement in telemedicine and teledentistry with virtual reality and metaverse

Cited by 39 publications

References 6 publications

Respiratory viral infections in the elderly

Respiratory viral infections in the elderly

Analysis of fall risk increasing drugs on Morse Fall Scale in geriatric patients (a study at geriatric outpatient clinic Airlangga University Teaching Hospital)

Limiting Factors in Implementing Pharmacovigilance Principles in the Elderly

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Advancement in telemedicine and teledentistry with virtual reality and metaverse

Cited by 39 publications

References 6 publications

Respiratory viral infections in the elderly

Respiratory viral infections in the elderly

﻿Analysis of fall risk increasing drugs on Morse Fall Scale in geriatric patients (a study at geriatric outpatient clinic Airlangga University Teaching Hospital)

Limiting Factors in Implementing Pharmacovigilance Principles in the Elderly

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Analysis of fall risk increasing drugs on Morse Fall Scale in geriatric patients (a study at geriatric outpatient clinic Airlangga University Teaching Hospital)