Beta-Blocker Use in Older Hospitalized Patients Affected by Heart Failure and Chronic Obstructive Pulmonary Disease: An Italian Survey From the REPOSI Register

Arcoraci, Vincenzo; Squadrito, Francesco; Rottura, Michelangelo; Pallio, Giovanni; Irrera, Natasha; Nobili, Alessandro; Natoli, G; Argano, Christiano; Squadrito, Giovanni; Corrao, Salvatore

doi:10.3389/fcvm.2022.876693

Cited by 10 publications

(3 citation statements)

References 91 publications

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“…For instance, a retrospective analysis of 4713 hospitalized patients with chronic kidney disease (CKD) aged ≥65 years reported that 21.9% were taking at least one inappropriate medication at the time of hospital admission, which was linked to multiple medication use and end-stage CKD [ 1 ]. Another study on patients with heart failure (HF) and chronic obstructive pulmonary disease (COPD) found a significant underuse of beta-blockers among older patients [ 2 ]. Moreover, the study identified cases of inappropriate prescribing of beta-blockers, including the use of contraindicated medications, affecting approximately 30% of patients with HF and COPD.…”

Section: Introductionmentioning

confidence: 99%

Gender Differences in Potentially Inappropriate Medication Use among Older Adults

Alwhaibi

Balkhi

2023

Pharmaceuticals

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Background: Use of potentially inappropriate medication (PIMs) is a prominent concern that leads to significant medication-related issues among older adults. Notably, older women tend to utilize more medicines than men; older women frequently take more drugs. In addition, some evidence suggests that prescription PIMs vary by gender. This study examines the gender-based variation in prescribing PIM among older adults in Saudi Arabia. Methods: A cross-sectional retrospective analysis of electronic medical records from a large hospital in Saudi Arabia was carried out. Patients over the age of 65 who received ambulatory treatment were included in the study. The utilization of PIM was assessed based on Beers criteria. Descriptive statistics and logistic regression were employed to describe patterns of PIM utilization and identify factors associated with their use. All statistical analyses were performed using Version 9.4 of the Statistical Analysis Software (SAS® 9.4). Results: The study comprised 4062 older people (age 65) who visited ambulatory care clinics; the average age was (72.6 ± 6.2) years. The majority of the study sample was women (56.8%). Among older adults, 44.7% of older men and 58.3% of older women reported having PIMs that should be avoided, indicating a higher prevalence of PIMs among women compared to men. In terms of the PIM categories used, women had a much higher utilization rate of cardiovascular and gastrointestinal drugs than men. In men, the use of PIMs was frequently associated with hypertension, ischemic heart disease, asthma, osteoarthritis, and cancer, while in women PIM use was associated with age, dyslipidemia, chronic kidney disease, and osteoporosis. Conclusions: This study revealed sex differences in PIM prescribing among older adults; PIM use is more common among women. Sex differences exist in clinical and socioeconomic characteristics and factors related to using potentially inappropriate medications. This study revealed essential areas that could be targeted by further interventions to improve drug-prescribing practices among older adults at risk of PIM.

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Section: Introductionmentioning

confidence: 99%

Gender Differences in Potentially Inappropriate Medication Use among Older Adults

Alwhaibi

Balkhi

2023

Pharmaceuticals

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“…Despite the clinical and pharmacological rationale suggesting the use of β-blockers in most patients with HF, it was reported that in hospitalized older patients (median age 82.8 years) affected by HF and COPD, only 36.9% were receiving a β-blocker on admission. This percentage became 38.0% at discharge, and there were no other β-blocker users after discharge [ 66 ]. These percentages were significantly lower than those observed in patients affected by HF alone (51.3 and 51.7%, respectively).…”

Section: The Pharmacological Treatment Of Copd In Older Adultsmentioning

confidence: 99%

Pharmacotherapies in Older Adults with COPD: Challenges and Opportunities

et al. 2023

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Older adults have a higher prevalence of chronic obstructive pulmonary disease (COPD), which will likely increase substantially in the coming decades owing to aging populations and increased long-term exposure to risk factors for this disease. COPD in older adults is characterized by low-grade chronic systemic inflammation, known as inflamm-aging. It contributes substantially to age-associated pulmonary changes that are clinically expressed by reduced lung function, poor health status, and limitations in activities of daily living. In addition, inflamm-aging has been associated with the onset of many comorbidities commonly encountered in COPD. Furthermore, physiologic changes that are often seen with aging can influence the optimal treatment of older patients with COPD. Therefore, variables such as pharmacokinetics, pharmacodynamics, polypharmacy, comorbidities, adverse drug responses, drug interactions, method of administration, and social and economic issues that impact nutrition and adherence to therapy must be carefully evaluated when prescribing medication to these patients because each of them alone or together may affect the outcome of treatment. Current COPD medications focus mainly on alleviating COPD-related symptoms, so alternative treatment approaches that target the disease progression are being investigated. Considering the importance of inflamm-aging, new anti-inflammatory molecules are being evaluated, focusing on inhibiting the recruitment and activation of inflammatory cells, blocking mediators of inflammation thought to be important in the recruitment or activation of these inflammatory cells or released by these cells. Potential therapies that may slow the aging processes by acting on cellular senescence, blocking the processes that cause it (senostatics), eliminating senescent cells (senolytics), or targeting the ongoing oxidative stress seen with aging need to be evaluated.

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“…Spontaneous reporting of suspected ADRs can create an agile and rapid system for identifying potential ADRs that have not yet been identified, known in pharmacovigilance as “signal generation”. This is of particular importance, especially in an ageing population, where the prevalence of multimorbidity (co-existence of two or more chronic conditions) and polypharmacy (the concomitant use of multiple medications) is continuously increasing, resulting in a higher risk of additional morbidity, potentially inappropriate medication, and drug-related adverse events [ 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. The “signals” of potential drug-related side effects and adverse reactions can be further studied in depth by regulatory authorities, as well as the participation of notifiers [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Reports of Symptoms Associated with Supraventricular Arrhythmias as a Serious Adverse Drug Reaction in the Spanish Pharmacovigilance Database

Pueyo-Val,

Avedillo-Salas,

Berdún-Viñegra

et al. 2023

Pharmaceuticals

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This study aimed to determine the type of drugs reported as suspected of causing severe supraventricular arrhythmias from the Spanish Human Pharmacovigilance System database. A total of 1053 reports were analysed, of which 526 (50%) were on men and 516 (49%) were on women. The most affected age group was the over-65s, with 593 reports (56%). Of the 1613 drugs, those belonging to the cardiovascular system (ATC Group C) were the most numerous (414 reports, 26%), with digoxin being the most frequent drug (49 reports, 12%). Other common groups were antiinfectives for systemic use (ATC Group J; 306 reports, 19%), antineoplastic and immunomodulating agents (ATC Group L; 198 reports, 12%), and nervous system drugs (ATC Group N; 185 reports, 11%). The most common supraventricular arrhythmia was atrial fibrillation (561 reports, 51%). Regarding outcomes, 730 (66%) patients recovered, 76 (7%) did not recover, 25 (3%) recovered but with sequelae, and 23 (2%) resulted in death. This study revealed that certain drugs have reported to be associated more frequently to supraventricular arrhythmias as serious adverse reactions, especially in the older population. Proper clinical management and effective strategies to ensure medication appropriateness should always be considered to improve patient safety when prescribing drugs.

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Beta-Blocker Use in Older Hospitalized Patients Affected by Heart Failure and Chronic Obstructive Pulmonary Disease: An Italian Survey From the REPOSI Register

Cited by 10 publications

References 91 publications

Gender Differences in Potentially Inappropriate Medication Use among Older Adults

Gender Differences in Potentially Inappropriate Medication Use among Older Adults

Pharmacotherapies in Older Adults with COPD: Challenges and Opportunities

Reports of Symptoms Associated with Supraventricular Arrhythmias as a Serious Adverse Drug Reaction in the Spanish Pharmacovigilance Database

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