Communicating information about drug safety

Ferner, Robin E; Aronson, Jeff

doi:10.1136/bmj.333.7559.143

Cited by 82 publications

(57 citation statements)

References 7 publications

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“…There is no strict definition used in the literature to describe polypharmacy; a quantitative definition of polypharmacy can range from 5–10 concurrent medications (16). We recognize that even one medication inappropriately prescribed can be burdensome to the patient.…”

Section: Discussionmentioning

confidence: 99%

The Burden of Polypharmacy in Patients Near the End of Life

McNeil

Kamal

Kutner

et al. 2016

Journal of Pain and Symptom Management

108

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Context Patients with advanced illness are prescribed multiple medications in the last year of life, intensifying the risk of negative consequences related to polypharmacy. Objectives To describe the medication burden of patients near the end of life and identify potential areas for improvement in clinician prescribing practices. Methods This was a pre-specified secondary analysis of data from a prospective trial. Eligible participants were adults with less than 12 months estimated prognosis taking a statin medication for primary prevention of cardiovascular disease. Participants were enrolled from 15 sites, randomized to continue or discontinue statin medications, and followed for up to a year. Concomitant medications were recorded at least monthly from study enrollment through death. Prescribed medications were categorized by class and subclass. Descriptive statistics were calculated. Results On average, participants (N=244) were 74.3 years old (SD 11.5) and lived 264 days (SD 128); 47.5% of the patients had a primary diagnosis of malignant tumor. This population was exposed to medications across 51 classes, 192 subclasses and 423 individual medications. Patients took an average of 11.5 (SD 5) medications at the time of enrollment and 10.7 (SD 5) medications at death or study termination. The five most common classes of medications prescribed near the end of life were, anti-hypertensives, broncholytics/bronchodilators, laxatives, antidepressants, and gastric protection agents. Conclusion There is a significant medication burden placed on patients with advanced illness. Although most medications were prescribed for supportive care, we observed a high prevalence of medications for managing non-life threatening comorbidities.

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Section: Discussionmentioning

confidence: 99%

The Burden of Polypharmacy in Patients Near the End of Life

McNeil

Kamal

Kutner

et al. 2016

Journal of Pain and Symptom Management

108

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“…Quanto maior for o número de tratamentos ou de medicamentos utilizados, mais baixos são os índices de adesão ao tratamento 15 . A polifarmácia, definida como o uso de 5 (cinco) ou mais fármacos 18 , representa um problema de saúde pública e têm sido associada ao uso de medicamentos potencialmente inapropriados (MPI) para a população idosa assim como ao aumento do risco de eventos adversos, aumento da admissão hospitalar, aumento do potencial de interações medicamentosas, aumento do número de MPI, aumento da possibilidade de cascata iatrogênica, problemas de adesão ao tratamento e risco elevado de quedas 19 . Pacientes com diversas condições clínicas e que apresentam esquemas terapêuticos complexos possuem maior possibilidade de falha terapêutica, baixa adesão ao tratamento, interações medicamentosas, erro de medicação ou desenvolvimento de reações adversas ao medicamento e intoxicações 20 .…”

Section: Discussionunclassified

Avaliação Da Adesão Ao Tratamento Em Condições Crônicas De Saúde Por Meio Do Cuidado Farmacêutico

Araujo¹,

Palhão²,

Silva³

et al. 2017

Rev. Bras. Farm. Hosp. Serv. Saúde

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“…Au total, 109 principes actifs ou groupes de principes actifs sont mentionné s comme interagissant avec l'amiodarone dans une ou plusieurs des 8 sources. Mais le nombre de mé dicaments indiqué dans chaque source varie de 12 à 48 (mé diane 38) et seulement 5 se retrouvent dans toutes les sources [27]. Vitry a fait un constat de mê me nature en comparant les interactions concernant 50 mé dicaments signalé es respectivement dans le British National Formulary [40], le dictionnaire Vidal [19], Micromedex [25] et Drug Interaction Facts [24] ; 1095 interactions ont é té relevé es.…”

Section: Afssapsunclassified