Elderly and Polypharmacy: Physiological and Cognitive Changes

Rodrigues, Daniela; Herdeiro, María Teresa; Figueiras, Adolfo; Coutinho, Paula; Roque, Fátima

doi:10.5772/intechopen.92122

Cited by 9 publications

(6 citation statements)

References 44 publications

(61 reference statements)

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“…Contrary to our clinical hypothesis, no significant correlation was observed between obesity and a prolonged LOS [ 7 - 9 ]. Similar studies have shown no statistically significant difference between patients with and without obesity and postoperative morbidity [ 10 ]. Moreover, a recent meta-analysis of 19 studies established that there was no significant difference in 30-day mortality or postoperative complications between patients with and without obesity [ 11 ].…”

Section: Discussionmentioning

confidence: 68%

Factors Associated With Prolonged-Stay Patients Within the Post-anesthesia Care Unit: A Cohort Retrospective Study

Alghamdi,

Filfilan,

Alghamdi

et al. 2024

Cureus

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Background: The post-anesthesia care unit (PACU) plays a crucial role in providing specialized care to postoperative patients. However, a subset of these patients experiences complications that result in a prolonged stay of 90 minutes or more in the PACU. This not only impacts the patient's quality of life but also disrupts hospital workflow, as it might cause postoperative pain, nausea, or vomiting. It is essential to identify the factors contributing to this prolonged length of stay (LOS) and explore strategies for its prevention and management.Methods: We conducted a retrospective cohort study of postoperative patients between 2020 and 2021. We included patients who had a prolonged stay, excluding cardiac patients, patients who had a planned prolonged stay, and patients waiting for an intensive care unit bed. We used a non-probability consecutive sampling technique. Data were obtained from the BestCare System, the hospital's information system, using a data collection sheet.Results: A total of 15,170 patients underwent surgical procedures during the study period, out of which only 181 (1.19%) experienced a prolonged PACU stay. Pain and altered mental status were strongly associated with a prolonged PACU stay (P = 0.035 and P = 0.0009, respectively). However, there was no significant association between overall comorbidities and prolonged LOS in the PACU, except for patients with asthma (P = 0.003). Different types and durations of surgeries did not significantly contribute to a prolonged PACU stay.Conclusions: Our study found that among the various variables examined, asthma, pain, and altered mental status were significantly associated with a prolonged LOS in the PACU. These findings suggest that targeted interventions addressing these factors may help reduce the incidence of prolonged PACU stays and optimize patient outcomes.

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Section: Discussionmentioning

confidence: 68%

Factors Associated With Prolonged-Stay Patients Within the Post-anesthesia Care Unit: A Cohort Retrospective Study

Alghamdi,

Filfilan,

Alghamdi

et al. 2024

Cureus

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“…Drug interactions, common in polypharmacy, can cause synergistic toxicity and thus be risk factors, such as the combination of corticosteroids and NSAIDs. Polypharmacy leads to problems in medication adherence and correct administration representing a risk for adverse events or ADR [31,36,37].…”

Section: The Healthcare Impact Of Adr In Older Patientsmentioning

confidence: 99%

“…Associating these criteria with information management tools such as Clinical decision support systems [CDSS] can allow improvements in patient therapy. These CSSDs, usually computerized, can verify interactions between medicine-disease or medicine-medicine, also detecting PIM [36].…”

Section: Potentially Inappropriate Medication For Older Adultsmentioning

confidence: 99%

“…In addition, they are more in line with the European reality, also having greater sensitivity demonstrated for the identification of inappropriate prescriptions. Although the STOPP criteria is explicit, only 29 of the 81 STOPP criteria can be applied only with information on the patient's medication profile [36].…”

Section: Potentially Inappropriate Medication For Older Adultsmentioning

confidence: 99%

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Pharmacovigilance in Older Adults

Gomes¹,

Gomes²,

Ribeiro-Vaz³

et al. 2021

New Insights Into the Future of Pharmacoepidemiology and Drug Safety

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Polypharmacy and physiological changes inherent to the aging process can cause significant modifications in the pharmacokinetic and dynamic regimens of drugs, making the elderly more susceptible to adverse drug effects. Adverse drug reactions (ADR) in older adults have a significant impact on hospital admissions, increasing hospital stay and healthcare costs. Most common ADR in this population are dose-related and predictable. However, they can be difficult to diagnose as they often have nonspecific symptoms. This could be minimized by decreasing the use and prescription of potentially inappropriate medication and being aware of possible drug interactions. Besides, being older patients underrepresented in clinical trials and due to their physiological modifications, serious or atypical ADR are more common in this age range. To minimize harm in older adults, effective pharmacovigilance must be encouraged.

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“…Aging involves pharmacokinetic and pharmacodynamic changes. 1 Older adults have a reduced ability to adjust to external environmental changes, increased susceptibility to disease, and a reduced ability to recover, which leads to a modified drug response and greater vulnerability to adverse drug reactions. 2 , 3 , 4 …”

Section: Introductionmentioning

confidence: 99%