Excessive polypharmacy and survival in polypathological patients

Díez-Manglano, Jesús; Giménez-López, Mercedes; Garcés-Horna, V.; Sevil-Puras, María; Castellar-Otín, Elena; González-García, Paloma; Fiteni-Mera, Isabel; Morlanes-Navarro, Teresa

doi:10.1007/s00228-015-1837-8

Cited by 43 publications

(26 citation statements)

References 32 publications

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“…In recent years, with the increase in the ageing society in Japan, polypharmacy has become a major problem in medical care. Although polypharmacy has not yet been clearly defined, prescription of 5 or more drugs is defined as polypharmacy in the majority of studies . Furthermore, a potentially inappropriate prescription is also included in the descriptive definition of polypharmacy .…”

Section: What Is Known and Objectivementioning

confidence: 99%

Polypharmacy in elderly patients in Japan: Analysis of Japanese real‐world databases

et al. 2020

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What is known and objective Polypharmacy is associated with an increased risk of adverse drug reactions (ADRs) and drug interactions, decreased adherence to medication and increased medical cost. Recently, polypharmacy has become a major problem in medical care in Japan as a result of the increase in the ageing population. The purpose of this study was to investigate the current situation of polypharmacy and the association between polypharmacy and adverse events. Methods A retrospective data analysis was performed using two different real‐world data from 2007 to 2015 in Japan. The Japanese Adverse Drug Event Report (JADER), a public spontaneous adverse drug reaction database constructed by the Pharmaceuticals and Medical Devices Agency (PMDA), and a large prescription database constructed by a database vendor (Japan Medical Information Research Institute, Inc Japan [JMIRI]) were analysed. Trends of polypharmacy during the study period were investigated. Results and discussion The mean number of drugs per report in the JADER database and per prescription in the JMIRI databases during the study period ranged from 4.8 to 5.6 and 3.5 to 3.7, respectively. The mean number of drugs increased with age in both the JADER and JMIRI databases, and the peak of the mean number of drugs was at 80‐89 years (5.74 drugs) in the JADER database and at 90‐99 years (4.97 drugs) in the JMIRI database. What is new and conclusions The number of drugs increased until age 90 years or more, even though adverse events are more likely to occur after the age of 80 in Japan. Therefore, polypharmacy in the elderly should be focused on the patients aged ≥80 years rather than patients aged ≥65 years from the viewpoint of the prevention of adverse events.

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Section: What Is Known and Objectivementioning

confidence: 99%

Polypharmacy in elderly patients in Japan: Analysis of Japanese real‐world databases

et al. 2020

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“…Apesar do sexo feminino não ter apresentado diferenças significativas quanto ao masculino, em outros estudos o sexo feminino esteve associado ao maior uso de polifarmácia (41,42) . Os motivos das razões do uso de medicamentos entre idosas, independente da polifarmácia, parecem estar ligados a diversas variáveis, dentre elas as de ordem biológica, as de ordem psicológica e também as variáveis de ordem sociocultural (41) .…”

Section: Discussionunclassified

Erros De Prescrição Em Uma Farmácia Básica Do Distrito Federal

et al. 2019

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RESUMOObjetivo: Analisar prescrições eletrônicas e manuais quanto à ocorrência de polifarmácia e tipos potenciais de erros de medicação no contexto da atenção primária. Material e método: Estudo de caráter descritivo, transversal e retrospectivo, baseado na avaliação de prescrições manuais e eletrônicas arquivadas na farmácia da Unidade Básica de Saúde do Distrito Federal de Brasília (DF). Foram incluídas as segundas vias das prescrições para as doenças crônicas não transmissíveis. Resultados: 1500 prescrições foram analisadas. Apontaram a não totalidade dos critérios de avaliação proposto neste estudo, dentre eles: ilegibilidade (35,5%), abreviaturas (97,7%), forma farmacêutica (57,6%), concentração (32,4%). A polifarmácia foi identificada em 46% dos usuários e estava diretamente relacionada à idade do usuário. Conclusão: As prescrições apresentaram incompletude de informações em relação ao que estabelece a legislação, são necessárias estratégias que busquem melhorar a promoção de saúde na atenção básica, como trabalhos de educação permanente e que visem sensibilizar os prescritores e demais atores envolvidos neste processo sobre o ato de prescrever medicamentos. Palavras chave: Polifarmácia; Atenção primária; Saúde; Erros de prescrição; Enfermagen em Saúde Comunitária. * Enfermeira. Docente da Estácio FATERN. Natal, Brasil. ABSTRACTObjective: To analyze electronic and manual prescriptions regarding the occurrence of polypharmacy and potential types of medication errors in the context of primary care. Material and method: A descriptive, cross-sectional and retrospective study based on the evaluation of prescriptions filed at the pharmacy of a Basic Health Unit of the Federal District of Brazil. Copies of prescriptions for chronic non-communicable diseases were included. Results: 1500 prescriptions were analyzed according to evaluation criteria, such as illegibility (35.5 %), abbreviations (97.7%), dosage form (57.6%), and concentration (32.4%). Polypharmacy was identified in 46% of users and it was directly related to the age of the user. Conclusion: Prescriptions presented incomplete information regarding current legislation. Strategies that seek to improve health promotion in primary care, such as permanent education and more awareness from prescribers and other actors involved in the process of prescribing medications, are required. RESUMENObjetivo: Analizar prescripciones electrónicas y manuales en cuanto a la ocurrencia de polifarmacia y tipos potenciales de errores de medicación en el contexto de la atención primaria. Material y método: Estudio de carácter descriptivo, transversal y retrospectivo, basado en la evaluación de prescripciones manuales y electrónicas archivadas en la farmacia de la Unidad Básica de Salud (UBS) del Distrito Federal (Brasil). Se incluyeron los duplicados de las prescripciones para las enfermedades crónicas no transmisibles. Resultados: Se analizaron 1.500 prescripciones considerando la no totalidad de los criterios de evaluación propuestos en este estudio, entre ellos: ilegibilid...

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“…It is therefore not surprising that most patients are at an increased risk of renal toxicity. The risk is linked to the complex polypharmacy that is usually prescribed in patients with diabetes and advanced CKD [256][257][258]. A recent review summarized potential drug-disease interactions between drugs recommended in the guideline for type 2 diabetes and 11 comorbid conditions.…”

Section: Adverse Environmental and Drug-disease Effects And Acute Ormentioning

confidence: 99%

Diabetic Kidney Disease: A Syndrome Rather Than a Single Disease

Piccoli¹,

Grassi²,

Cabiddu³

et al. 2015

Rev Diabet Stud

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The term "diabetic kidney" has recently been proposed to encompass the various lesions, involving all kidney structures that characterize protean kidney damage in patients with diabetes. While glomerular diseases may follow the stepwise progression that was described several decades ago, the tenet that proteinuria identifies diabetic nephropathy is disputed today and should be limited to glomerular lesions. Improvements in glycemic control may have contributed to a decrease in the prevalence of glomerular lesions, initially described as hallmarks of diabetic nephropathy, and revealed other types of renal damage, mainly related to vasculature and interstitium, and these types usually present with little or no proteinuria. Whilst glomerular damage is the hallmark of microvascular lesions, ischemic nephropathies, renal infarction, and cholesterol emboli syndrome are the result of macrovascular involvement, and the presence of underlying renal damage sets the stage for acute infections and drug-induced kidney injuries. Impairment of the phagocytic response can cause severe and unusual forms of acute and chronic pyelonephritis. It is thus concluded that screening for albuminuria, which is useful for detecting "glomerular diabetic nephropathy", does not identify all potential nephropathies in diabetes patients. As diabetes is a risk factor for all forms of kidney disease, diagnosis in diabetic patients should include the same combination of biochemical, clinical, and imaging tests as employed in non-diabetic subjects, but with the specific consideration that chronic kidney disease (CKD) may develop more rapidly and severely in diabetic patients.

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Excessive polypharmacy and survival in polypathological patients

Abstract: A greater use of drugs may not be harmful but is also not associated with a higher probability of survival in polypathological patients.

Cited by 43 publications

References 32 publications

Polypharmacy in elderly patients in Japan: Analysis of Japanese real‐world databases

Polypharmacy in elderly patients in Japan: Analysis of Japanese real‐world databases

Erros De Prescrição Em Uma Farmácia Básica Do Distrito Federal

Diabetic Kidney Disease: A Syndrome Rather Than a Single Disease

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