Iatrogenesis and neurological manifestations in the elderly

Zerah, Lorène; Bihan, Kévin; Kohler, Samuel; Mariani, Louise‐Laure

doi:10.1016/j.neurol.2019.11.010

Cited by 6 publications

(4 citation statements)

References 98 publications

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“…In the revised tool, 'orthostatic hypotension' was added to the 'fall/fracture trigger' category, and three new diagnostic triggers were created (Table 3, Appendices 7 and 9). The list of potential causative drugs or potential causes for underuse associated with these new triggers was based on the drugs reported by the adjudication committee and in the literature [25,26,27]. To avoid overlaps and improve the relevance of the remaining triggers, we removed 'Mention of a (potential) ADE in the medical record' and 'Abrupt medication stop within 24 hours of admission' from the revised version (Table 3,…”

Section: Predictable Overlaps Were Found Between: (1) the Triggers 'I...mentioning

confidence: 99%

Performance of a trigger tool for detecting drug-related hospital admissions in older people: analysis from the OPERAM trial

et al. 2021

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Background identifying drug-related hospital admissions (DRAs) in older people is difficult. A standardised chart review procedure has recently been developed. It includes an adjudication team (physician and pharmacist) screening using 26 triggers and then performing causality assessment to determine whether an adverse drug event (ADE) occurred (secondary to an adverse drug reaction, overuse, misuse or underuse) and whether the ADE contributed to hospital admission (DRA). Objective to assess the performance of those triggers in detecting DRA. Design retrospective study using data from the OPERAM (OPtimising thERapy to prevent Avoidable hospital admissions in Multimorbid older people) trial. Settings four European medical centres. Subjects multimorbid (≥ 3 chronic medical conditions) older (≥ 70 years) inpatients with polypharmacy (≥ 5 chronic medications) were enrolled in the OPERAM trial (N = 2,008) and followed for 12 months. We included patients with ≥1 adjudicated hospitalisation during the follow-up. Methods the positive predictive value (PPV; number of DRAs identified by trigger/number of triggers) was calculated for each trigger and for the tool as a whole. Results of 1,235 hospitalisations adjudicated for 832 patients, 716 (58%) had at least one trigger; an ADE was identified in 673 (54%) and 518 (42%) were adjudicated as DRAs. The overall PPV of the trigger tool for detecting DRAs was 0.66 [0.62–0.69]. Conclusions this tool performs well for identifying DRAs in older people. Based on our results, a revised version of the tool was proposed but will require external validation before it can be incorporated into research and clinical practice.

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Section: Predictable Overlaps Were Found Between: (1) the Triggers 'I...mentioning

confidence: 99%

Performance of a trigger tool for detecting drug-related hospital admissions in older people: analysis from the OPERAM trial

et al. 2021

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“…O envelhecimento é uma condição inerente à humanidade e com ele são observadas alterações estruturais e funcionais no organismo, como a menor reserva hídrica, o aumento na quantidade de lipídios e a redução da funcionalidade hepática e renal (Zerah et al, 2020). Tais alterações incorrem diretamente em mudanças tanto na farmacodinâmica quanto na farmacocinética dos idosos, o que os torna mais vulneráveis a determinados medicamentos e seus efeitos adversos (Mercadante et al, 2021).…”

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Polifarmácia na saúde dos idosos: revisão integrativa de literatura

Castro

Figueiredo²,

Vieira³

et al. 2022

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Introdução: Em idosos acometidos de multimorbidades, o uso de polifármacos demonstrou complicações de grande relevância. Os idosos que fazem uso de em média cinco fármacos, podem aumentar os riscos de má nutrição, pneumonia, hipoglicemia, redução de mobilidade, fraturas, hospitalizações em geral e internações com longos prazos de permanência. Objetivo: Apresentar evidências científicas disponíveis até o presente, que trazem associação entre o uso de vários medicamentos e o agravamento na saúde de idosos com doenças crônicas. Metodologia: Trata-se de uma revisão de literatura, realizada nos meses de março e abril de 2022, nas seguintes bases de dados: National Library of Medicine (PubMed MEDLINE), Scientific Electronic Library Online (Scielo), Cochrane Database of Systematic Reviews (CDSR), Google Scholar, Biblioteca Virtual em Saúde (BVS) e EBSCO Information Services. Resultado e discussão: A polimedicação tem se tornado um hábito e com isso um embate crescente na experiência clínica, afetando os idosos por serem mais sucestíveis a doenças crônicas. Dentre as enfermidades encontradas, as mais comuns foram: câncer, doenças neuropsíquicas, diabetes mellitus, insuficiência renal e doenças cardiovasculares. Além da idade avançada, existe outros fatores influentes nessa problemática como o acesso fácil a medicação e a falta de informação. Considerações finais: Apesar do processo de envelhecimento natural trazer vulnerabilidades na saúde do idoso, a prescrição de medicamentos com efeitos prejudiciais quando usados simultaneamente, iatrogenia medicamentosa, também geram reações adversas. No entanto, isso pode ser evitado, com base na divulgação de estudos sobre a senescência e a senilidade e o uso responsável de fármacos.

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“…For the elderly and people with weak motion capability [1], excretion is a highfrequency, high-risk, and high-consumption feature of physical strength utilization in daily life [2], which needs to be undertaken with the help of the nursing staff. Long-term and repeated auxiliary excretion increases the physical burden and work burden of the nursing staff [3] and reduces their work efficiency [4].…”

Section: Introductionmentioning

confidence: 99%

A Novel Auxiliary Excretion Approach to a Lavatory Robot with Safety and Robustness

et al. 2022

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The excretion behavior in daily life for the elderly and the disabled is a high frequency, high physical load, and risky behavior. Therefore, we proposed an auxiliary lavatory robot (ALR) with autonomous movement and self-cleaning capability. When the nursing staff assists a user in transferring from a standing or lying state to sitting on the ALR, the ALR can follow the user according to their position and posture. Over the whole transfer process, the ALR always provides the user with the best transfer position and posture, which is an effective approach to reduce workload and physical load. However, confusion and occlusion of the lower limbs between the nursing staff and the user would affect the user’s posture recognition. First, in this paper, a method combined with object segmentation and shape constraint was proposed to extract the contour of the lower limbs of the user and the nursing staff. Then, depending on the position constraint and dynamic characteristics of the legs contour and back contour of the user, a dynamic posture recognition approach based on a two-level joint probabilistic data association algorithm (JPDA) was proposed. Finally, the leg target recognition experiment, path-tracking experiment, and auxiliary excretion transfer experiment were implemented to verify the effectiveness and robustness of our proposed algorithm. The experimental results showed that our proposed method improved the safety and convenience of the user, and it also reduced the workload and physical load of the nursing staff. The ALR, integrated with the proposed method, has a good universal property for the elderly and disabled with weak motion capability in hospitals, pension centers, and families.

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Iatrogenesis and neurological manifestations in the elderly

Cited by 6 publications

References 98 publications

Performance of a trigger tool for detecting drug-related hospital admissions in older people: analysis from the OPERAM trial

Performance of a trigger tool for detecting drug-related hospital admissions in older people: analysis from the OPERAM trial

Polifarmácia na saúde dos idosos: revisão integrativa de literatura

A Novel Auxiliary Excretion Approach to a Lavatory Robot with Safety and Robustness

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