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(searched for: doi:10.1007/s40520-020-01772-0)
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Melanie Murphy, Kathleen Bennett, Marie Wright, Martina O’Reilly, Marian Conroy, Carmel Hughes, Sarah McLean,
Published: 15 November 2022
International Journal of Clinical Pharmacy pp 1-10; https://doi.org/10.1007/s11096-022-01506-4

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Camilla da P. Tranhago, Luana L. Colatto, , Alexandra S. Do C. Teixeira, André De O. Baldoni, Lorena R. Ayres, Daniela A. M. G. Do Bem
Published: 1 November 2022
Journal of Pharmacy Practice; https://doi.org/10.1177/08971900221137629

Abstract:
Background: The use of potentially inappropriate medications (PIM) by the elderly is commonly studied, but studies evaluating the use of PIM by frail elderly covered by prepaid health plans are still lacking. Objective: To identify the prevalence of use and the factors associated with the use of PIM by the elderly patients with high and moderate risk of clinical-functional vulnerability, according to the Beers criteria 2019. Methods: A cross-sectional study was developed with elderly people from a private health plan in Vitória-ES, Brazil. Socioeconomic, demographic and clinical data were collected through a digital platform and a structured questionnaire through an interview, from October 2018 to June 2019. The association between the use of PIM and independent variables was verified by univariate logistic regression with their respective confidence intervals (CI) 95%. The Multiple Model included the variables with P ≤ .20. Results: 332 elderly patients were interviewed (mean age 81.5 years, gender 237 female, 95 male). A 65% prevalence of PIM use was identified. In the multiple logistic regression model, the variables associated with the use of PIM were self-medication ( P = .004), high risk of clinical-functional vulnerability ( P = .022), use of psychotropic medications ( P = .000001), musculoskeletal medications ( P = .04) and alimentary tract medications ( P = .03). Physical exercises were considered a protection factor ( P = .02). Conclusion: The high prevalence of PIM use indicates the need for improvement in elderly private health care, to increase pharmacotherapy safety for this population.
, Julie Byles, Syed Shahzad Hasan, Nicholas Egan,
International Journal of Pharmacy Practice, Volume 29, pp 548-555; https://doi.org/10.1093/ijpp/riab054

Abstract:
Objectives: Home Medicines Reviews (HMRs) can optimize medications for frail older adults. This study aimed to determine the use of HMRs according to frailty status and the association between frailty and use of HMRs. Methods: The study included 9139 female participants enrolled in the Australian Longitudinal Study on Women’s Health from 2003 (aged 77–82 years) to 2017 (aged 91–96 years). Generalized estimating equations (GEEs) using log-binomial regressions were used to determine associations using repeated measures on individuals over time. Key findings: The majority of participants in the study remained non-frail and did not receive HMRs from 2003 [7116 (77.86%)] to 2017 [1240 (71.31%)]. The use of HMRs was low in both groups with 33 (1.68%; 95% CI, 1.16 to 2.36) frail and 64 (0.89%; 95% CI, 0.69 to 1.14) non-frail participants receiving HMRs in 2003; by 2017, 19 (4.19%; 95% CI, 2.54 to 6.46) frail and 45 (3.50%; 95% CI, 2.57 to 4.66) non-frail participants received HMRs. Frailty was not associated with receiving a HMR (RR 1.06; 95% CI, 0.95 to 1.20), although for every 1-year increase, participants were 10% more likely to receive a HMR (RR 1.10; 95% CI, 1.09 to 1.11). Participants with continuous polypharmacy, ≥4 chronic diseases, >4 general practitioner visits and Department of Veterans Affairs coverage were more likely to receive a HMR. Conclusions: Despite the proven value of HMRs for frail older people, HMRs were not used for most frail and non-frail community-dwelling women in this study. Reasons for low use of the service should be explored, with interventions to raise awareness of the benefits of the service.
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