Medication In Elderly Patients Research Articles

Characteristics of the current situation of drug use in elderly patients with chronic diseases in Chongqing: A cross-sectional survey.

Following improved accessibility to medical services, the phenomenon of polypharmacy in elderly patients with comorbidity has been increasing globally. Polypharmacy patients are prone to drug interactions, adverse drug reactions, and even the risk of death etc. Therefore, there is an urgent need to fully understand the current status and characteristics of drug use in elderly patients with chronic diseases, focusing on polypharmacy factors to ensure that medications for elderly patients are effective and safe. To collect and analyze the characteristics of the current drug use situation in elderly patients with chronic diseases in Chongqing and further explore the influencing factors for polypharmacy, providing references for formulating more effective and safe medication regimens for elderly patients. Most elderly patients affected with chronic diseases in Chongqing were willing to go to hospitals or pharmacies to buy medicines. However, they were not familiar with their disease conditions and drug-related adverse reactions and could not be regularly followed up or monitored. The number of diseases, medications, and adverse drug reactions increased with the increasing age of elderly patients. The problem of irrational use of drugs in elderly patients with chronic diseases was relatively prominent, especially the use of traditional Chinese medicines. The medication situation in elderly patients with chronic diseases was not optimistic, and the problem of polypharmacy was relatively prominent. Further large-scale studies are needed to provide a certain reference for improving the current status of drug use in elderly patients.

Perioperative management of antithrombotic therapy in elderly patients undergoing lumbar discectomy: a retrospective study on 163 patients.

The prevalence of lumbar disc herniation (LDH) has risen alongside the aging population, often necessitating neurosurgical intervention. However, managing antithrombotic medications in elderly patients with a history of major cardiovascular events (MACE) presents challenges, as treatment may require modification or cessation. This study aims to compare surgical outcomes among elderly patients receiving antithrombotic drugs and assess their impact and potential complications. The findings aim to inform the management of elderly patients with cardiovascular and spinal conditions undergoing neurosurgery. This retrospective, observational study was conducted at a single center. A total of 163 patients aged 60 or above who underwent lumbar discectomy for LDH were included. Patients were categorized into three groups based on their antithrombotic drug management: Group A (46 patients) replaced antiplatelet agents with low-dose aspirin for secondary prevention, Group B (54 patients) discontinued antiplatelet agents for primary prevention one week preoperatively and replaced them with LMWH, and Group C (63 patients) did not receive antithrombotic medication. Intraoperative blood loss, surgical time, and postoperative hospitalization were analyzed across all three groups. Continuous variables were compared between groups using the two-tailed Mann-Whitney test, with significance set at p < 0.05. No significant differences were found in intraoperative blood loss or surgical time among groups A, B, and C. Similarly, no significant differences were observed between groups B and C across all analyzed variables. No early or delayed hemorrhagic complications occurred perioperatively or during the 3-month postoperative follow-up period. The study suggests that elective discectomy surgery in patients receiving anticoagulant and antiplatelet therapies may proceed without early complications and can be safely continued perioperatively. These findings have implications for the management of elderly patients requiring neurosurgical intervention in the context of cardiovascular comorbidities.

Analysis of Beer's Criteria 2019 and Patient Characteristics of Potentially Inappropriate Medication in Elderly Patients with Diabetes Mellitus

Background: Elderly patients with type 2 diabetes mellitus with polypharmacy and various comorbidities often have problems with Potentially Inappropriate Medications (PIMs). One of the methods commonly used to detect this event is Beer's Criteria 2019.Objectives: This study aims to: (1) identify the characteristics of elderly hospitalized patients with type 2 DM; (2) analyze the incidence of PIM in patients; and (3) analyze the relationship between characteristics (age, gender, comorbidities, length of stay, and number of drugs given) with the incidence of PIMs.Methods: The research was conducted at two type C hospitals in the city of Bengkulu, with a total of 105 patients using the purposive sampling method. This research is a cross-sectional study with data collection techniques in the form of medical record data from patients for the period January – December 2022 who received drug therapy. Data analysis consists of comparing data with Beer'’s Criteria, quantitative descriptive and Fisher'’s test.Results: The research results showed that: (1) the largest age group in Hospitals ) had comorbidities, the highest number of drugs given was more than 10 types of drugs, and the majority of patients were hospitalized for less than five days; (2) There was an incidence of PIMs of 98.65% (73 patients) in Hospital (3) Statistical tests show that there is no relationship between age, gender, comorbidities, number of medications and length of stay with the incidence of PIMs.Conclusion: There is still inappropriate use of drugs given to elderly DM patients. It is hoped that further researchers will be able to find out the reasons for giving these drugs to elderly patients.

Use of High-Risk Potentially Inappropriate Medications in Elderly Patients on Polypharmacotherapy in Estonia

Use of High-Risk Potentially Inappropriate Medications in Elderly Patients on Polypharmacotherapy in Estonia

Patterns and Outcomes of Polypharmacy and Effect of Potentially Inappropriate Medications in Elderly Patients undergoing Orthopaedic Surgeries: A Retrospective Observational Study

Introduction: Prescription of Potentially Inappropriate Medication (PIM) among elderly patients is becoming a global concern. There has been an increase in the number of elderly patients coming for operative procedures, especially in orthopaedic surgery, due to the association of advanced age with chronic musculoskeletal conditions, such as osteoarthritis, and an increased incidence of fragility fractures. Aim: To determine the prevalence of polypharmacy and PIMs among elderly patients undergoing orthopaedic surgery. Materials and Methods: A retrospective observational study was conducted from February 2022 to April 2022 in the Orthopaedic Department of Anaesthesiology, MOSC Medical College, Kolenchery, Ernakulam, Kerala, India. Hospital records of 130 patients aged 65 years and above, who underwent orthopaedic surgeries from January 2016 to December 2021, were included. The prescriptions during the perioperative period were analysed for polypharmacy, defined as the use of five or more drugs. The American Geriatric Society (AGS) 2019 Beers criteria were used to identify PIMs, drug interactions, and drugsyndrome interactions. Chi-square tests were performed on clinically significant variables to assess their effect on hospital stay, with a p-value of &lt;0.05 considered significant. Results: Polypharmacy was highest on postoperative day 1, with 119 patients (91.5%) experiencing it. The study observed a high prevalence of PIMs, with 106 patients (81.53%) affected. The most commonly used PIMs were Pantoprazole, followed by Piroxicam, Regular human Insulin, and Glimepride. A significant association was observed between hospital stay ≥10 days, postoperative Intensive Care Unit (ICU) stay, and preoperative polypharmacy (p-value=0.002). Conclusion: Polypharmacy and PIMs in patients above 65 years of age admitted for surgeries remain major concerns. Further exploration of current pharmacologic practices in the perioperative period and interventions, such as physician education programs regarding PIMs, are needed.

Evaluating potentially inappropriate medications in elderly patients in a pharmacy setting in Bulgaria: A pilot study utilizing the EU (7)-PIM List

Objective: The primary aim of this study was to evaluate, for the first time, the use of the EU-7 PIM List in identifying potentially inappropriate medications among older patients. Researchers have firmly established the connection between drug-related problems, which include increased morbidity and mortality rates and the heightened utilization of healthcare services. While previous studies have focused on methodologies for identifying potentially inappropriate medications in Bulgaria, further research is warranted to explore the applicability of the widely recognized EU(7)- PIM List. Materials and methods: A prospective review was conducted on patient prescriptions aligned with the National Health and Insurance Fund, explicitly focusing on patients aged over 65 years from a single pharmacy in Veliko Turnovo City, Bulgaria. The review spanned from November 2022 to April 2023. The prescriptions analyzed in this study exclusively comprised medications covered by the insurance fund. The pharmacy manager provided patient prescription data in a coded form, which included information on the patients’ age, corresponding medications, and accompanying ICD codes. Results: The study analyzed a sample of 255 patients. Healthcare providers prescribed 2,623 medications, and 61.96% of the patients had polypharmacy, taking more than five medications daily. Among the study population, 67% with polypharmacy had at least one PIM based on the EU (7)-PIM List criteria. In total, 173 potentially inappropriate medications (PIMs) were identified. The main PIMs were categorized into four groups: alimentary tract and metabolism, blood and blood-forming organs, cardiovascular system (CVS), and nervous system. Most PIMs (75.72%) were in the ATC cardiovascular system. Within the CVS category, 11 PIMs were associated with digoxin intake and 11 with antiarrhythmics such as propafenone, flecainide, and amiodarone. In addition, trimetazidine was linked to 9 PIMs, and centrally acting antiadrenergic agents had 22 PIMs, with moxonidine being the most prevalent (n=16). Peripherally acting agents were linked to 22 PIMs, primarily doxazosin. The study identified 24 PIMs related to diuretics, specifically spironolactone, and 18 PIMs related to selective calcium channel blockers such as verapamil. The antithrombotic agent category had the highest share, with 30 identified PIMs, including acenocoumarol, dabigatran, rivaroxaban, and apixaban. Furthermore, the examination of ICD codes confirmed that most PIMs occurred within CVS, with patients having ICD I11.0 and ICD I11.9 being associated with 40 and 47 PIMs, respectively. Conclusion: This study highlights many PIMs among patients with cardiovascular diseases. Using the EU (7)-PIM List as a pilot study demonstrates its effectiveness in managing adult patients’ conditions. Given the significant role of PIMs in deprescribing strategies for older patients with polypharmacy, there is a need for prescribers, educators, and drug regulatory institutions to show increased interest in regulatory measures and specific aspects related to PIM use. This is important because the demographic trend of population ageing continues, and organizations increasingly focus on the elderly population.

Tailored interventions to improve adherence to medication in elderly patients with Parkinson’s disease: a study protocol for a randomized controlled trial (AdhCare)

BackgroundNonadherence to medication is a major issue in patients with chronic disorders such as Parkinson’s disease (PD). Many interventions for increasing adherence have been tested, and these have shown weak-to-moderate efficiency. Although the best methods to improve adherence remain unclear, it is reasonable to use tailored interventions instead of the “one-size-fits-all” approach.MethodsA randomized, controlled, triple-blinded trial in elderly patients with PD is conducted to test the efficacy of AdhCare, a tailored intervention to enhance adherence compared with that achieved with routine care (64 participants per arm). Motor function, quality of life, and adherence measures will be assessed at baseline and at 3 and 6 months of follow-up. The type of intervention depends on the main personal reason for nonadherence (e.g., forgetting to take the medication or poor knowledge about the medication).DiscussionThe results of this study will provide valuable information for health professionals and policymakers on the effectiveness of tailored interventions in elderly patients with PD.Trial registrationGerman Clinical Trials Register DRKS00023655. Registered on 24 February 2021. Last update on 22 March 2023.

Medication complexity and COVID-19 pandemic impact on the cost burden in non-COVID elderly patients at the emergency department

Background: The global increase in the elderly population and the incidence of emergency conditions due to physiological changes pose cost challenges for emergency services. COVID-19 potentially affects the financial burden of medication in elderly patients. Objective: To analyse the impact of medication complexity on the cost burden in elderly patients admitted to the Emergency Department (ED) before and during the COVID-19 pandemic. Method: A retrospective observational study was conducted among elderly patients (aged &gt; 60 years) who visited ED but were not hospitalised between January to April 2020. The medication complexity was measured using the Medication Regimen Complexity Index (MRCI) while the cost was collected from the hospital information system. Result: A total of 321 ED visits were included in this study. The results showed that the mean of the total medication was 3.89 ± 1.70, while the mean score of the MRCI was 15.20 ± 6.54. The mean medication cost required was IDR 56,342 for each ED visit. Conclusion: This study provided an overview and input to control medication costs for elderly patients in the emergency setting. Interested parties can design policies that are beneficial in economics and therapeutic outcomes.

The relationship between the role of the family and the use of control card with the level of compliance with medication in elderly patients at UPTD Puskesmas Wonokromo

Introduction: Non-compliance is the cause of therapy failure, which has an impact on the worsening of the patient's condition because of complications and damage to organs. Family support plays an important role for the elderly because the family is a support system, which requires the presence of the family to assist in daily activities, for example in terms of reminding you to take medication regularly and so on. The purpose of this study was to analyze the relationship between the role of the family and the use of control cards with the level of adherence to medication in elderly patients. Methods: This research is an analytic correlation with a cross-section approach. The population in this study was all elderly in the UPTD Puskesmas Wonokromo, with a total of 993 elderly. The number of samples studied amounted to 285 respondents. The data collection technique used non-probability sampling purposive sampling, the instrument used was a family role questionnaire, a Morisky Medication Adherence Scale (MMAS) medication adherence quasi-satire, and a drug control card sheet. Data analysis using a rank- spearman statistic test with a significant value of p &lt; = 0.05. Results: The results showed that of the 285 respondents, almost half (49.1%) had good family roles, most (55.4%) had routine control cards and most (55.4%) medication adherence was obedient. Based on the Spearman rank test found that the significance level &lt; = 0.05, so there is a relationship between family roles and the use of control cards with the level of adherence to taking medication for elderly patients. Conclusion: There is a relationship between the role of the family and the use of control cards with the level of adherence to taking medication in elderly patients.

Experience of teaching doctors the principles of rational pharmacotherapy on the example of patients with a fall in a hospital

The postgraduate education of doctors in the principles of rational pharmacotherapy, conducted on the educational program «Polypragmasia in a therapeutic and preventive organization: a problem and a solution» of 36 academic hours, allowed to reduce the total number of simultaneously prescribed medications in elderly patients of a cardiological profile in a gerontological hospital (the number of medications received by patients older than 75 years before and after training, respectively 9.48±2.6 vs 7.12±1.9, p&lt;0.001). A decrease in polypragmasia contributed to a decrease in the frequency of suspected unforeseen serious adverse reactions, which included falls associated with taking medications. The simultaneous introduction of Safety Protocols, Standard Operating Procedures for identifying patients at high risk of falling and conducting incident analysis led to the analysis of each case of an elderly and senile patient falling in a hospital and a review of the treatment received.

Relationship between Side Effects of Anti-tuberculosis Drugs (ATDs) and Adherence to Medication in Elderly Patients with Tuberculosis

One of the obstacles to the treatment of tuberculosis (TB) patients is the sideeffects of anti-tuberculosis drugs (ATDs) which cause patients to be reluctant to continue the medication. The elderly experience various physical and physiological changes in the bodysystem, including susceptibility to drug side effects, decreased knowledge and memory,resulting in non-compliance with taking the medication. This study aims to determine therelationship between ATDs side effects and compliance with taking medication for elderlypatients at the Tanjung Selor Health Center, Bulungan Regency, North Kalimantan Province.This study used a quantitative cross-sectional approach. The sample was taken by totalpopulation, namely elderly tuberculosis patients undergoing tuberculosis treatment as many as30 respondents. The research instrument was a questionnaire of drug side effects and ATDscompliance. Statistical test used Fisher's Exact. The results showed that most patients (76.7%)complained of OAT side effects and the rest without OAT side effects (23.3%). Treatmentcompliance was 20% compliant, and 80% were non-compliant. Fisher's Exact statistical testobtained p-value = 0.016 (&lt; α = 0.05). It was concluded that there was a significant relationship between OAT side effects and treatment compliance in elderly patients with tuberculosis. Recommendations for health workers to give special attention to elderly patients with medication monitoring and compliance motivation. Future researchers should identify the involvement of family and health workers to monitor the side effects of anti-tuberculosis drugs.

Prevalence and clinical implications of polypharmacy and potentially inappropriate medication in elderly patients with heart failure: results of six months' follow-up.

To investigate the prevalence of polypharmacy and potentially inappropriate medication (PIM) in elderly patients with heart failure (HF) and their impact on readmission and mortality. We conducted a study of 274 participants aged 60 years or older with HF. The prevalence of polypharmacy (defined as the use of five or more medications) was calculated, and the 2019 American Geriatrics Society Beers criteria were applied to access PIMs. Medications and PIMs were characterized at admission and discharge, and changes in prescriptions during hospitalization were compared. The impact of polypharmacy and PIM on readmission and mortality were investigated. The median age of this study population was 68 years old. The median number of prescribed drugs was 7 at admission and 10 at discharge. At discharge, 99.27% of all patients were taking five or more drugs. The incidence of composite endpoint and cardiovascular readmission increased with the number of polypharmacy within 6 months. The use of guideline-directed medical therapy reduced the incidence of composite endpoint events and cardiovascular readmission, while the use of non-cardiovascular medications increased the composite endpoint events. The frequency of PIMs was 93.79% at discharge. The incidence of composite endpoint events increased with the number of PIMs. "PIMs in older adults with caution" increased cardiovascular readmission and "PIMs based on kidney function" increased cardiovascular mortality. Several comorbidities were associated with cardiovascular mortality or non-cardiovascular readmission. Polypharmacy and PIM were highly prevalent in elderly patients with HF, and their use was associated with an increased risk of composite endpoint events, readmission and mortality. Non-cardiovascular medications, "PIMs in older adults with caution", "PIMs based on kidney function" and several comorbidities were important factors associated with hospital readmission and mortality. Our findings highlight the importance of medication optimization in the management of HF in elderly patients.

Ultrasound-guided stellate ganglion block for the treatment of migraine in elderly patients: A retrospective and observational study.

This study aimed to assess the effectiveness and safety of ultrasound-guided stellate ganglion block (SGB) in the prophylactic treatment of migraine in the elderly. Treatment of migraine in the elderly is often difficult and troublesome due to multiple comorbidities, drug interactions, and adverse effects (AEs). SGB may be an effective treatment approach for migraine in the elderly as its clinical use is rarely limited by concomitant diseases and age-related physiological changes; however, no studies have evaluated the effectiveness of SGB in the treatment of migraine in the elderly population. This is a retrospective observational case series study. We retrospectively analyzed patients with migraine aged ≥65 years, who underwent ultrasound-guided SGB for headache management between January 2018 and November 2022. Pain intensity using the numerical rating scale (NRS, 0-10), number of days with headache per month, duration of headache, and the consumptions of acute medications were recorded before SGB treatment, and at 1, 2, and 3 months after the last SGB. Safety assessment included thorough documentation of serious and minor AEs related to SGB. Of 71 patients, 52 were analyzed in this study. After the final SGB, the NRS scores decreased significantly from a mean (± standard deviation [SD]) of 7.3 (1.2) at baseline to 3.3 (1.4), 3.1 (1.6), and 3.6 (1.6) at 1, 2, and 3 months, respectively (vs. baseline, p < 0.001). The mean (SD) number of headache days per month significantly reduced from 23.1 (5.5) to 10.9 (7.1) (p < 0.001), 12.7 (6.5) (p = 0.001), and 14.0 (6.8) days (p = 0.001) at the 1-, 2-, and 3-month follow-ups, respectively. The values of headache duration were also significantly lower at the 1-month (mean [SD] 12.5 [15.8] h, p = 0.001), 2-month (mean [SD] 11.3 [15.9] h, p = 0.001), and 3-month follow-ups (mean [SD] 14.3 [16.0] h, p = 0.001) compared to pre-treatment baseline (mean [SD] 22.7 [17.1] h). There were 33/52 (64%) patients experiencing at least a 50% reduction in acute medications consumption 3 months after the final SGB treatment. The overall AEs rate associated with ultrasound-guided SGB was 9.0% (26/290 SGBs). There were no serious AEs; all reported AEs were minor and transient. Stellate ganglion block treatment could reduce pain intensity, headache frequency, and duration of migraine, thereby reducing the need for adjunctive medications in elderly patients. Ultrasound-guided SGB might be a safe and effective intervention for the treatment of migraine in elderly patients.

A Review of Clinical Influencing Factors in the Selection of Cardiac Medications in the Elderly

Aging is a stage of the natural life cycle. It is a set of natural and coordinated growth changes all organs and body systems undergo to burnout. It is impossible to determine the exact time of old age for two reasons. First, the aging process is different for humans due to individual, hereditary factors. Second, aging has a set of physiological, psychological and, social factors. This review aimed to gather appropriate clinical information and facts for clinicians when practicing heart medications in elderly patients, preventing potentially inappropriate practices. The absorption of heart medications decreases due to diminished bowel movements in the elderly. In the elderly, the blood flows to the entire gastrointestinal tract decreases and as a result, the entry of the medications into the general bloodstream decreases. Delayed absorption weakens the potency of the medication while prolonging its effects. These effects might be unsafe because most heart medications have a narrow therapeutic index. Factors influencing the selection of alpha &amp;amp; beta blockers, nitrates, CCCBs, ACE-Is, diuretics, and digoxin will be reviewed.

Patients with elderly onset inflammatory bowel disease have a decreased chance of initiation of all types of medications and increased risk of surgeries-A nationwide cohort study.

In patients with elderly (≥60 years) onset inflammatory bowel disease (IBD), we studied initiation of medications, drug persistency and surgeries. A nationwide cohort study based on Danish registries, comprising incident IBD patients ≥18 years from 1995 to 2020 (N = 69,039). Patients were divided into elderly (N = 19,187) and adult onset (N = 49,852). Outcomes were initiation of thiopurines, 5-ASA, biologics and corticosteroids within 1 and 5 years after diagnosis, and for those who initiated medications, we estimated drug persistency. Surgeries were examined within 1 and 5 years. We used regression models controlling for covariates. In elderly patients, the adjusted hazard ratios (aHR) for initiating thiopurines, 5-ASA and biologics within 1 year were 0.44 (95% CI 0.42-0.47), 0.77 (95% CI 0.75-0.79) and 0.29 (95% CI 0.26-0.31) respectively. The results were similar within 5 years. In elderly patients, drug persistency for thiopurines, 5-ASA and biologics was not impaired within 5 years. The aHR of stopping steroids within 1 and 5 years were 0.80 (95% CI 0.76-0.84) and 0.77 (95% CI 0.74-0.80) respectively. The risk of surgeries was increased in the elderly patients (in ulcerative colitis, within 5 years, aHR 1.39 [95% CI 1.27-1.52], and in Crohn's disease 1.13 [95% CI 1.04-1.23]). We found significantly low chance of initiation of IBD medications in elderly patients, the reason may not be due to mild disease course. In elderly patients, drug persistency was comparable to adults. Clinicians should carefully consider whether they underuse IBD-specific medications in elderly patients, and special attention should be applied to timely discontinuation of corticosteroids.

Adherence to medication in elderly patients

Adherence to medication in elderly patients

The interaction between physical frailty and prognostic impact of heart failure medication in elderly patients.

Frailty is highly prevalent and associated with poor prognoses in elderly patients with heart failure (HF). However, the potential effects of physical frailty on the benefits of HF medications in elderly patients with HF are unclear. We aimed to determine the influence of physical frailty on the prognosis of HF medications in elderly patients with HF with reduced and mildly reduced ejection fraction (HFr/mrEF). From the combined HF database of the FRAGILE-HF and Kitasato cohorts, hospitalized HF patients with a left ventricular ejection fraction<50% and age≥65years were analysed. Patients treated with or without renin-angiotensin-aldosterone system inhibitors (RAASi) and beta-blockers at discharge were compared. Physical frailty was defined by the presence of ≥3 items on the Japanese version of the Cardiovascular Health Study criteria. The primary endpoint was all-cause mortality rate. Among the 1021 enrolled patients, 604 patients (59%) received both RAASi and beta-blockers, and 604 patients (59%) were diagnosed as physically frail. Patients receiving both RAASi and beta-blockers showed a significantly lower 1year mortality than those not receiving either, even after adjusting for covariates (hazard ratio: 0.50, 95% confidence interval: 0.34-0.75). This beneficial effect of both medications on 1year mortality was comparable between patients with and without physical frailty (hazard ratio: 0.53 and 0.51, respectively; P for interaction=0.77). The presence of physical frailty did not interact with the beneficial prognostic impact of RAASi and beta-blocker combination therapy in elderly patients with HFr/mrEF.

Comparative Safety and Effectiveness of Direct Oral Anticoagulants and Warfarin during Chemotherapy in Cancer Patients with Venous Thromboembolism Aged 75 Years or Older: A Nationwide Inpatient Database Study

Introduction: Venous thromboembolism (VTE) is a life-threatening complication occurring in cancer patients. Direct oral anticoagulants (DOACs) or warfarin are widely prescribed for treating cancer-associated VTE. However, data are sparse as to the effectiveness and bleeding complications associated with these medications in elderly patients. The purpose of this study was to compare effectiveness and safety profiles between DOACs and warfarin in elderly cancer patients undergoing chemotherapy. Methods: Using the Diagnosis Procedure Combination inpatient database, we retrospectively identified cancer patients aged ≥75 years who developed VTE during chemotherapy (n = 4,278, January 2016 to March 2020). Eligible patients were divided into those receiving warfarin (n = 557) and DOACs (n = 3,721). We conducted a 1:4 propensity score matching analysis to adjust for measured confounders. The primary outcome was VTE recurrence requiring hospitalization. Secondary outcomes were major bleeding requiring hospitalization and inhospital death from all causes within 6 months. Results: The propensity-matched cohort included 557 patients in the warfarin group and 2,278 patients in the DOACs group. The proportion of VTE recurrence requiring hospitalization was lower in the DOACs group (5.3% vs. 7.5%; odds ratio [OR], 0.69; 95% confidence interval [CI], 0.48–0.98). The proportion of recurrent deep vein thrombosis was 6.3% and 4.4%, while that of recurrent pulmonary emboli was 1.3% and 1.3% in the warfarin and DOACs groups, respectively. No statistically significant differences were found in the proportion of major bleeding events requiring hospitalization (1.6% vs. 1.1%; OR, 1.47; 95% CI, 0.62–3.50) or all-cause inhospital mortality (11.1% vs. 9.9%; OR, 1.14; 95% CI, 0.84–1.56) between the DOACs and warfarin groups. Conclusion: Our findings suggest that DOACs may be more effective than warfarin in terms of VTE recurrence requiring hospitalization and that these medications may be equivalent in terms of safety.

A Cross Sectional Study to Evaluate Medication Compliance among Patients with Hypertension

The purpose of this study is to investigate the level of compliance of patients with hypertension to the medication given to them. For this purpose, a quantitative cross-sectional study was carried out in a sample of 73 elderly patients with hypertension. The Self-Efficacy For Appropriate Medication Use Scale (SEAMS) was used to assess medication compliance. The research findings showed that elderly patients with hypertension show a moderate level of compliance to medication. Years since diagnosis, age and years since initiation of treatment were significantly associated with the level of medication compliance in these patients. More studies are needed to illuminate the factors that influence the level of compliance with medication in elderly patients with hypertension.

Association of drug therapy with falls in elderly and senile patients: Subanalysis of the epidemiological study EVKALIPT

Aim to evaluate the structure of drug therapy in patients with falls and to identify the associations of falls with drug administration.&#x0D; Material and methods. This work is a subanalysis of the epidemiological study EVKALIPT. 4301 patients who had information about presence or absence of falls in the previous year were selected. The patients were divided into 2 groups: 1 group (n = 1307) having falls, 2 group (n = 2994) without falls. We studied the complaints and medical history, conducted general examination and analyzed medical documentation to get the information on drug treatment. A regular intake of 5 or more drugs was considered polypharmacy.&#x0D; Results. All patients had chronic diseases. In patients with falls, most diseases were more common, the Charlson Comorbidity Index was higher (5.532.4 versus 4.732.03, p0.001), as well as the proportion of high comorbidity (62.2% versus 47.7%, p0.001). All study participants took medications, on average 5.4 2.6 drugs. The patients with falls received higher number of drugs (5.732.6 versus 5.32.5, p0.001). The frequency of polypharmacy was 64.6% and 56.7% (p0.001) in groups 1 and 2, respectively. The patients with falls were more likely to take sartans, beta-blockers, diuretics, centrally acting antihypertensives, anticoagulants, nitrates, amiodarone, insulin, NSAIDs, proton pump inhibitors, calcium, vitamin D, anti-osteoporrotic therapy. Administration of a number of drugs was associated with falls (OR 1.18-2.15). For some drugs, a trend in favor of falls was revealed. Only statin therapy was associated with a 24% reduction in the odds of falling. The presence of polypharmacy increased the risk of falls by 1.3 times (OR 1.27, 95% CI 1.10-1.46, p=0.001).&#x0D; Conclusion. Polypharmacy and drug evaluation are important in assessing the risk of falls. In clinical practice, it is necessary to regularly conduct an audit of medications in elderly patients.