Association between Statins Prescribed for Primary and Secondary Prevention and Major Adverse Cardiac Events among Older Adults with Frailty: A Systematic Review
ConclusionThis review identified only observational evidence that among older people with frailty, statins are associated with reduced mortality when prescribed for secondary prevention, and an absence of evidence evaluating statin therapy for primary prevention. Randomised trial data are needed to better inform the use of statins among older adults living with frailty. (Source: Drugs and Aging)
Source: Drugs and Aging - September 15, 2020 Category: Geriatrics Source Type: research

Sedative Load in Community-Dwelling Older Adults with Mild –Moderate Alzheimer’s Disease: Longitudinal Relationships with Adverse Events, Delirium and Falls
AbstractBackgroundOlder adults are frequently prescribed medications with sedative effects, which are associated with numerous adverse consequences. However, the prevalence and longitudinal associations of sedative medication use in community-dwelling older adults with mild –moderate Alzheimer’s disease (AD) has not been explored to date.ObjectivesOur objective was to assess the prevalence of sedative medication use in community-dwelling older adults with mild –moderate AD and examine the longitudinal association between sedative medication use and adverse events (AEs).MethodsThe association between basel...
Source: Drugs and Aging - September 14, 2020 Category: Geriatrics Source Type: research

Romosozumab: A Review in Postmenopausal Osteoporosis
AbstractRomosozumab (Evenity®), a humanized monoclonal antibody, promotes bone formation and inhibits bone resorption by inhibiting sclerostin, a protein involved in the regulation of bone formation. Subcutaneous romosozumab is approved in several countries, including those of the EU for treating severe osteoporosis as well as in the USA for osteoporosis in postmenopausal women at high risk of fracture. In pivotal phase III trials (FRAME and ARCH), 12  months’ once-monthly romosozumab 210 mg significantly reduced vertebral and clinical fracture risk versus placebo and oral alendronate in postmenopausal ...
Source: Drugs and Aging - September 10, 2020 Category: Geriatrics Source Type: research

Correction to: Suitable Use of Injectable Agents to Overcome Hypoglycemia Risk, Barriers, and Clinical Inertia in Community-Dwelling Older Adults with Type 2 Diabetes Mellitus
The article Suitable Use of Injectable Agents to Overcome Hypoglycemia Risk, Barriers, and Clinical Inertia in Community-Dwelling Older Adults with Type 2 Diabetes Mellitus, written by Willy M. Valencia, Hermes J. Florez and Ana M. Palacio was originally published Online First without open access. (Source: Drugs and Aging)
Source: Drugs and Aging - September 9, 2020 Category: Geriatrics Source Type: research

Drug-Related Orthostatic Hypotension: Beyond Anti-Hypertensive Medications
AbstractOrthostatic hypotension (OH) is an abnormal blood pressure response to standing, which is associated with an increased risk of adverse outcomes such as syncope, falls, cognitive impairment, and mortality. Medical therapy is one the most common causes of OH, since numerous cardiovascular and psychoactive medications may interfere with the blood pressure response to standing, leading to drug-related OH. Additionally, hypotensive medications frequently overlap with other OH risk factors (e.g., advanced age, neurogenic autonomic dysfunction, and comorbidities), thus increasing the risk of symptoms and complications. Co...
Source: Drugs and Aging - September 7, 2020 Category: Geriatrics Source Type: research

Predictors of Mortality in the Older Population: The Role of Polypharmacy and Other Medication and Chronic Disease-Related Factors
AbstractBackgroundPolypharmacy has been associated with increased mortality but the contribution of different medication-related factors to this is unknown.AimsThe aim of this study was to identify demographic and medication-related predictors of mortality in the older population. Given the intrinsic link between polypharmacy and multimorbidity, the secondary aim was to examine if the medicines or underlying diseases predicted mortality.MethodsPatients aged ≥ 65 years from an outpatient multimorbidity clinic were included. Medication-related factors included the medicines count, high-risk medicines, inapprop...
Source: Drugs and Aging - September 4, 2020 Category: Geriatrics Source Type: research

Comparative Effectiveness of Angiotensin II Receptor Blockers and Angiotensin-Converting Enzyme Inhibitors in Older Nursing Home Residents After Myocardial Infarction: A Retrospective Cohort Study
AbstractBackgroundEvidence regarding differences in outcomes between angiotensin II receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) among older nursing home (NH) residents after acute myocardial infarction (AMI) is limited.ObjectivesThe purpose of our study was to estimate the post-AMI effects of ARBs versus ACEIs on mortality, rehospitalization, and functional decline outcomes in this important population.MethodsThis retrospective cohort study used national Medicare claims linked to Minimum Data Set assessments. The study population included individuals aged  ≥ 65 years ...
Source: Drugs and Aging - August 18, 2020 Category: Geriatrics Source Type: research

Optimizing the Treatment of Moderate-to-Severe Psoriasis in Older Adults
AbstractPsoriasis is a lifelong disease and its prevalence in older adults continues to increase as the population ages. Therefore, it is important for physicians to understand the management of the disease in this population. While the management of psoriasis in older adults is similar to the management of patients below the age of 65  years, there are special considerations when treating older patients. Older patients may have more comorbidities, more immunosuppression, and are often taking additional medications that can interact with those being used to treat psoriasis. Safer and more effective treatment options f...
Source: Drugs and Aging - August 10, 2020 Category: Geriatrics Source Type: research

Age-Related Lymphocyte Output During Disease-Modifying Therapies for Multiple Sclerosis
ConclusionsThis observational study indicated that different age-related changes of the new T and B lymphocyte production could be one of the reasons for the emergence, in the real-world setting, of adverse events not otherwise observed in clinical trials; thus, caution is advised when choosing disease-modifying therapies for multiple sclerosis patients. (Source: Drugs and Aging)
Source: Drugs and Aging - August 6, 2020 Category: Geriatrics Source Type: research

Safety and Tolerability Results from the PILLAR Study: A Phase IV, Double-Blind, Randomized, Placebo-Controlled Study of Mirabegron in Patients  ≥ 65 years with Overactive Bladder-Wet
AbstractBackgroundIn older patients with overactive bladder (OAB), mirabegron, a β3-adrenoreceptor agonist, represents an alternative treatment that may have a favorable risk –benefit profile.ObjectivesOur objective was to further examine the safety and tolerability of mirabegron versus placebo treatment in patients aged  ≥ 65 years with OAB-wet.MethodsWe conducted a 12-week, double-blind, randomized, placebo-controlled phase IV study to compare mirabegron with placebo. Community-dwelling patients aged  ≥ 65 years with OAB-wet (one or more incontinence episode and thre...
Source: Drugs and Aging - July 28, 2020 Category: Geriatrics Source Type: research

Real-World Effectiveness and Safety of Apremilast in Older Patients with Psoriasis
ConclusionApremilast seems to be an effective and safe therapeutic option for psoriasis in the elderly. The main AEs reported by patients did not seem to differ from those reported previously in younger populations. However, AEs were more frequent in patients  >  75 years old leading to more frequent discontinuation of apremilast compared with younger patients, suggesting a higher level of vigilance is needed in the elderly. (Source: Drugs and Aging)
Source: Drugs and Aging - July 21, 2020 Category: Geriatrics Source Type: research

Use of Antidepressants in Older People during a 10-Year Period: An Observational Study on Prescribed Doses and Serum Levels
ConclusionsOver a 10-year period, prescribed doses of antidepressants have been slightly reduced in older Norwegian patients, but a considerable proportion is still exposed to high serum concentrations of antidepressants. (Source: Drugs and Aging)
Source: Drugs and Aging - July 20, 2020 Category: Geriatrics Source Type: research

Use of Antibiotics in Chronic Obstructive Pulmonary Disease: What is Their Current Role in Older Patients?
AbstractChronic obstructive pulmonary disease (COPD) has considerable morbidity and mortality in the older adult population. The role of antibiotics in the management of acute exacerbations of COPD (AECOPD) is currently evolving. Despite only mild benefits, most patients with AECOPD in ambulatory settings receive antibiotics based on clinical criteria. Utilization of point-of-care C-reactive protein (CRP) has reduced antibiotic prescriptions by 20% without compromising clinical outcomes. A strict protocol allowing antibiotic use only in patients with clinical criteria and CRP  ≥ 20 mg/L has the potent...
Source: Drugs and Aging - July 20, 2020 Category: Geriatrics Source Type: research

Immune Checkpoint Inhibitors for Patients Aged  ≥ 75 Years with Advanced Cancer in First- and Second-Line Settings: A Meta-Analysis
The objective of this comprehensive meta-analysis was to assess the efficacy of ICIs in patients aged  ≥ 75 years.MethodsWe performed a meta-analysis of published randomized controlled trials concerning ICIs (as monotherapy or in combination) versus standard therapy in patients with advanced solid tumors between January 2010 and January 2020. We compared overall survival between older (aged  ≥ 75 years) and younger (
Source: Drugs and Aging - July 17, 2020 Category: Geriatrics Source Type: research

Platinum-Based Chemotherapy in Older Patients with Non-Small Cell Lung Cancer: What to Expect in the Real World
ConclusionsThis study evaluated the real-world use of PBC in older patients with NSCLC, offering an insight into the determinants of its prescription and the pattern of care of these patients. Of note, PBC use was associated with a higher likelihood of hospitalization for chemotherapy-related toxicity, with no benefit on survival compared to SAC. (Source: Drugs and Aging)
Source: Drugs and Aging - July 17, 2020 Category: Geriatrics Source Type: research

Factors Affecting Prescriber Implementation of Computer-Generated Medication Recommendations in the SENATOR Trial: A Qualitative Study
ConclusionThis study has demonstrated that the clinical relevance of the SENATOR prescribing recommendations was a significant factor affecting their implementation. Whilst software refinement will be necessary to improve the quality of recommendations, future interventions will need to be multifaceted to overcome the complex prescriber specialty culture within the acute hospital environment. (Source: Drugs and Aging)
Source: Drugs and Aging - July 17, 2020 Category: Geriatrics Source Type: research

Does Older Age have an Impact on Rituximab Efficacy and Safety? Results from the NOR-DMARD Register
The objective of this study was to compare the efficacy and safety of rituximab in older vs younger patients with rheumatoid arthritis.MethodsData on 367 patients with rheumatoid arthritis treated with rituximab in the Norwegian Disease-Modifying Antirheumatic Drug (NOR-DMARD) register were analysed, comparing patients aged  ≥ 65 years (n = 91) with patients aged 
Source: Drugs and Aging - July 9, 2020 Category: Geriatrics Source Type: research

Medication Counselling in Older Patients Prior to Hospital Discharge: A Systematic Review
ConclusionsSubstantial heterogeneity between the included studies was found for the components of medication counselling and the reported outcomes. Study findings suggest that medication counselling should be part of multifaceted interventions, but the evidence concerning clinical outcomes remains inconclusive. (Source: Drugs and Aging)
Source: Drugs and Aging - July 8, 2020 Category: Geriatrics Source Type: research

Assessment of Poor Inhaler Technique in Older Patients with Asthma or COPD: A Predictive Tool for Clinical Risk and Inhaler Performance
ConclusionsIndividual risk assessment in older individuals should focus on inhaler technique performance (mainly on dose activation and end pause) and adherence, smoking, respiratory comorbidities and cognitive impairment. Placebo device training provided by doctors seems to best suit these patients. (Source: Drugs and Aging)
Source: Drugs and Aging - June 30, 2020 Category: Geriatrics Source Type: research

Recent Advances in the Management of Migraine in Older Patients
AbstractAlthough the prevalence of migraine tends to decrease in the fifth to sixth decades of life, there are still a significant number of patients  >  65 years of age who experience migraine or have new-onset migraine. Because these older patients are often excluded from clinical trials, there are fewer evidence-based treatment guidelines for them. Migraine treatment in the older population requires careful consideration of changes in medicati on metabolism and increased medical comorbidities. Furthermore, older patients can present with an atypical migraine phenotype and have a higher rate of seco...
Source: Drugs and Aging - June 23, 2020 Category: Geriatrics Source Type: research

Overactive Bladder in Frail Older Adults
AbstractOveractive bladder (OAB) and frailty are multidimensional syndromes, and the prevalence of both increases with age. Little evidence exists for a direct association between OAB and frailty, but urinary urgency may well be a precursor of frailty in older people. Frail older adults are no less deserving of treatment than fit older adults, and lifestyle, behavioral, and pharmacological interventions remain the primary options for treatment, with some evidence for efficacy.  Data on onabotulinumtoxinA therapy or percutaneous tibial nerve stimulation in frail older adults are sparse. Frail older adults are often exc...
Source: Drugs and Aging - June 19, 2020 Category: Geriatrics Source Type: research

Correction to: Bimatoprost Implant: First Approval
This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other th ird party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and ...
Source: Drugs and Aging - June 19, 2020 Category: Geriatrics Source Type: research

Attitudes Towards Deprescribing Among Older Adults with Limited Life Expectancy and Their Relatives: A Systematic Review
ConclusionsAttitudes towards deprescribing among older adults with limited life expectancy and their relatives vary and highlight several barriers and enablers to the deprescribing process. Several of these factors must be addressed to successfully implement deprescribing initiatives in this patient group. (Source: Drugs and Aging)
Source: Drugs and Aging - June 15, 2020 Category: Geriatrics Source Type: research

Safety of Janus Kinase Inhibitors in Older Patients: A Focus on the Thromboembolic Risk
AbstractThe Janus kinase (JAK) –signal transducer and activator of transcription (STAT) pathway is a membrane-to-nucleus signaling cascade that effects activation of gene transcription. JAK inhibitors have demonstrated effectiveness in autoimmune diseases such as rheumatoid arthritis. An increased risk of infection, mainly vari cella-zoster reactivation, with these new agents is of concern. Comorbid conditions, along with pharmacokinetic variations in drug metabolism in the older population, further increase the risk of adverse outcomes. Newly raised concerns for potential adverse effects such as deep vein thrombosis...
Source: Drugs and Aging - June 8, 2020 Category: Geriatrics Source Type: research

Factors Associated with Reinitiation of Statin Treatment in Older Patients with Peripheral Arterial Disease
ConclusionsIn patients with characteristics associated with a lower probability of reinitiation, more concentrated outreach and further evaluation of these groups to identify interventions that might be helpful to encourage reinitiation are needed. (Source: Drugs and Aging)
Source: Drugs and Aging - June 8, 2020 Category: Geriatrics Source Type: research

A Structured Literature Review and International Consensus Validation of FORTA Labels of Oral Anticoagulants for Long-Term Treatment of Atrial Fibrillation in Older Patients (OAC-FORTA 2019)
ConclusionOAC-FORTA 2019 confirms that AFib can be successfully treated with positively labeled antithrombotics at advanced age. (Source: Drugs and Aging)
Source: Drugs and Aging - June 5, 2020 Category: Geriatrics Source Type: research

Diabetic Kidney Disease in Older People with Type 2 Diabetes Mellitus: Improving Prevention and Treatment Options
AbstractAge-related metabolic and renal changes predispose older people to an increased risk of diabetes mellitus and diabetic kidney disease, respectively. As the prevalence of the ageing population is increasing, because of increased life expectancy, the prevalence of older people with diabetic kidney disease is likely to increase. Diabetic kidney disease is associated with an increased risk of adverse outcomes and increased costs to healthcare systems. The management includes promotion of a healthy lifestyle and control of cardiovascular risk factors such as hyperglycaemia, hypertension and dyslipidaemia. Older people a...
Source: Drugs and Aging - June 3, 2020 Category: Geriatrics Source Type: research

Association Between Potentially Inappropriate Medications and Hospital Encounters Among Older Adults: A Meta-Analysis
ConclusionPIM use among older patients was associated with more hospital encounters. These unnecessary encounters likely cause a substantial burden to the healthcare system and patients. (Source: Drugs and Aging)
Source: Drugs and Aging - June 3, 2020 Category: Geriatrics Source Type: research

Treatment Patterns of Lipid-Lowering Therapy in Patients with Coronary Artery Disease Aged Above and Below 75  Years: A Retrospective Cross-Sectional Study of 1500 Patients in a Tertiary Care Referral Center in Germany
AbstractIntroductionLipid-lowering therapy of elderly patients with coronary artery disease (CAD) inherits a medical challenge, as these patients experience a higher absolute risk reduction but may be more prone to side effects. We aimed to evaluate the treatment patterns in lipid-lowering therapy, comparing CAD patients above versus below 75  years of age.MethodsWe retrospectively included patients with known CAD admitted to the West German Heart and Vascular Center. Low-density lipoprotein cholesterol (LDL-C) levels and intensity of statin therapy (based on dosage and type of statin) were assessed from all available...
Source: Drugs and Aging - May 28, 2020 Category: Geriatrics Source Type: research

Bimatoprost Implant: First Approval
This article summarizes the milestones in the development of bimatoprost implant leading to this first approval for use in the reduction of IOP in patients with OAG or OHT. (Source: Drugs and Aging)
Source: Drugs and Aging - May 23, 2020 Category: Geriatrics Source Type: research

Potentially Inappropriate Medications, Drug –Drug Interactions, and Anticholinergic Burden in Elderly Hospitalized Patients: Does an Association Exist with Post-Discharge Health Outcomes?
ConclusionPolypharmacy, a very simple measure, outperformed sophisticated PIM and DDI indicators of quality of therapy as a correlate of primary clinical outcomes, whereas ACB was associated with physical function decline. Thus, innovative approaches to the definition and research of PIMs and DDIs are eagerly awaited from the perspective of averaging the quantitative burden and qualitative interaction of drugs. (Source: Drugs and Aging)
Source: Drugs and Aging - May 22, 2020 Category: Geriatrics Source Type: research

Hand Grip Strength May Affect the Association Between Anticholinergic Burden and Mortality Among Older Patients Discharged from Hospital
AbstractBackground and ObjectiveThe relationship between anticholinergic burden and mortality is unclear, and the impact of anticholinergic burden on prognosis may vary in the presence of other conditions common in old age. We aimed to investigate the role of hand grip strength as a potential effect modifier in the association between anticholinergic burden and 1-year mortality in older patients discharged from hospital.MethodsOur series consisted of 620 older patients consecutively admitted to seven geriatric and internal medicine acute care wards in the context of a prospective multicenter observational study. Overall an...
Source: Drugs and Aging - May 16, 2020 Category: Geriatrics Source Type: research

Management of Older Adults with Mantle Cell Lymphoma
AbstractMantle cell lymphoma (MCL) is a B-cell non-Hodgkin lymphoma that is largely a disease of older adults with a median age at diagnosis of 67  years. MCL is considered incurable with current therapies and has historically been associated with a poor prognosis. A subset of patients will present with features of more indolent disease and can be safely observed for a period of time after diagnosis, but the majority will require treatment at some point in the disease course. Younger patients who are eligible to undergo intensive induction chemotherapy followed by consolidation with an autologous stem cell transplant ...
Source: Drugs and Aging - May 5, 2020 Category: Geriatrics Source Type: research

Prescribed Doses of CYP2D6-Metabolized Drugs and Hemodynamic Responses in Relation to CYP2D6 Genotype Among Older Patients Exposed to Polypharmacy
ConclusionIn this real-life clinical setting of patients aged  ≥ 70 years, dosing of CYP2D6 substrates were not adjusted according to genotype-predicted CYP2D6 metabolism. The increased occurrence of orthostatism in patients with reduced/absent CYP2D6 metabolism may indicate that individualized dosing based on genotype has the potential to prevent adver se effects in these vulnerable patients. (Source: Drugs and Aging)
Source: Drugs and Aging - April 29, 2020 Category: Geriatrics Source Type: research

Measuring Medication Self-Management Capacity: A Scoping Review of Available Instruments
ConclusionDevelopment of standardized instruments to quantify medication self-management capacity is still growing. The choice of instrument for use in a specific clinical or research setting will depend on the purpose for making the assessment and the population that it will be applied to. Results of this review can assist in selecting an appropriate instrument or guiding the development of new instruments for assessment of medication self-management capacity for specific clinical or research purposes. (Source: Drugs and Aging)
Source: Drugs and Aging - April 28, 2020 Category: Geriatrics Source Type: research

Immunotherapy in Older Patients with Advanced Melanoma: A Review of the Current Evidence
AbstractDespite the increasing incidence of metastatic melanoma in the older population, there is relatively limited specific data surrounding the use of immunotherapy for the treatment of advanced melanoma for patients above the age of 65  years. To date, there has not been a prospective trial done to evaluate the safety and efficacy of using immunotherapy to treat older patients with advanced melanoma. Older patients are often under-represented in clinical trials. In addition, older patients in clinical trials may have lower Easter n Cooperative Oncology Group (ECOG) performance score and fewer co-morbidities, and t...
Source: Drugs and Aging - April 20, 2020 Category: Geriatrics Source Type: research

An Analysis of Anesthesia Induction Dosing in Female Older Adults
AbstractBackground/ObjectivesIn the context of an aging surgical population, appropriate anesthetic induction dose adjustments for the older adult remain poorly defined. In the present study, we describe the prevalence of excess induction agent dose in reference to US  Food and Drug Administration (FDA) guidance and seek to investigate the possible association of such excess dose with postinduction hypotension and postoperative acute kidney injury (AKI).Study DesignA retrospective observational study was conducted in a large tertiary teaching hospital in accordance with our a priori analytic protocol as registered on ...
Source: Drugs and Aging - April 17, 2020 Category: Geriatrics Source Type: research

Chronic Post-Surgical Pain in the Frail Older Adult
AbstractOlder adults are the fastest growing segment of the population and surgical procedures in this group increase each year. Chronic post-surgical pain is an important consideration in the older adult as it affects recovery, physical functioning, and overall quality of life. It is increasingly recognized as a public health issue but there is a need to improve our understanding of the disease process as well as the appropriate treatment and prevention. Frailty, delirium, and cognition influence post-operative outcomes in older adults and have been implicated in the development of chronic post-surgical pain. Further rese...
Source: Drugs and Aging - April 16, 2020 Category: Geriatrics Source Type: research

Use of SGLT2 Inhibitors in Older Adults: Scientific Evidence and Practical Aspects
AbstractDiabetes mellitus (DM) is an increasingly prevalent condition that has a significant impact on health systems worldwide, particularly in older people. It is estimated that 30% of people aged  >  65 years fulfil the diagnostic criteria for DM, with 90% having type 2 DM (T2DM). Generally, specific guidelines for the treatment of T2DM in older people address in a very limited manner the use of more recent therapies, such as sodium–glucose co-transporter-2 inhibitors (SGLT2i), which have important benefits for older people, such as a low risk of hypoglycemia, reduction of cardiovascular and ...
Source: Drugs and Aging - April 1, 2020 Category: Geriatrics Source Type: research

Trends in the Dispensing and Costs of Glucose-Lowering Medications Among Older Australians: Findings from National Claims Data
AbstractBackgroundTemporal changes in the dispensing of glucose-lowering drugs (GLD) and their associated costs among elderly populations is unclear. This information is especially relevant to countries in which medications are partly or fully government subsidized.ObjectiveOur objective was to estimate the trends in prevalence, incidence and costs associated with GLD dispensed to older Australians.MethodsWe analysed Pharmaceutical Benefits Scheme data for 76,906 people aged  ≥ 65 years dispensed diabetes medications over the period 2013–2016.ResultsOlder males were dispensed more GLD than were ...
Source: Drugs and Aging - March 30, 2020 Category: Geriatrics Source Type: research

The Evolving Complexity of Treating Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor-2 (HER2)-Negative Breast Cancer: Special Considerations in Older Breast Cancer Patients —Part II: Metastatic Disease
AbstractBreast cancer is a disease of aging, and the incidence of breast cancer is projected to increase dramatically as the global population ages. The majority of breast cancers that occur in older adults are hormone-receptor positive, human epidermal growth factor receptor-2 (HER2)-negative phenotypes, with favorable tumor biology; yet, because of underrepresentation in clinical trials, less evidence is available to guide the complex care for this population. Providing care for older patients with metastatic breast cancer, with coexisting medical conditions, increased risk of treatment toxicity, and frailty, remains a c...
Source: Drugs and Aging - March 30, 2020 Category: Geriatrics Source Type: research

Frailty and Co-Prescribing of Potentially Interacting Drugs in New Users of Warfarin
ConclusionsThe overall frequency of potential drug interactions was moderate and frail patients were not exposed to warfarin drug interactions more often than non-frail patients. Further studies in larger study populations are required to verify these results. (Source: Drugs and Aging)
Source: Drugs and Aging - March 9, 2020 Category: Geriatrics Source Type: research

Comparison of Healthcare Resource Utilization and Costs between Rivaroxaban and Warfarin for Nonvalvular Atrial Fibrillation in a Skilled Nursing Facility Setting
AbstractBackgroundUse of direct-acting oral anticoagulants for patients with nonvalvular atrial fibrillation (NVAF) in skilled nursing facilities (SNFs) is increasing. Rivaroxaban is commonly used in this setting as an alternative to warfarin, based on comparable or increased efficacy in preventing stroke and a similar or lower risk of major bleeding.ObjectiveThe aim of this study was to compare healthcare resource utilization (HCRU) and costs between NVAF patients receiving rivaroxaban or warfarin in SNFs.MethodsThis retrospective study examined de-identified claims from Optum® Clinformatics® Extended Data Mart (1...
Source: Drugs and Aging - March 9, 2020 Category: Geriatrics Source Type: research

Psychotropic Drug-Associated Pneumonia in Older Adults
AbstractThe use of psychotropic drugs (antipsychotics, benzodiazepines and benzodiazepine-related drugs, and antidepressants) is common, with a prevalence estimates range of 19 –29% among community dwelling older adults. These drugs are often prescribed for off-label use, including neuropsychiatric symptoms. The older adult population also has high rates of pneumonia and some of these cases may be associated with adverse drug events. In this narrative review, we summariz e the findings from current observational studies on the association between psychotropic drug use and pneumonia in older adults. In addition to stu...
Source: Drugs and Aging - February 28, 2020 Category: Geriatrics Source Type: research

Benzodiazepine Prescribing in People with Chronic Obstructive Pulmonary Disease: Clinical Considerations
AbstractBenzodiazepines, available clinically for almost six decades, are still one of the most widely prescribed classes of medication. The proportion of the population prescribed benzodiazepines increases with age, and harms also increase with age. The prevalence of prescribing in people  >  85 years of age is as high as one in three, including in people with chronic obstructive pulmonary disease (COPD). The prevalence of COPD also increases with age. In COPD, indications cited for prescribing a benzodiazepine include anxiety, sleep disorders, or chronic breathlessness. Each of thes e symptoms is pr...
Source: Drugs and Aging - February 28, 2020 Category: Geriatrics Source Type: research

The Evolving Complexity of Treating Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor-2 (HER2)-Negative Breast Cancer: Special Considerations in Older Breast Cancer Patients —Part I: Early-Stage Disease
AbstractThe median age for breast cancer diagnosis is 62  years, but a disproportionate number of patients are over the age of 75 years and the majority of those have hormone receptor-positive, human epidermal growth factor receptor-2 (HER2)-negative cancers. This review provides a logical algorithm to guide providers through the many complicated issue s involved in adjuvant systemic therapy decisions in older patients with hormone receptor-positive, HER2-negative breast cancer. For this subtype of breast cancer, the mainstay of treatment is surgery and adjuvant endocrine therapy with tamoxifen or an aromata...
Source: Drugs and Aging - February 26, 2020 Category: Geriatrics Source Type: research

Atopic Dermatitis in Older Adults: A Review of Treatment Options
AbstractAtopic dermatitis (AD) in older adults (elderly AD) has recently emerged as a newly defined subgroup of AD. When selecting treatment options, clinical characteristics of elderly AD and age-specific factors of older patients must be considered. As in other age groups, regular application of moisturizers in combination with topical corticosteroids and calcineurin inhibitors, adjunctive administration of oral antihistamines/anti-allergic drugs, and avoidance of exacerbating factors comprise basic treatments for elderly AD. For moderate-to-severe cases and/or in those with a decreased ability to use topical treatments,...
Source: Drugs and Aging - February 21, 2020 Category: Geriatrics Source Type: research

Safety and Efficacy of Naldemedine for the Treatment of Opioid-Induced Constipation in Patients with Chronic Non-Cancer Pain Receiving Opioid Therapy: A Subgroup Analysis of Patients  ≥ 65 Years of Age
AbstractBackgroundOpioid-induced constipation (OIC), the most common side effect of opioid treatment, is under-recognized and undertreated in older patients. Naldemedine, an oral, peripherally acting μ-opioid receptor antagonist (PAMORA), is approved in Japan, the United States, and the European Union for treatment of OIC in adult patients.ObjectiveThis integrated analysis of three phase 3 trials (COMPOSE-1, COMPOSE-2, and COMPOSE-3) evaluated the safety and efficacy of naldemedine for up to 12  weeks in a subgroup of patients aged ≥ 65 years.MethodsPatients aged 18 –80 years with c...
Source: Drugs and Aging - February 21, 2020 Category: Geriatrics Source Type: research

Adverse Drug Events in Patients with Chronic Kidney Disease Associated with Multiple Drug Interactions and Polypharmacy
ConclusionMultiple pharmacodynamic interactions related to QTc prolongation, hyperkalaemia and haemorrhage are frequently associated with a negative outcome in older adults with CKD and often require recurrent medical treatment or rehospitalization. (Source: Drugs and Aging)
Source: Drugs and Aging - February 13, 2020 Category: Geriatrics Source Type: research

Comment on: “Pharmacological Management of Osteoporosis in Rheumatoid Arthritis Patients: A Review of the Literature and Practical Guide”
(Source: Drugs and Aging)
Source: Drugs and Aging - February 12, 2020 Category: Geriatrics Source Type: research