Senior Care Pharmacist最新文献_第10页

Real-World Analysis of Long-Acting and NPH-Containing Insulins on Glycemic Control. 长效胰岛素和含 NPH 胰岛素的血糖控制真实世界分析

Senior Care Pharmacist Pub Date : 2024-01-01 DOI: 10.4140/TCP.n.2024.42

Genevieve Hale, Valerie Marcellus, Tina Benny, Cynthia Moreau, Elaina Rosario, Alexandra Perez

{"title":"Real-World Analysis of Long-Acting and NPH-Containing Insulins on Glycemic Control.","authors":"Genevieve Hale, Valerie Marcellus, Tina Benny, Cynthia Moreau, Elaina Rosario, Alexandra Perez","doi":"10.4140/TCP.n.2024.42","DOIUrl":"10.4140/TCP.n.2024.42","url":null,"abstract":"Introduction Affordability of insulin products has become a concern in the past several years as the average price of various insulin products has increased. While awaiting legislation at the federal level that would address issues leading to high insulin costs, providers may have shifted prescribing practices to prescribe the lowest-priced insulin products to achieve patients' treatment goals. Objective To compare the prevalence of hypoglycemic events between patients receiving lower-cost neutral protamine Hagedorn (NPH)-containing human insulins and higher-cost long-acting insulin analogs in Medicare Part D enrollees within a management services organization, as well as assessing glycemic control and changes in body mass index. Methods This was a multicenter, retrospective study conducted at three primary care clinics. The co-primary outcomes were percent difference of documented mild and severe hypoglycemic events between individuals receiving NPH-containing human insulin and long-acting insulin. Results A total of 72 patients met inclusion criteria and were receiving NPH-containing human insulins or the long-acting insulin analogs, 15 and 57 patients, respectively. Severe hypoglycemic events occurred in 3.5% vs 0% of the long-acting insulin analog and NPH-containing human insulin group, respectively (P = 0.999). Mild hypoglycemic episodes were experienced by 31.6% versus 33.3% of long-acting insulin analog and NPH, respectively (P = 0.539). For secondary outcomes, no difference was observed in glycemic control outcomes across insulin groups. Conclusion Among Medicare Part D patients with type 2 diabetes mellitus, the use of NPH-containing human insulins was not associated with an increased risk of mild or severe hypoglycemia-related episodes or reduced glycemic control compared with long-acting insulin. Study findings suggest that lower-cost, NPH-containing human insulins may be an alternative to higher-cost, long-acting insulin analogs.","PeriodicalId":41635,"journal":{"name":"Senior Care Pharmacist","volume":"39 1","pages":"42-49"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Federal and State Programs and Resources for Chronic Kidney Disease. 慢性肾脏疾病的联邦和州计划和资源。

Senior Care Pharmacist Pub Date : 2023-12-01 DOI: 10.4140/TCP.n.2023.524

Paul Baldwin

引用次数: 0

The Effect of Pharmacist-Initiated Deprescribing Interventions in Older People: A Narrative Review of Randomized Controlled Trials. 药师主动处方干预对老年人的影响:一项随机对照试验的述评。

Senior Care Pharmacist Pub Date : 2023-12-01 DOI: 10.4140/TCP.n.2023.506

Michelle Nguyen, Manju T Beier, Diana N Louden, Darla Spears, Shelly L Gray

{"title":"The Effect of Pharmacist-Initiated Deprescribing Interventions in Older People: A Narrative Review of Randomized Controlled Trials.","authors":"Michelle Nguyen, Manju T Beier, Diana N Louden, Darla Spears, Shelly L Gray","doi":"10.4140/TCP.n.2023.506","DOIUrl":"10.4140/TCP.n.2023.506","url":null,"abstract":"Background Polypharmacy is common among older people and may be associated with adverse drug events (ADEs) and poor health outcomes. Pharmacists are well-positioned to reduce polypharmacy and potentially inappropriate medications. Objective The objective of this narrative review was to summarize the results from randomized-controlled trials that evaluated pharmacist-led interventions with the goal or effect to deprescribe medications in older individuals. Data Sources We searched Medline, Embase, CINAHL Complete, APA PsycInfo, Web of Science Core Collection, and Cochrane Central Register of Controlled Trials. Data Synthesis Of the 25 studies included, the interventions were conducted in nursing facilities (n = 8), outpatient/community dwellings (n = 8), or community pharmacies (n = 9). Interventions were categorized as comprehensive medication reviews (n = 10), comprehensive medication reviews with pharmacist follow-up (n = 11), and educational interventions provided to patients and/or providers (n = 4). Pharmacist-led interventions had a beneficial effect on 22 out of 32 total medication-related outcomes (eg, number of medications, potentially inappropriate medications, or discontinuation). Most (n = 18) studies reported no evidence of an effect for other outcomes such as health care use, mortality, patient-centered outcomes (falls, cognition, function, quality of life), and ADEs. Discussion Interventions led to improvement in 69% of the medication-related outcomes examined across study settings. Five studies measured ADEs with none accounting for adverse drug-withdrawal events. Large well-designed studies that are powered to find an effect on patient-centered outcomes are needed. Conclusion Pharmacist-led interventions had a significant beneficial effect on medication-related outcomes. There was little evidence of benefit on other outcomes.","PeriodicalId":41635,"journal":{"name":"Senior Care Pharmacist","volume":"38 12","pages":"506-523"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138470963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Midodrine-Induced Nightmares in the Treatment of Orthostatic Hypotension: A Case Report. midodrin诱发的恶梦治疗直立性低血压1例。

Senior Care Pharmacist Pub Date : 2023-12-01 DOI: 10.4140/TCP.n.2023.501

Lara Tran, Michael Brodeur

{"title":"Midodrine-Induced Nightmares in the Treatment of Orthostatic Hypotension: A Case Report.","authors":"Lara Tran, Michael Brodeur","doi":"10.4140/TCP.n.2023.501","DOIUrl":"10.4140/TCP.n.2023.501","url":null,"abstract":"Background Midodrine was the first medication approved by the Food and Drug Administration (FDA) for the treatment of orthostatic hypotension. Pharmacologically, midodrine is a peripheral selective alpha-1-adrenergic agonist that can improve standing, sitting, and supine systolic blood pressure. Common side effects include bradycardia, supine hypertension, and paresthesia. A novel side effect of midodrine-induced nightmares has been reported in our patient. To our knowledge, this is the first reported case of midodrine-induced nightmares. Objective To investigate and report a clinically significant and unique drug adverse event of midodrine in the treatment of orthostatic hypotension. Case Presentation This report describes a case of persistent nightmares associated with midodrine use in an 83-year-old male who experienced frequent syncope episodes treated with midodrine for orthostatic hypotension (OH). After the initiation of midodrine, the patient complained of increased nightmares, which quickly led to his refusal of the medication, despite the initial improvements in his blood pressure. The timing of administration included an evening dose at 21:00. This novel adverse event of midodrine-induced nightmares will be highlighted and explored in this case report. Conclusion This case demonstrated a unique adverse event of nightmares caused by midodrine. It is hypothesized that autonomic dysfunction plays a role and further investigations should be conducted to confirm this theory. We hope that our case report highlights the importance of careful consideration when prescribing midodrine in older people with orthostatic hypotension.","PeriodicalId":41635,"journal":{"name":"Senior Care Pharmacist","volume":"38 12","pages":"501-505"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138470961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Characterizing the Complexity of Senior Care Pharmacy. 老年护理药学的复杂性特征。

Senior Care Pharmacist Pub Date : 2023-12-01 DOI: 10.4140/TCP.n.2023.488

Chris Alderman

引用次数: 0

Diversification and Expansion of Clinical Pharmacy Services: Is it Time for Senior Care Pharmacists to Step Into the Light? 临床药学服务的多元化与扩大化:老年护理药师是时候走向光明了吗?

Senior Care Pharmacist Pub Date : 2023-12-01 DOI: 10.4140/TCP.n.2023.490

Kalin M Clifford

引用次数: 0

New Drugs: Faricimab-svoa (Vabysmo^™) for Macular Degeneration and Diabetic Macular Edema and Omidenepag Isopropyl (Omlonti^™) for Glaucoma and Ocular Hypertension. 新药:Faricimab-svoa (Vabysmo™)治疗黄斑变性和糖尿病性黄斑水肿，Omidenepag异丙基(Omlonti™)治疗青光眼和高眼压。

Senior Care Pharmacist Pub Date : 2023-12-01 DOI: 10.4140/TCP.n.2023.497

Lana Gettman

引用次数: 0

Considerations on the Weight Loss-Associated Glucagon-like Peptide-1 Receptor Agonists for Older People. 老年人减肥相关胰高血糖素样肽-1受体激动剂的考虑。

Senior Care Pharmacist Pub Date : 2023-12-01 DOI: 10.4140/TCP.n.2023.493

Jonathan H Watanabe

{"title":"Considerations on the Weight Loss-Associated Glucagon-like Peptide-1 Receptor Agonists for Older People.","authors":"Jonathan H Watanabe","doi":"10.4140/TCP.n.2023.493","DOIUrl":"10.4140/TCP.n.2023.493","url":null,"abstract":"Obesity rates for older people have increased around the world1 with rates tripling over the past four decades.² While previously considered a phenomenon of developed countries, the increased prevalence of obesity is now established in developing countries as well.³ Factors stimulating this epidemic include modifications in the global food supply chain, rise in consumption and availability of energy-dense, low-nutrient foods, sedentary occupations, expanding urbanization, changes in transportation means, as well as environmental components.³ The increasing prevalence of obesity in older people in the United States over time has been well documented by federal agencies. Over the time periods 1999-2002, 2003-2006, and 2007-2010, a linear increase in the prevalence of obesity among older men in all age groups was observed. The obesity prevalence among men 65 to 74 years of age increased from about 31.6% in 1999-2002 to 41.5% in 2007-2010. In men older than 74 years of age, obesity prevalence increased from 17.7% in 1999-2002 to 26.5% in 2007-2010. Of interest is that, in women, the change over the same time period was not statistically significant for the older age groups (40.3% obesity in 65- to 74-year-old women and 28.7% in women older than 74 years of age in the 2007-2010 analysis period).⁴.","PeriodicalId":41635,"journal":{"name":"Senior Care Pharmacist","volume":"38 12","pages":"493-496"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138470958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Geriatric Pharmacotherapy Case Series: Chronic Obstructive Pulmonary Disease. 老年药物治疗案例系列：慢性阻塞性肺病。

Senior Care Pharmacist Pub Date : 2023-11-01 DOI: 10.4140/TCP.n.2023.465

Nadia Khartabil

引用次数: 0

Infectious Disease: Historic Triumphs and Future Tragedy? 传染病：历史的胜利与未来的悲剧？

Senior Care Pharmacist Pub Date : 2023-11-01 DOI: 10.4140/TCP.n.2023.486

Paul Baldwin

引用次数: 0