The American journal of geriatric pharmacotherapy
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Am J Geriatr Pharmacother · Jun 2008
Multicenter Study Clinical TrialEffect of darbepoetin alfa administered once monthly on maintaining hemoglobin levels in older patients with chronic kidney disease.
The anemia of chronic kidney disease (CKD) is associated with increased hospitalizations, increased cardiovascular morbidity and mortality, and diminished quality of life in the elderly. Darbepoetin alfa is an erythropoiesis-stimulating agent that has been shown to be effective in treating anemia in patients with CKD (but not on dialysis) when administered using extended-dosing regimens. ⋯ Darbepoetin alfa administered QM maintained Hb levels > or =11 g/dL in patients with CKD (not on dialysis) aged <65, 65 to 74, and > or =75 years. This treatment regimen may help optimize anemia management for older community-dwelling and long-term care patients.
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Am J Geriatr Pharmacother · Jun 2008
ReviewUse of computer decision support interventions to improve medication prescribing in older adults: a systematic review.
Older adults take multiple medications and are at high risk for adverse drug effects. ⋯ Various types of CDS interventions may be effective in improving medication prescribing in older adults, but few studies reported clinical outcomes related to changes in medication prescribing. Data from this study should help to guide refinement and testing of future CDS interventions that specifically target older adult populations that are taking multiple medications.
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Am J Geriatr Pharmacother · Jun 2008
Methodology of an ongoing, randomized controlled trial to prevent falls through enhanced pharmaceutical care.
Falls are the leading cause of both fatal and nonfatal injuries among adults aged > or =65 years in the United States. Past research suggests that individuals taking multiple medications are at increased risk of falls. Central nervous system-active drugs in particular have been associated with increased risk. ⋯ The study is using a rigorous randomized controlled research design, which will enhance the internal validity of its findings. Results of the study, which will be reported after the completion of follow-up data collection activities, will enable us to assess the effects of the intervention on both medication use and the incidence of falls. If the intervention is found to be effective, it will provide a resource for community pharmacists working with older adults at high risk of medication-related falls.
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Am J Geriatr Pharmacother · Jun 2008
A before and after study of medical students' and house staff members' knowledge of ACOVE quality of pharmacologic care standards on an acute care for elders unit.
The Assessing Care of Vulnerable Elders (ACOVE) comprehensive set of quality assessment tools for ill older persons is a standard designed to measure overall care delivered to vulnerable elders (ie, those aged > or =65 years) at the level of a health care system or plan. ⋯ A pharmacotherapist-led educational intervention improved the scores of medical students and house staff on a test evaluating knowledge of evidence-based recommendations for pharmacotherapy in the elderly.
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Am J Geriatr Pharmacother · Jun 2008
Case ReportsAdverse effects of propafenone after long-term therapy with the addition of citalopram.
Propafenone, a class IC antiarrhythmic, and citalopram, a selective serotonin reuptake inhibitor (SSRI), are widely used in older patients. Although a potential interaction between propafenone and SSRIs has been noted, a MEDLINE search revealed no published reports of an interaction between propafenone and citalopram. ⋯ This is the first report of a possible interaction between propafenone and citalopram, which caused propafenone adverse effects (eg, dizziness, falls) and mimicked coronary artery disease.