The American journal of geriatric pharmacotherapy
-
Am J Geriatr Pharmacother · Apr 2010
Inpatient medication reconciliation at admission and discharge: A retrospective cohort study of age and other risk factors for medication discrepancies.
Medication discrepancies are unintended differences between medication regimens (ie, between a patient's home regimen and medications prescribed on admission to the hospital). ⋯ Medication discrepancies on admission and medication differences at discharge were prevalent for adult patients admitted to the general medicine, cardiology, and general surgery services in this academic teaching hospital. Medication reconciliation processes have a high potential to identify clinically important discrepancies for all patients.
-
Am J Geriatr Pharmacother · Apr 2010
Assessment of a safety enhancement to the hospital medication reconciliation process for elderly patients.
Medication history taking is important because clinicians rely on the information that is collected; however, medication histories are often inaccurate and incomplete. The use of a medication at home without a corresponding disease or condition in the patient's records (ie, "unspecified" medication) warrants investigation of the need for that medication. The process of reconciling medications with current diseases or conditions on hospital admission has not been officially advocated by The Joint Commission, but it could help clinicians better assess the continued need for home medications and possibly decrease the use of polypharmacy. ⋯ Many of the unspecified medications that were identified in this study have been associated with polypharmacy in the literature. The results of this study suggest that matching home medications with indications for those medications on admission to the hospital enhanced the medication reconciliation process. Direct patient questioning by the pharmacist clarified medication use and contributed to more accurate and complete medication history taking.
-
Ranolazine is increasingly being prescribed for the treatment of chronic stable angina. This report describes an adverse effect that may be related to ranolazine. ⋯ No previous cases of ranolazine-related DOE requiring drug cessation have been published. Ranolazine may be associated with DOE in this elderly man.
-
Community-acquired pneumonia (CAP) is a frequent cause of hospitalization and death among the elderly. ⋯ Adherence to established guidelines, along with customization of antimicrobial therapy based on local rates and patterns of resistance and patient-specific risk factors, likely will improve the treatment outcome of elderly patients with CAP.
-
Am J Geriatr Pharmacother · Feb 2010
ReviewExtraskeletal effects of vitamin D in older adults: cardiovascular disease, mortality, mood, and cognition.
Vitamin D insufficiency is prevalent among older adults and may be associated with higher risk for cardiovascular (CV) disease, mortality, depression, and cognitive deficits. ⋯ Vitamin D insufficiency appears to be highly prevalent among older adults. Evidence from epidemiologic studies and small clinical trials suggests an association between 25(OH)D concentrations and systolic blood pressure, risk for CV disease-related deaths, symptoms of depression, cognitive deficits, and mortality. The Women's Health Initiative Randomized Trial did not find a benefit of vitamin D supplementation on blood pressure, myocardial infarction, or mortality in postmenopausal women.