Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Aug 2021
Multicenter Study Observational StudyClinical pharmacist interventions in cardiovascular disease pharmacotherapy in elderly patients on excessive polypharmacy : A retrospective pre-post observational multicentric study.
Cardiovascular diseases (CVD) are often treated with excessive polypharmacy (10 or more medications) in primary care, and these patients are mostly excluded from trials. Collaborative care, including clinical pharmacists (CP), is one of the possible approaches to address these problems; however, it has not been studied yet in this part of Europe. Hence, the main aim of the study was to determine how CP interventions in a medical review form (MR) can have an impact on the pharmacotherapy in patients on excessive polypharmacy with CVD (number of medications, potential drug-drug interactions of type X-pXDDI, potentially inappropriate medications in the elderly-PIM and treatment guidelines adherence). ⋯ CPs' interventions significantly improved the quality of pharmacotherapy prescribing by reducing the total number of medications and pXDDIs and led to better hypertension treatment guidelines adherence.
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Wien. Klin. Wochenschr. · Aug 2021
ReviewConsidering additive effects of polypharmacy : Analysis of adverse events in geriatric patients in long-term care facilities.
Potential additive effects of polypharmacy are rarely considered in adverse events of geriatric patients living in long-term care facilities. Our aim, therefore, was to identify adverse events in this setting and to assess plausible concomitant drug causes. ⋯ Patients in long-term facilities frequently suffer from many adverse events. Concomitantly administered drugs have to be frequently considered as plausible causes for adverse events. These additive effects of drugs should be more focused in patient care and research.
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Wien. Klin. Wochenschr. · Aug 2021
Review Meta AnalysisEffect of music on patients with cardiovascular diseases and during cardiovascular interventions : A systematic review.
The therapeutic effects of music have been known for thousands of years. Recently, studies with music interventions in patients with cardiovascular diseases yielded controversial results. The aim of this review is to provide an overview of the effects of receptive music intervention on the cardiovascular system. ⋯ Currently no definite effect of receptive music intervention on the cardiovascular system can be verified. Further research is needed to assess music as an inexpensive and easy applicable form of therapy.
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Wien. Klin. Wochenschr. · Aug 2021
ReviewReal-world evidence and product development: Opportunities, challenges and risk mitigation.
Real-world evidence (RWE) is derived from real-world data (RWD) sources including electronic health records, claims data, registries (disease, product) and pragmatic clinical trials. The importance of RWE derived from RWD has been once again demonstrated during the coronavirus disease 2019 (COVID-19) pandemic, as it can improve patient care by complementing information obtained from traditional clinical trial programs. Additionally, RWE can generate insights into disease mechanisms, epidemiology, patient flows in and out of healthcare systems, and drivers and barriers to optimal clinical care in real-world settings. ⋯ RWE can also optimize the design of clinical studies, inform benefit risk assessments and use networks of pragmatic studies to help with clinical trial feasibilities and eventual trial initiation. The challenges of RWD include data quality, reproducibility and accuracy which may affect validity. RWD and RWE must be fit for purpose and one must be cognizant of inherent biases.
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Wien. Klin. Wochenschr. · Aug 2021
ReviewTranscatheter treatment by valve-in-valve and valve-in-ring implantation for prosthetic tricuspid valve dysfunction.
Valve degeneration after surgical tricuspid valve replacement or repair is frequent and may require repeat replacement/repair. For high-risk patients, transcatheter valve-in-valve and valve-in-ring procedures have emerged as valuable treatment alternatives. Preprocedural transthoracic echocardiography is the method of choice to detect malfunction of the prosthesis including degenerative stenosis and/or regurgitation requiring reintervention. ⋯ Suitable transcatheter valves are the Edwards Sapien 3 and the Medtronic Melody valves. Differences in surgical prostheses or annuloplasty implants are important for device selection, height consideration and additional ballooning prior to or after implantation. Transesophageal echocardiography postimplantation is convenient for the assessment of transvalvular gradients or paravalvular leaks.