A polypharmacy risk prediction model for elderly patients based on sociodemographic and clinical factors.

OBJECTIVE: Elderly people take increasing amounts of medication. The aim of our study was to determine the effects of different sociodemographic and clinical factors on polypharmacy and to develop a risk prediction model in outpatients aged 65 years and older. MATERIALS AND METHODS: Cross-sectional, observational, descriptive study of outpatients aged 65 years and older scheduled for a specialist visit. Data on sociodemographic (age, sex, place of residence, and institutionalization) as well as on clinical variables (number of prescribing physicians and number of diagnoses) were collected. Polypharmacy was defined as the uninterrupted use of more than 5 medications within the last 3 months. To determine the risk factors for polypharmacy among these patients, a multivariate logistic regression model was developed and subsequently validated using bootstrap resampling techniques. The model was assessed for its discrimination accuracy using the area under the curve (ROC AUC). RESULTS: A total of 225 outpatients were included for development of the model. Polypharmacy was found in 46.7% of patients. The determinants that best predicted polypharmacy included: age, institutionalization, number of prescribing physicians, and number of diagnoses. The ROC AUC was 0.85. CONCLUSION: The predictive model developed in this study, which consists of 4 readily obtainable variables, may be a useful tool for identifying and monitoring elderly patients at risk for polypharmacy.
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A cross-sectional study of psychotropic drug use in the elderly: Consuming patterns, risk factors and potentially inappropriate use.

OBJECTIVES: The aims of the present study were: (1) to describe psychotropic drug consumption patterns in an outpatient population aged 65 years and older; (2) to determine the impact of a number of demographic and clinical factors on psychotropic consumption; and (3) to determine the ratio of potentially inappropriate psychotropic agents prescribed to the above population. METHODS: Cross-sectional, observational study of outpatients aged 65 years and older. Data on sociodemographic and clinical variables were collected. Psychotropic drugs were classified into three categories: anxiolytics-hypnotics, antidepressants, and antipsychotics. To determine the risk factors for psychotropic drug use among these patients, a multivariate logistic regression model was developed and subsequently validated using bootstrap resampling techniques. To identify the psychotropic drugs to be avoided, a review of treatments received by the patients was performed based on the 2015 version of the Beers criteria. RESULTS: The study included 225 outpatients of whom 30.7% were on psychotropic drugs for chronic treatment. The highest likelihood of psychotropic utilisation corresponded to the following profile: female, living in a nursing home, having two or more prescribing physicians, and having received six or more different diagnoses. According to Beers criteria, 51 patients (22.7% of the sample and 73.9% of patients on psychotropic drugs) had been prescribed at least one potentially inappropriate psychotropic drug. CONCLUSION: Elderly patients commonly use psychotropic medications and are the most vulnerable to the adverse effects of these drugs. It is necessary to re-evaluate the pertinence and accuracy of these medical prescriptions.

Errores de medicación asociados a la administración oral de metotrexato. Datos de notificación espontánea y revisión de la bibliografía médica / Medication errors associated with oral administration of methotrexate. Data from spontaneous reporting and medical literature review

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La notificación espontánea de reacciones adversas desde una Oficina de Farmacia / Spontaneous adverse reaction reporting from a pharmacy office

En España, la notificación de sospechas de reacciones adversos al Sistema Español de Farmacovigilancia (SEFV) es obligatoria para todos los profesionales sanitarios. Sin embargo, la notificación procedente de oficinas de farmacia es baja. El objetivo de este trabajo fue evaluar la capacidad de identificar sospechas de reacciones adversas en lo oficina de farmacia y valorar el grado de causalidad de las sospechas generadas. Se recogieron todas las sospechas de reacciones adversas generadas durante un período de seguimiento de 5 años. En cada caso, se çompletó el formulario de tarjeta amarilla, que se envió al centro de Farmacovigilancia, en el que se procesaron siguiendo los normas del SEFV. Se recogieron 39 notificaciones, de las que 7 fueron valoradas como graves. Afectaban preferentemente a mujeres y ancianos. Los grupos farmacológicos sospechosos implicados con más frecuencia fueron cardiovascular, infecciosos y sistema nervioso central: El 22,2 % de las sospechas de reacciones adversas graves y el 44,7% de las leves, se referían a especialidades farmacéuticas de reciente comercialización. El grado de certeza de las notificaciones recibidas fue muy alto. Nuestros resultados destacan el potencial de la oficina de farmacia en lo detección de reacciones adversas y la consistencia de las sospechas generadas

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