Potentially Inappropriate Medication and Polypharmacy in Nursing Home Residents: A Cross-Sectional Study.

Inappropriate prescribing in the elderly is a risk factor for higher adverse drugs reactions, hospitalisation, and mortality rates. Therefore, it is necessary to identify irrational prescriptions and implement interventions to improve geriatric clinical practices in nursing homes. This study aimed to examine and compare the prevalence of potentially inappropriate medications in nursing home residents using three different updated criteria: 2019 Beers criteria, PRISCUS list, and v2 STOPP criteria, and to determine the prevalence of potential prescribing omissions according to v2 START criteria. A descriptive, observational, and cross-sectional study design was used. A total of 218 residents were involved in this study. Data on drug use were collected from medical charts. Information was screened with the software CheckTheMeds. Potentially inappropriate medications were present in 96.3%, 90.8%, and 35.3% of residents, according to the STOPP, Beers, and PRISCUS criteria or list, respectively. Inappropriate medication was found to be significantly associated with polypharmacy and severe or moderate drug-drug interactions with the three tools and with pathologies and unnecessary drugs only for STOPP criteria. The most frequent inappropriate medications were benzodiazepines and proton pump inhibitors. A regular use of software to review medications in nursing home residents would help to reduce the risk of these drug-related problems.

Drug-Related Problems and Polypharmacy in Nursing Home Residents: A Cross-Sectional Study.

At present, 19.2% of the Spanish population is aged 65 or older. Polypharmacy is a frequent condition among the elderly, especially in those living in nursing homes, which is associated with adverse outcomes, such as adverse drug events or drug-drug interactions. This study aimed to assess the pattern of polypharmacy in a nursing home in Leon, one of Spain's most ageing regions, and its relationship with different drug-related problems. A descriptive, observational, and cross-sectional study design was used; 222 residents were involved in this study. Data on drug use were collected from medical charts. Information was screened with the software CheckTheMeds, BOT PLUS and Drug-Reax. Residents were on a median of 7 medicines. Polypharmacy and inappropriate medications were present in 78.8% and 96.8% of residents, respectively. Drug-related problems were present in almost all the populations evaluated. Drug-drug interactions were very common in participants (81.1%), being severe/moderate in 24.7%. A high prevalence of polypharmacy and drug-related problems in the nursing home population assessed has been observed. A significantly higher risk of suffering drug-drug interactions was revealed for increasing polypharmacy and anticholinergic risk. A regular evaluation of drug prescribing in nursing home residents is necessary to minimize drug-related problems risk.

Brewing with Starchy Adjuncts: Its Influence on the Sensory and Nutritional Properties of Beer.

In brewing, the use of cereals (wheat, barley, maize, rice, sorghum, oats, rye or millet), pseudo-cereals (buckwheat, quinoa or amaranth) and tubers (sweet potato), as starch adjuncts, is being promoted for the production of a variety of high-quality beers, from sensory and nutritional points of view. The sensory properties of the obtained beer depend on the characteristics of each adjunct but also on the forms in which the adjunct is added: whole cereal, grits, malted, extruded grains, torrefied and syrup. Among these common forms, the extruded grains (maize or rice) produce a higher content of aroma compounds in beer. From a nutritional point of view, the use of non-conventional starch adjuncts, such as black rice, buckwheat or sweet potato, leads to an increase in the polyphenol content of the beer, and thus, its antioxidant capacity. Cereals such as maize, rice, sorghum or millet are the most promising for the production of gluten-free beers. A close relationship can be developed between the use of adjuncts in the beer industry and the use of commercial enzymes. Advances made by biotechnology to design new enzymes with different functionalities could be associated to a future increase in adjunct usage in brewing.

Prevalence and Associated Factors of Polypharmacy in Nursing Home Residents: A Cross-Sectional Study.

In Spain, there has been a progressive increase in aging. Specifically, Leon has been one of the Spanish provinces with the highest aging index. Polypharmacy is highly prevalent among the elderly, with significant consequences for safety. The aim of this study was to assess the consumption of drugs in a nursing home in the province of Leon and establish the relationship between polypharmacy and the most common comorbid diseases. A descriptive, observational, and cross-sectional study design was used. Residents' information and treatments were collected by reviewing on medical charts, completed with clinical information obtained from the physician of the nursing home. The mean age of residents was 86.8 years, and 63.8% were female. Mean medical consumption amounted to 7.02 prescriptions. Polypharmacy was observed in 54.9% of residents, and excessive polypharmacy in 22.1%. The most commonly used medications (ATC classification) were those acting on the cardiovascular system (84.4%) and the nervous system (82.8%). A high-level of drug consumption was observed in the nursing home. Interventions should focus on those residents hospitalized the last year and with recent contact with a general practitioner. There is a need to develop a comprehensive monitoring system to assess the quality of prescriptions for nursing home residents.