Current medical research and opinion
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There is a lack of robust epidemiological evidence on antipsychotic (AP) use in patients with agitation in Alzheimer's disease (AD). Authors studied AP use in patients with AD and agitation and compared their use with patients with other or no neuropsychiatric symptoms (NPS). ⋯ Patients with AD and agitation were frequently prescribed APs and for long periods in routine clinical practice in the UK. The high real-life usage of APs suggests that physicians prefer using APs for the treatment of agitation despite recommendations against their long-term use. These data support a need for AP therapies that better address known safety concerns with currently used APs to treat agitation in elderly patients with AD.
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Since 2014, valproate has not been recommended for use in girls and women of childbearing potential unless other treatments are ineffective or not tolerated. Risk minimization measures (RMMs) of valproate were implemented to reduce the potential risks of developmental disorders among pregnant women. A drug utilization study was carried out to assess the effectiveness of RMMs. ⋯ Results from this study indicated some improvement in physician prescribing and a potential reduction in valproate-exposed pregnancies in the UK. Given only modest improvement has been achieved, additional RMMs were implemented in 2018.
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To measure health state preferences and estimate utility values for tardive dyskinesia (TD) from the perspective of the US general population, accounting for factors affecting quality of life (QOL). ⋯ Utility decrements for TD in this study were slightly larger than previously reported values, potentially due to incorporation of QOL and social consequences in TD health state descriptions. An important limitation of this analysis is that participants' willingness to trade future years of healthy life may not indicate actual willingness to accept the life decrement. These findings can be leveraged to improve cost-effectiveness analyses used to assess the value of treatments for TD.
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Anemia is an adverse outcome and common complication in chronic kidney disease patients. This is usually associated with iron deficiency, inflammation and blood loss. However, little is known about the prevalence of anemia and its predictors among chronic kidney disease patients in Southern Ethiopia. This study aimed to determine anemia and its predictors among adult non-dialysis chronic kidney disease patients in Southern Ethiopia. ⋯ Anemia was a severe public health problem and associated with cardiovascular disease, diabetes mellitus and stages of chronic kidney disease. Thus, early diagnosis, treatment and prevention of anemia are recommended.
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Atrial fibrillation (AF) is common in older adults. CHA2DS2-VASC (congestive heart failure, hypertension, age ≥75 (doubled), diabetes mellitus, prior stroke or transient ischemic attack (doubled), vascular disease, age 65-74, female) and HASBLED(Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly) are the most established risk stratification tools in assessing suitability for anticoagulation in AF. However, there are no established screening tools for geriatric syndromes on anticoagulation risks in older adults. ⋯ Age and CKD were significantly associated with anticoagulation prescription in patients with AF. Further studies on the impact of geriatric syndromes on anticoagulation prescription and outcomes in older adults are needed with specific guidelines for patients with geriatric syndromes and AF.