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Ageing of the population and selected aspects of risky drug prescribing in senior age (II.)
Zpěváková, Gabriela ; Fialová, Daniela (advisor) ; Pokladníková, Jitka (referee)
Institution/department: Charles University, Faculty of Pharmacy in Hradec Kralove, Department of Social and Clinical Pharmacy Title of diploma thesis: Ageing of the population and selected aspects of risky drug prescribing in senior age (II.) Supervisor: Assoc. Prof. Daniela Fialova, PharmDr. Ph.D. Author: Gabriela Zpevakova INTRODUCTION: Ageing of the population in developed and developing countries is accompanied with increasing proportion of seniors. Because of age-related physiological and pathological changes, polymorbidity is very common in older patients and often accompanied with polypharmacy and higher risk of drug-drug interactions (DDIs). Moreover, age-related changes in drug pharmacokinetics and pharmacodynamics contribute to higher clinical significance of various DDIs. The aim of this diploma theis was to determine the prevalence and most common DDIs in the Czech sample of seniors assessed during the EuroAgeism H2020 project in three different settings of care - acute, ambulatory care and in community pharmacies. The secondary aim of the thesis was also to thoroughly describe mechanisms of most common DDIs, their clinical relevance and available evidence. METHODOLOGY: For determining the prevalence of DDIs we used Czech data of seniors 65+ (in total N=1602) collected during the...
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Theatre Na zábradlí in the period from the leaving of Jan Grossman till the coming of Evald Schorm
Fialová, Daniela ; Just, Vladimír (advisor) ; Topolová, Barbara (referee)
This thesis deals with the Theatre Na zábradlí in the period since the leave of director Jan Grossman in 1968 until the arrival of director Evald Schorm in 1976. The work at first summarizes the social and political situation after the invasion of Warsaw Pact troops in August 1968 and put this situation into the context of culture. Then there is summarized the first ten years of the Theatre Na zábradlí and described the reason why the artistic director Jan Grossman had left.The main part is devoted to the Theatre in the years 1968-1976, and personalities which at that time worked in the theater. They were especially Jaroslav Gillar, Jaroslav Chundela and film directors - Jiří Menzel, Juraj Herz, Jiří Krejčík, Jaromil Jireš and Evald Schorm. The face of this scene in the difficult period of the Czech history is created through the contemporary reviews. The years 1976-1978 (time until the emigration of Jaroslav Chundela) are then described shortly to make complete documentation of this period.
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The Pharmacotherapy of Chronic Non-maligant Pain Among Geriatric Patients
Bártová, Barbora ; Fialová, Daniela (advisor) ; Matoulková, Petra (referee)
Charles University in Prague, Faculty of Pharmacy in Hradec Králové Department of Social and Clinical Pharmacy Candidate: Mgr. Barbora Bartova Consultant: PharmDr. Daniela Fialova, PhD. Title of Thesis: The Pharmacotherapy of Chronic Non-malignant Pain among Geriatric Patients Introduction: Epidemiological studies demonstrate that prevalence of chronic pain increases with higher age. Furthermore, pain among older patients is often underrecognized and/or undertreated. Although rational treatment of geriatric pain has been extensively studied during the past decade, many older people still suffer from uncontrolled or insufficiently treated pain. The aim of this study is to evaluate the treatment of non-malignant chronic pain by general practitioners (GPs) in geriatric patients. Further, we discuss the role of pharmacist in rational pain pharmacotherapy as well as complex pharmacotherapy management in these patients. Methods: Data were obtained by prospective assessment of 80 geriatric patients 65+ (mean age 75,0 years (range 65-94 yrs), 80 % females) suffering from chronic nonmalignant pain. Evaluation of pain management and complex drug regimens was provided by specifically trained pharmacist in two general practices in Brno, Czech Republic (between March 2010 and December 2011). To assess the...
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Application of explicite criteria of medications potentially inappropriate in the old age in the evaluation of quality of prescribing (III.)
Grešáková, Silvia ; Fialová, Daniela (advisor) ; Zimčíková, Eva (referee)
Introduction: Propotion of older people is rapidly increasing in the world population. Elderly represents a specific, heterogenous population which is because of many reasons more vulnerable to some adverse drug events. Many explicit criteria of potentially inappropriate medication used in the elderly have been developed in order to improve the quality and safety of geriatric pharmacotherapy. These criteria represent basic tools, defining fundamental prescribing rules for the evaluation of appropriate choice and dosing of medications in the old age and for the evaluation of potentially inappropriate prescriptions in older patiens. The aim of the diploma thesis was to compare advantages and disadvantages of explicit criteria published until the end of 2015 year and to summarizea list of allpotentially inappropriate medications in the elderly (regardless of diagnoses and concomitantly used medications), applicable in the epidemiological studies of the EU COST Action 1402project and in subsequent studies. Methods: Using systematic literature search in PubMed dataset, conducted in the period 04/2015 - 12/2015, all explicit and explicit- implicit criteria (published in the foreign peer- reviewed scientific journals bythe end of year 2015 and validated by expert panels) have been identified. Information...
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Evaluation of potentially inappropriate drugs and drug procedures in the old age (I.)
Krivošová, Michaela ; Fialová, Daniela (advisor) ; Kostřiba, Jan (referee)
Introduction: Proportion of the population over the age of 65 is continuously increasing in the European Union, and therefore, the number of polymorbid patients with polypharmacy, limited functional capacities and syndrome of geriatric frailty is rising every year as well. In order to support the quality of geriatric prescribing and to lower possible adverse drug events, explicit criteria for potentially inappropriate drugs and drug procedures for elderly have been created. The aim of the diploma thesis was to evaluate how many potentially inappropriate medications (PIMs) for elderly out of 22 explicit criteria were registered in 6 countries (Czech Republic, Hungary, Portugal, Serbia, Spain and Turkey) participating at the 1st phase of the EU COST Action IS1402 initiative and which criterion or what group of regional criteria (European, American, Asian) would be the most specific and most suitable in individual countries for prospective international study following the quality of PIM prescribing. Methods: Of 22 explicit criteria of drugs/drug procedures potentially inappropriate in the old age, validated and published in peer-review journals and journals with the impact factor by 2015 year, a list of all until now known 345 PIMs was created (disregarding the dosage scheme, interval of use or...
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Analysis of pharmacotherapy in nursing homes
Šulcová, Hana ; Vlček, Jiří (advisor) ; Fialová, Daniela (referee)
ŠULCOVÁ, Hana: Analysis of pharmacotherapy in nursing homes. [Rigorózní práce]/Hana Šulcová - Charles University in Prague. Faculty of Pharmacy in Hradec Králové, Department of Social and Clinical Pharmacy - Prof. RNDr. Jiří Vlček, CSc., Hradec Králové, 2013. Geriatric patients of these days are typical of their multimorbidity and often concurrently use large amounts of drugs. However, their body reacts to certain drugs or groups of drugs differently than the body of younger ones due to all involutional changes that come with aging process. Polypharmacy and the use of medication that is potentially inappropriate in the elderly are a common cause of adverse drug reactions and put the patient's health at risk. Residents of nursing homes are more susceptible to multi-drug use and potential adverse drug reactions than community-dwelling seniors. This study is cross-sectional analysis of the pharmacotherapy in the nursing homes, focusing on the analysis of potentially inappropriate medications in the elderly (using STOPP criteria) and drug interactions (using databases AISLP and Micromedex). Five questionnaires focusing on the comprehensive geriatric assessment and respondents' awareness of their pharmacotherapy were also a part of the study. The respondents' demographic information and medical data...
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Evaluation of rationality and risks of pharmacotherapyin older patients in long-term care facilities
Lukačišinová, Anna ; Fialová, Daniela (advisor) ; Alušík, Štefan (referee) ; Paluch, Zoltán (referee)
Objectives Main objectives of this doctoral thesis were to review available information on pharmacological properties of benzodiazepines and their age-related changes; to evaluate the prevalence of benzodiazepine use in older patients residing in long term care facilities; to investigate the association between use of benzodiazepines and occurrence of falls in acutely hospitalized older patients; and to describe utilization of benzodiazepines in the Czech Republic. Methods A narrative review of literature focused on pharmacokinetics, pharmacodynamics, adverse effects and association of benzodiazepines with falls in older population was conducted. The evaluation of benzodiazepine use in long term care facilities was analysed in a retrospective cross-sectional study using data from the EC 7th Framework Program SHELTER project (Service and Health in the Elderly in Long Term Care). A prospective cohort study data of acutely hospitalized patients in Australia were used to evaluate association between benzodiazepines and falls. To describe utilization of benzodiazepines in the Czech Republic, data from the State Institute for Drug Control and from databases of General Health Insurance Fund were used. This dissertation thesis is a summary of published articles from above stated works and analyses. Results...
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Cardiovascular risc factors and complications associated with atherosclerosis - their prevalence and control in seniors in the EUROAGEISM H2020 project
Kubíková, Veronika ; Fialová, Daniela (advisor) ; Kostřiba, Jan (referee)
INTRODUCTION Cardiovascular diseases (CVD) are currently on the first place among the causes of death worldwide and also in the Czech Republic (CR). The most common causes of death among CVDs are disorders associated with atherosclerosis (ATS) and the prevalence of atherosclerosis and their complications increases with increasing age. The aim of this diploma thesis was to document CVS morbidity in geriatric patients in the sample of FIP7 program of the EUROAGEISM H2020 project, mainly the prevalence of CVS disorders associated with ATS, and to evaluate the controll of risk factors associatedwith general risks of progression of ATS. METHODS The data collection for this theses was carried out in the CR from September 2018 to January 2019 in patients in acute care at the age of 65 and older at geriatric wards in Hradec Králové (HK) and Brno. Patients involved in the study were those admitted to hospitalization at the time of data collection, were complying with inclusion criteria and undersigned the informed consent. The Ethics committee of the Faculy of Pharmacy, Charles University and ethics committee of participating healthcare facilities approved the project. Information have been obtained using the questionnaire for comprehensive geriatric assessment which is the secured instrument of the...
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Rationality of benzodiazepines use in older patients
Magátová, Adriana ; Fialová, Daniela (advisor) ; Lukačišinová, Anna (referee)
Institution/department: Charles University, Faculty of Pharmacy in Hradec Králové, Department of Social and Clinical Pharmacy Title of diploma thesis: Rationality of benzodiazepine use in older patients Supervisor: Assoc. Prof. Daniela Fialová, PharmDr. Ph.D. Author: Adriana Magátová Introduction: Benzodiazepines are one of the most commonly prescribed potentially inappropriate drugs (PIMs) in geriatric patients in Europe and are responsible for common problems associated with risky drug prescription in older age (eg, cognitive impairment, falls, orthostatic hypotension, drug dependence, and others). Physiological and pathophysiological changes associated with the aging process, as well as frequent polymorbidity and polypharmacotherapy, are associated with more frequent occurrence of drug-related complications in older age. With the growing proportion of geriatric population, the importance of preventing drug complications in older adults increases. The aim of this study was to compare prescribing habits in the use of BZD and in the use of drug combinations with sedative potential and to determine the association of their use with drug-related risks in geriatric patients in community pharmacy practice in Spain (SP) and the Czech Republic (CZ) and in groups of patients assessed in various healthcare settings...
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