|
|
Evaluation of the rationality of prescribing of selected potentially inappropriate medications in ambulatory geriatric patients
Leština, Roman ; Fialová, Daniela (advisor) ; Dvořáčková, Eliška (referee)
Institution/department: Charles University, Faculty of Pharmacy in Hradec Kralove, Department of Social and Clinical Pharmacy Title of diploma thesis: Evaluation of the rationality of prescribing of selected potentially inappropriate medications in ambulatory geriatric patients Supervisor: Assoc. Prof. Daniela Fialova, PharmDr. Ph.D. Author: Roman Lestina Introduction: Rational therapy in the geriatric population is an essential area due to the ever-increasing percentage of geriatric patients in the population. Due to the frequent polypharmacotherapy in these patients, including possible polypragmatism, it is important to constantly monitor potential drug problems and address potential drug risks in a timely manner. As an auxiliary tool in rational geriatric pharmacotherapy, expert groups have defined many potentially inappropriate medications (PIMs), which often contribute to drug reactions in the elderly, and which should be given more attention in clinical practice. This diploma thesis focused on 10 selected, most frequently used PIMs in the geriatric outpatient clinic of the University Hospital in Hradec Králové, and its aim was to monitor how often these drugs are prescribed in high-risk situations in geriatric patients (i.e., in the presence of symptoms, laboratory results and diseases, which...
|
|
|
Ageing of the population and selected aspects of the rationality of drug prescribing of statins in older age (II.)
Pekařová, Martina ; Fialová, Daniela (advisor) ; Kostřiba, Jan (referee)
Title: Ageing of the population and selected aspects of the rationality of drug prescribing of statins in older age (II.) Author: Martina Pekařová Tutor: Assoc. Prof. Daniela Fialová, PharmDr, Ph.D. University: Charles University Faculty: Faculty of Pharmacy in Hradec Králové Department: Department of Social and Clinical Pharmacy INTRODUCTION: In the geriatric population, cardiovascular diseases based on atherosclerosis rank first place in morbidity and mortality. A positive effect on cardiovascular morbidity can generally reduce overall morbidity, polymorbidity, polypharmacotherapy, and prolong the quality of life of older patients. Statins are often underprescribedin the treatment of ATS heart disease in older age or are underdosed in both primary and secondary prevention. The main goals of the diploma thesis was to analyze the rationality of statin prescription in the Czech population of seniors, assessed in the EuroAgeism H2020 project in three different health care settings (acute, outpatient and community pharmacy settings of health care). The aim was to describe various aspects of rational / irrational statine therapy in patients older than 65 years (choice of drugs, drug combinations, dosing timing, indications according to the degree of CVS risk in seniors, and indications in the presence...
|
|
|
Use of anticholinergic drugs in seniors
Havrošová, Andrea ; Fialová, Daniela (advisor) ; Lukačišinová, Anna (referee)
Introduction: In the past decades, the representation of seniors is increasing and the knowledge and the approaches to geriatrics and gerontology are more and more important. With the increasing age, there is also a grow in number of diseases and drugs (high incidence of polymorbidity and polypharmacotherapy). With regard to physiological, pathological and other changes related to aging, there is a higher risk of complications after drugs. For the rational use of drugs with old people, it is essential to eliminate negative influence and negative impacts of various drugs or non-drugs factors and to ensure the maximum effectiveness, safety and cost-effectiveness of given drugs regimens. Especially using anticholinergic drugs can have negative effect on older people (e.g confusion) while aging, "the cholinergic deficit" is increasing. As the anticholinergic drugs is necessary for seniors, it is required to use drugs with the lowest anticholinergic activity. This diploma thesis evaluates the prevalence of anticholinergic drugs usage. It also elaborates which anticholinergic drugs and combinations of these anticholinergic drugs are most commonly prescribed to geriatric patients in acute, ambulatory and pharmacy healthcare in the Czech Republic. Methodology: The analyzed data were collected from 2018 to...
|
|
|
The rational use of proton pump inhibitors among geriatric patients in the Czech Republic
Geletová, Ivana ; Fialová, Daniela (advisor) ; Kostřiba, Jan (referee)
Institution/department: Charles University, Faculty of Pharmacy in Hradec Kralove, Department of Social and Clinical Pharmacy Title of diploma thesis: The rational use of proton pump inhibitors among geriatric patients in the Czech Republic Supervisor: Assoc. Prof. Daniela Fialova, PharmDr. Ph.D. Author: Ivana Geletova Introduction: The dynamic process of ageing requires adequate attention at a global level, mainly in the area of providing a proper healthcare. Ageing process is specific by significant involutional changes and is often complicated by higher polymorbidity and polypharmacotherapy. Therefore, it is necessary to eliminate the negative impact of possible drug-related and nondrug-related risk factors and to ensure the rational use of medicines. Proton pump inhibitors (PPIs) are one of the most frequently prescribed classes of drugs in older adults, administered especially for the treatment of gastrointestinal tract (GIT) disorders associated with increased secretion of gastric acid and/or impairment of GIT or as a preventive treatment of potential drug-related and other gastropathies. This diploma thesis focused on evaluating the prevalence of use of PPIs among geriatric patients in acute, ambulatory and pharmacy settings of healthcare in the Czech Republic, in the EUROAGEISM H2020...
|
|
|
Ageing of the population and use of low-dose drug regimens in older patients (II.)
Koleníková, Jana ; Fialová, Daniela (advisor) ; Kostřiba, Jan (referee)
Title: Ageing of the population and use of low-dose drug regimens in older patients (ii.) Author: Jana Koleníková Tutor: Assoc. Prof. Daniela Fialová, PharmD, Ph.D. University: Charles University Faculty: Faculty of Pharmacy in Hradec Králové Department: Department of Social and Clinical Pharmacy Introduction: Proportion of seniors in the population is increasing worldwide, therefore rational pharmacotherapy in older adults is more emphasized. The drug pharmacokinetics and pharmacodynamics change in older age due to physiological and pathological changes, but also due to frequent polymorbidity and polypharmacotherapy. The use of certain medicines is therefore considered risky in seniors. For this reason, explicit expert criteria of medications potentially inappropriate in the aged (so called PIMs) have been created in many countries. Considering the fact that seniors were usually not included in randomized controlled trials, information about specific dosing in older adults for many medications is not stated in Summary of Product Characteristics (SmPCs) which provide basic information on effective and safe administration of medicines. The aim of the diploma thesis was to clarify whether in case of PIMs specific information about geriatric dosing is stated in SmPCs, or at least general warnings that...
|
|
|
Risks and problems associated with polypharmacy in older patients - A self-screening tool for identifying risks of pharmacotherapy by patients themselves
Pitrová, Markéta ; Fialová, Daniela (advisor) ; Kostřiba, Jan (referee)
Title: Risks and Problems Associated with Polypharmacy in Older Patients - A Self-Screening Tool for Identifying Risks of Pharmacotherapy by Patients Themselves Author: Markéta Pitrová Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové Supervisor: Assoc. Prof. Daniela Fialová, PharmD, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové and Department of Geriatrics and Gerontology, 1st Faculty of Medicine and General Teaching Hospital, Prague, Czech Republic BACKGROUND With the increasing number of older adults in the population nowadays, the importance of rational pharmacotherapy - the indication of the most effective, most safe and most cost-effective drug treatments - in older people grows. In order to early assess and resolve the risks of pharmacotherapy in this population, different pharmacotherapy risk assessment and risk management tools have been developed for use by physicians, pharmacists and other health care professionals. As the active involvement of older adults in the process of pharmacotherapy risk assessment and risk management increases, it is crucial to create also patient self- assessment tools in this area. Thus, the aim of the diploma thesis was to develop and test in a pilot study a new patient...
|
|
|
Evaluation of rationality and risks of pharmacotherapy in 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...
|
|
|
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...
|
|
|
Rational pharmacotherapy of osteoarthritis in older age
Miklasová, Monika ; Fialová, Daniela (advisor) ; Lukačišinová, Anna (referee)
Topic: Rational pharmacotherapy of osteoarthritis in older age Author: Monika Miklasová, MSc. Supervisor: Assoc. Prof. Daniela Fialová, PharmD, Ph.D. Department: Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction: Osteoarthritis (OA) is a chronic degenerative disorder. Its prevalence increases with processes of ageing and causal possibilities of pharmacological treatment are limited. Pharmacotherapy focuses mainly on symptomatic treatment of pain which should not be underestimated, but adequately treated. Goal: The aim of the rigorous thesis was to evaluate, in a group of ambulatory geriatric patients suffering from osteoarthritis and visiting general practitioners' offices, which medicinal products they use on prescription or as over-the-counter for the treatment of pain in OA. Another aim was to document how patients subjectively evaluate the efficacy of these medications (ie, how long does it take to experience the analgesic effect, how high is the maximum reduction of the intensity of pain, and how long does the analgesic effect last). Methods: The study included 204 geriatric patients in the age of 65 years and older who were treated for osteoarthritis in three general practitioners' offices in Uherské Hradiště, Czech Republic....
|
|
|
Ageing of the population and specific aspects of prescribing of hypnotics in older adults (II.)
Puldová, Karolína ; Fialová, Daniela (advisor) ; Kostřiba, Jan (referee)
Title: Ageing of the population and specific aspects of prescribing of hypnotics in older adults (II.) Student: Karolína Puldová, Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Czech Republic Supervisor: Assoc. Prof. Daniela Fialová, PharmD, Ph.D., Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové and Department of Geriatrics and Gerontology, 1st Faculty of Medicine and General Teaching Hospital, Prague, Czech Republic Introduction: World population is ageing and rational geriatric pharmacotherapy receives increasing attention. In seniors, rational pharmacotherapy is complicated by many risk factors, especially by physiological and pathological changes accompanying ageing, polymorbidity, polypharmacy, higher risk of adverse drug events, drug interactions and other risk factors. Particularly psychotropics belong to drug classes where rational prescribing in seniors often requires respecting of different rules. This diploma thesis focuses on specific aspects of irrational prescribing of hypnosedatives in ambulatory geriatric patients, particularly in the area of use of nongeriatric doses and nongeriatric lenght of therapy. Methodology: Data collection for this diploma thesis has been conducted between 2019-2020 years in the...
|
guest ::
RSS feed.