|
|
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...
|
|
|
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...
|
|
|
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...
|
|
|
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...
|
|
|
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...
|
|
|
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...
|
|
|
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...
|
|
|
Risks of gastrotoxicity and rationality of presribing of proton pump inhibitors in seniors in acute care in the EUROAGEISM H2020 project
Masaryková, Petra ; Fialová, Daniela (advisor) ; Doseděl, Martin (referee)
INTRODUCTION The deepening process of demographic aging has a significant impact on all areas of the society. With increasing age, the presence of illness, as well as the amount of used drugs increases. The most commonly prescribed drugs are often proton pump inhibitors, which play an irreplaceable role in the treatment of many gastrointestinal diseases. The trend of the overuse of proton pump inhibitors as the main antisecretory drugs is mainly related to their long-term administration in the prophylaxis of concurrent use of gastrotoxic drugs. The aim of this work was to evaluate the rationality of use of proton pump inhibitors including indications, administered dosages and duration of treatment. METHODS The data collected and used in this work are a part of the FIP7 project of the EUROAGEISM H2020 program. The study involved 438 geriatric patients in acute care institutions in Brno, Prague, and Hradec Králové, who were hospitalized between August 2018 and January 2019. The inclusion criteria were age over 65 years and adherence to inclusion criteria of the study. Seniors with severe cognitive impairment (MMSE < 10 points), memory impairment, speech or hearing impairment, patients hospitalized in the intensive care unit and in the terminal stage of the disease were excluded from the study. Data...
|
|
|
Analyses of the rationality of hypnotics use in acute care geriatrics in the czech set of the Euroageism H2020 project
Zelinková, Andrea ; Fialová, Daniela (advisor) ; Malý, Josef (referee)
Introduction: As the population is aging and the number of the seniors is rising, the importance of knowledge and methods of geriatry and gerontology grows bigger. The seniors represent highly specified group of patients whose health care and treatment should be paid especial attention. Multimorbidity, polypharmacotherapy and an enlarged risk of adverse drug events often make such treatment more complicated. Complex geriatric assessment and acceptance of principals of geriatric prescription both represent key values of rational treatment. This thesis is dedicated to the issue of insomnia and rating of sedative/hypnotic treatment in the czech sample of seniors in acute care. Methodology: The data for this thesis were collected between the years 2018-2019 within EUROAGEISM H2020 project. They include information on 438 patients 65 years of age and older which was collected from three geriatric medical acute care centres in Czech republic (Prague, Brno, Hradec Králové) and gained from the medical documentation combined with the information from patient and medical staff themselves, which were interviewed with use of standardized questionnaire of the EUROAGEISM H2020 research project. The questionnaire was composed from sociodemographic characteristics, assesment of functional ability, nutrition state...
|
guest ::
