JoVE Visualize What is visualize?
Stop Reading. Start Watching.
Advanced Search
Stop Reading. Start Watching.
Regular Search
Find video protocols related to scientific articles indexed in Pubmed.
Potentially Suboptimal Prescribing for Older Veteran Nursing Home Patients With Dementia.
Ann Pharmacother
PUBLISHED: 11-09-2014
Show Abstract
Hide Abstract
Nursing home patients with dementia may be more likely to suffer adverse drug events from suboptimal prescribing. Previous studies have not used national samples, nor have they examined multiple types of suboptimal prescribing by dementia severity.
Related JoVE Video
Medication misadventures in older adults: literature from 2013.
J Am Geriatr Soc
PUBLISHED: 10-22-2014
Show Abstract
Hide Abstract
The objective of this paper is to review articles published in 2013 examining drug-related problems in the elderly and comment on their potential impact on clinical practice. To identify articles, we did a systematic search of the English-language literature restricted to those aged 65 + from January 2013 to December 2013 using Medline and Google Scholar and a combination of the following search terms: drug-related problems, medication-related problems, medication errors, suboptimal prescribing, inappropriate prescribing, underutilization, polypharmacy, medication monitoring, medication dispensing, medication administration, medication adherence, adverse drug events, and adverse drug withdrawal events. A manual search of major general medicine and clinical pharmacology journals was also conducted to identify additional articles. A total of 51 articles were identified of which 20 were chosen to highlight. Three were annotated and critiqued and the additional 17 articles were summarized in an appendix. One article reported the results of a randomized controlled trial that showed that a pharmacist intervention successfully reduced suboptimal prescribing in older hospital patients. Another paper from this group previously reported data from the same study showing that the intervention also reduced medication related readmissions to the hospital. An observational study compared the use of two thiazide diuretics in older outpatients. They found that chlorthalidone was more likely to cause hypokalemia than hydrochlorothiazide. Finally, in a randomized controlled trial a pharmacist intervention resulted in the reduction of anticholinergic burden but did result in an improvement in cognition. These studies highlight that medication errors and adverse drug events continue to be important issues for health care professionals caring for older adults.
Related JoVE Video
Gastroprotective Agent Underuse in High-Risk Older Daily Nonsteroidal Anti-Inflammatory Drug Users over Time.
J Am Geriatr Soc
PUBLISHED: 10-03-2014
Show Abstract
Hide Abstract
To examine whether older adults taking nonsteroidal anti-inflammatory drugs (NSAIDs) decreased the underuse of gastroprotective agents over time.
Related JoVE Video
Clinical consequences of polypharmacy in elderly.
Expert Opin Drug Saf
PUBLISHED: 09-27-2013
Show Abstract
Hide Abstract
Introduction: Polypharmacy, defined as the use of multiple drugs or more than are medically necessary, is a growing concern for older adults. MEDLINE and EMBASE databases were searched from January 1, 1986 to June 30, 2013) to identify relevant articles in people aged > 65 years. Areas covered: We present information about: i) prevalence of polypharmacy and unnecessary medication use; ii) negative consequences of polypharmacy; and iii) interventions to improve polypharmacy. Expert opinion: International research shows that polypharmacy is common in older adults with the highest number of drugs taken by those residing in nursing homes. Nearly 50% of older adults take one or more medications that are not medically necessary. Research has clearly established a strong relationship between polypharmacy and negative clinical consequences. Moreover, well-designed interprofessional (often including clinical pharmacist) intervention studies that focus on enrolling high-risk older patients with polypharmacy have shown that they can be effective in reducing aspects of unnecessary prescribing with mixed results on distal health outcomes.
Related JoVE Video
The medication appropriateness index at 20: where it started, where it has been, and where it may be going.
Drugs Aging
PUBLISHED: 09-25-2013
Show Abstract
Hide Abstract
Potentially inappropriate prescribing for older adults is a major public health concern. While there are multiple measures of potentially inappropriate prescribing, the medication appropriateness index (MAI) is one of the most common implicit approaches published in the scientific literature. The objective of this narrative review is to describe findings regarding the MAIs reliability, comparison of the MAI with other quality measures of potentially inappropriate prescribing, its predictive validity with important health outcomes, and its responsiveness to change within the framework of randomized controlled trials. A search restricted to English-language literature involving humans aged 65+ years from January 1992 to June 2013 was conducted using MEDLINE and EMBASE databases using the search term medication appropriateness index. A manual search of the reference lists from identified articles and the authors article files, book chapters, and recent reviews was conducted to identify additional articles. A total of 26 articles were identified for inclusion in this narrative review. The main findings were that the MAI has acceptable inter- and intra-rater reliability, it more frequently detects potentially inappropriate prescribing than a commonly used set of explicit criteria, it predicts adverse health outcomes, and it is able to demonstrate the positive impact of interventions to improve this public health problem. We conclude that the MAI may serve as a valuable tool for measuring potentially inappropriate prescribing in older adults.
Related JoVE Video
Changes in cholesterol-lowering medications use over a decade in community-dwelling older adults.
Ann Pharmacother
PUBLISHED: 06-18-2013
Show Abstract
Hide Abstract
The impact of evidence-based guidelines and controlled trial data on use of cholesterol-lowering medications in older adults is unclear.
Related JoVE Video
The quality of quality measures: HEDIS® quality measures for medication management in the elderly and outcomes associated with new exposure.
Drugs Aging
PUBLISHED: 05-07-2013
Show Abstract
Hide Abstract
Clinical validation studies of the Healthcare Effectiveness Data and Information Set (HEDIS®) measures of inappropriate prescribing in the elderly are limited.
Related JoVE Video
Racial differences in antilipemic use and lipid control in high-risk older adults: post-Medicare Part D.
Am. Heart J.
PUBLISHED: 04-12-2013
Show Abstract
Hide Abstract
Older blacks are less likely to receive guideline-recommended antilipemic therapy and achieve lipid control than older whites because, in part, of out-of-pocket costs. We sought to determine whether racial differences in antilipemic use and lipid control narrowed after Medicare Part Ds implementation.
Related JoVE Video
Utility of an adverse drug event trigger tool in Veterans Affairs nursing facilities.
Consult Pharm
PUBLISHED: 02-12-2013
Show Abstract
Hide Abstract
To determine the utility (i.e., positive predictive value [PPV] and time requirement) of an adverse drug event (ADE) trigger tool in Veterans Affairs (VA) nursing facilities and to describe the most common types of potential ADEs detected with the trigger tool.
Related JoVE Video
Prevalence and correlates of self-reported medication non-adherence among older adults with coronary heart disease, diabetes mellitus, and/or hypertension.
Res Social Adm Pharm
PUBLISHED: 01-04-2013
Show Abstract
Hide Abstract
Information about the prevalence and correlates of self-reported medication nonadherence using multiple measures in older adults with chronic cardiovascular conditions is needed.
Related JoVE Video
Prevalence of unplanned hospitalizations caused by adverse drug reactions in older veterans.
J Am Geriatr Soc
PUBLISHED: 12-08-2011
Show Abstract
Hide Abstract
To describe the prevalence of unplanned hospitalizations caused by adverse drug reactions (ADRs) in older veterans and to examine the association between this outcome and polypharmacy after controlling for comorbidities and other patient characteristics.
Related JoVE Video
Impact of Medicare Part D on antidepressant treatment, medication choice, and adherence among older adults with depression.
Am J Geriatr Psychiatry
PUBLISHED: 11-30-2011
Show Abstract
Hide Abstract
Depression in older adults is often undertreated due, in part, to medication costs. We examined the impact of improved prescription drug coverage under Medicare Part D on use of antidepressants, medication choice, and adherence.
Related JoVE Video
Angiotensin-converting enzyme inhibitor and statin use and incident mobility limitation in community-dwelling older adults: the Health, Aging and Body Composition study.
J Am Geriatr Soc
PUBLISHED: 11-04-2011
Show Abstract
Hide Abstract
To evaluate whether the use of angiotensin-converting enzyme (ACE) inhibitors and statins is associated with a lower risk of incident mobility limitation in older community dwelling adults.
Related JoVE Video
Analgesic use for knee and hip osteoarthritis in community-dwelling elders.
Pain Med
PUBLISHED: 10-12-2011
Show Abstract
Hide Abstract
To examine the prevalence and correlates of non-opioid and opioid analgesic use and descriptively evaluate potential undertreatment in a sample of community-dwelling elders with symptomatic knee and/or hip osteoarthritis (OA).
Related JoVE Video
Medication use and functional status decline in older adults: a narrative review.
Am J Geriatr Pharmacother
PUBLISHED: 09-28-2011
Show Abstract
Hide Abstract
Functional status is the cornerstone of geriatric care and serves as an indicator of general well-being. A decline in function can increase health care use, worsen quality of life, threaten independence, and increase the risk of mortality. One of several risk factors for decline in functional status is medication use.
Related JoVE Video
Trends in use of high-risk medications for older veterans: 2004 to 2006.
J Am Geriatr Soc
PUBLISHED: 08-30-2011
Show Abstract
Hide Abstract
To examine the change in use of high-risk medications for the elderly (HRME), as defined by the National Committee on Quality Assurances Healthcare Effectiveness Data and Information Set (HEDIS) quality measure (HEDIS HRME), by older outpatient veterans over a 3-year period and to identify risk factors for HEDIS HRME exposure overall and for the most commonly used drug classes.
Related JoVE Video
Improving the pharmacologic management of pain in older adults: identifying the research gaps and methods to address them.
Pain Med
PUBLISHED: 08-11-2011
Show Abstract
Hide Abstract
There has been a growing recognition of the need for better pharmacologic management of chronic pain among older adults. To address this need, the National Institutes of Health Pain Consortium sponsored an "Expert Panel Discussion on the Pharmacological Management of Chronic Pain in Older Adults" conference in September 2010 to identify research gaps and strategies to address them. Specific emphasis was placed on ascertaining gaps regarding use of opioid and nonsteroidal anti-inflammatory medications because of continued uncertainties regarding their risks and benefits.
Related JoVE Video
Exposure to potentially harmful drug-disease interactions in older community-dwelling veterans based on the Healthcare Effectiveness Data and Information Set quality measure: who is at risk?
J Am Geriatr Soc
PUBLISHED: 08-10-2011
Show Abstract
Hide Abstract
To identify prevalence and risk factors for exposure to drug-disease interactions included in the Healthcare Effectiveness Data and Information Set (HEDIS) Drug-Disease Interaction (Rx-DIS) measure.
Related JoVE Video
Potential underuse, overuse, and inappropriate use of antidepressants in older veteran nursing home residents.
J Am Geriatr Soc
PUBLISHED: 08-08-2011
Show Abstract
Hide Abstract
To examine prevalence and resident- and site-level factors associated with potential underuse, overuse, and inappropriate use of antidepressants in older Veterans Affairs (VA) Community Living Center (CLC) residents.
Related JoVE Video
A review of the effectiveness of antidepressant medications for depressed nursing home residents.
J Am Med Dir Assoc
PUBLISHED: 07-21-2011
Show Abstract
Hide Abstract
Antidepressant medications are the most common psychopharmacologic therapy used to treat depressed nursing home (NH) residents. Despite a significant increase in the rate of antidepressant prescribing over the past several decades, little is known about the effectiveness of these agents in the NH population.
Related JoVE Video
Do geriatric conditions increase risk of adverse drug reactions in ambulatory elders? Results from the VA GEM Drug Study.
J. Gerontol. A Biol. Sci. Med. Sci.
PUBLISHED: 02-14-2011
Show Abstract
Hide Abstract
Many clinicians prescribe cautiously to older adults with common geriatric conditions for fear of causing adverse drug reactions (ADRs). However, little is known about the association between these conditions and risk of ADRs.
Related JoVE Video
Year in review: medication mishaps in the elderly.
Am J Geriatr Pharmacother
PUBLISHED: 01-20-2011
Show Abstract
Hide Abstract
This paper reviews articles from 2010 that examined medication mishaps (ie, medication errors and adverse drug events [ADEs]) in the elderly.
Related JoVE Video
Managing medications in clinically complex elders: "Theres got to be a happy medium".
JAMA
PUBLISHED: 10-14-2010
Show Abstract
Hide Abstract
Multiple medication use is common in older adults and may ameliorate symptoms, improve and extend quality of life, and occasionally cure disease. Unfortunately, multiple medication use is also a major risk factor for prescribing and adherence problems, adverse drug events, and other adverse health outcomes. Using the case of an older patient taking multiple medications, this article summarizes the evidence-based literature about improving medication use and withdrawing specific drugs and drug classes. It also describes a systematic approach for how health professionals can assess and improve medication regimens to benefit patients and their caregivers and families.
Related JoVE Video
The effect of medication use on urinary incontinence in community-dwelling elderly women.
J Am Geriatr Soc
PUBLISHED: 07-31-2010
Show Abstract
Hide Abstract
To evaluate whether use of certain medications with potential urological effects is associated with development of incident urinary incontinence in community-resident older women.
Related JoVE Video
The quality of warfarin prescribing and monitoring in Veterans Affairs nursing homes.
J Am Geriatr Soc
PUBLISHED: 07-19-2010
Show Abstract
Hide Abstract
To describe the quality of warfarin prescribing and monitoring in Veterans Affairs (VA) nursing homes and to assess the factors associated with maintaining a therapeutic international normalized ratio (INR).
Related JoVE Video
Pain and its treatment in older nursing home hospice/palliative care residents.
J Am Med Dir Assoc
PUBLISHED: 06-30-2010
Show Abstract
Hide Abstract
The objectives of this study were to determine the prevalence of pain, describe its treatment, and determine factors associated with any pain in older residents assigned to a hospice specialty unit bed or receiving services from a hospice/palliative care/end-of-life special program in US nursing homes.
Related JoVE Video
What types of inappropriate prescribing predict adverse drug reactions in older adults?
Ann Pharmacother
PUBLISHED: 05-12-2010
Show Abstract
Hide Abstract
Adverse drug events happen all too often in older adults, but we still do not have a clear understanding of potentially modifiable risk factors, with the exception of polypharmacy. This paper critiques the article in this issue of The Annals entitled, "Inappropriate Prescribing Predicts Adverse Drug Events in Older Adults." A validated measure for self-reported adverse drug events was used, along with a modified measure for inappropriate prescribing that we developed nearly 2 decades ago (ie, Medication Appropriateness Index). Besides discussing the strengths and weaknesses of this article, we also recommend future research directions in this area.
Related JoVE Video
Potentially inappropriate medications and risk of hospitalization in retirees: analysis of a US retiree health claims database.
Drugs Aging
PUBLISHED: 05-11-2010
Show Abstract
Hide Abstract
One important health outcome of inappropriate medication use in the elderly is risk of hospitalization. We examined this relationship over 3 years in a retiree health claims database to determine the strength of this association using alternative definitions of potentially inappropriate medications. Prescription and hospitalization claims for US retirees from a single large corporation were examined over the 3-year period, 2003-5. Purging the database of non-employees (dependents, spouses), employees aged <65 years (who were not Medicare-eligible) and retirees not covered for the full 3-year period left a sample of 7459 retirees. Respondents medications were categorized according to two lists of drugs to avoid: Beers (2003 update) and the National Committee for Quality Assurance (NCQA). Logistic regression models were developed to examine risk of hospitalization in 2005 relative to use of potentially inappropriate medications across different periods of follow-up. Retirees taking one or more of the potentially inappropriate medications on the Beers or NCQA lists were 1.8-1.9 times more likely to have a hospital admission in models that adjusted for age, gender, number of prescriptions overall and aggregate disease severity. Risk of hospitalization increased in a dose-response relationship according to number of potentially inappropriate medications. Consistency in the strength of the association between drugs to avoid and hospital admission across different definitions of inappropriate medication use suggests the finding is robust. Findings from the retiree cohort provide further evidence for the inappropriateness of these medications among the elderly.
Related JoVE Video
The Medicare drug benefit (Part D) and treatment of heart failure in older adults.
Am. Heart J.
PUBLISHED: 04-28-2010
Show Abstract
Hide Abstract
Adherence to pharmacotherapy for heart failure is poor among older adults in part because of high prescription drug costs. We examined the impact of improvements in drug coverage under Medicare Part D on utilization of, and adherence to, medications for heart failure in older adults.
Related JoVE Video
A cross-sectional analysis of the prevalence of undertreatment of nonpain symptoms and factors associated with undertreatment in older nursing home hospice/palliative care patients.
Am J Geriatr Pharmacother
PUBLISHED: 04-19-2010
Show Abstract
Hide Abstract
Approximately 25% of all US deaths occur in the long-term care setting, and this figure is projected to rise to 40% by the year 2040. Currently, there is limited information on nonpain symptoms and their appropriate treatment in this setting at the end of life.
Related JoVE Video
Interventions to improve suboptimal prescribing in nursing homes: A narrative review.
Am J Geriatr Pharmacother
PUBLISHED: 04-12-2010
Show Abstract
Hide Abstract
Appropriate medication prescribing for nursing home residents remains a challenge.
Related JoVE Video
Medication misadventures in the elderly: a year in review.
Am J Geriatr Pharmacother
PUBLISHED: 03-16-2010
Show Abstract
Hide Abstract
This paper reviews recent articles examining medication misadventures that can be defined as medication errors and adverse drug events in the elderly.
Related JoVE Video
Potentially inappropriate prescribing of primarily renally cleared medications for older veterans affairs nursing home patients.
J Am Med Dir Assoc
PUBLISHED: 03-04-2010
Show Abstract
Hide Abstract
Inappropriate prescribing of primarily renally cleared medications in older patients with kidney disease can lead to adverse outcomes.
Related JoVE Video
Antidepressant prescribing in US nursing homes between 1996 and 2006 and its relationship to staffing patterns and use of other psychotropic medications.
J Am Med Dir Assoc
PUBLISHED: 01-15-2010
Show Abstract
Hide Abstract
Few studies have examined factors associated with antidepressant prescribing in older nursing home residents.
Related JoVE Video
Underuse of indicated medications among physically frail older US veterans at the time of hospital discharge: results of a cross-sectional analysis of data from the Geriatric Evaluation and Management Drug Study.
Am J Geriatr Pharmacother
PUBLISHED: 10-26-2009
Show Abstract
Hide Abstract
Medication underutilization, or the omission of a potentially beneficial medication indicated for disease management, is common among older adults but poorly understood.
Related JoVE Video
Central nervous system medication use and incident mobility limitation in community elders: the Health, Aging, and Body Composition study.
Pharmacoepidemiol Drug Saf
PUBLISHED: 07-09-2009
Show Abstract
Hide Abstract
To evaluate whether CNS medication use in older adults was associated with a higher risk of future incident mobility limitation.
Related JoVE Video
Racial differences in medication use among older, long-stay Veterans Affairs nursing home care unit patients.
Consult Pharm
PUBLISHED: 06-27-2009
Show Abstract
Hide Abstract
To examine racial differences in medication use by older long-stay Veterans Affairs Nursing Home Care Unit (NHCU) patients.
Related JoVE Video
Results of a longitudinal analysis of national data to examine relationships between organizational and market characteristics and changes in antipsychotic prescribing in US nursing homes from 1996 through 2006.
Am J Geriatr Pharmacother
PUBLISHED: 04-08-2009
Show Abstract
Hide Abstract
The aim of this work was to examine the association between organizational characteristics, market characteristics, and changes in antipsychotic medication use in US nursing homes over time.
Related JoVE Video
Assessing the quality of prescribing and monitoring erythropoiesis-stimulating agents in the nursing home setting.
J Am Med Dir Assoc
PUBLISHED: 03-20-2009
Show Abstract
Hide Abstract
As many as 50% of all nursing home (NH) residents meet the World Health Organization criteria for anemia. The objectives of this study were to determine the prevalence and appropriateness of prescribing and monitoring of erythropoiesis-stimulating agents (ESAs) used to treat anemia in the NH setting.
Related JoVE Video
Related JoVE Video
Number and dosage of central nervous system medications on recurrent falls in community elders: the Health, Aging and Body Composition study.
J. Gerontol. A Biol. Sci. Med. Sci.
PUBLISHED: 02-04-2009
Show Abstract
Hide Abstract
Few studies have examined the risk of multiple or high doses of combined central nervous system (CNS) medication use for recurrent falls in the elderly. The study objective was to evaluate whether multiple- or high-dose CNS medication use in older adults was associated with a higher risk of recurrent (>or=2) falls.
Related JoVE Video
Consensus guidelines for oral dosing of primarily renally cleared medications in older adults.
J Am Geriatr Soc
PUBLISHED: 01-28-2009
Show Abstract
Hide Abstract
To establish consensus oral dosing guidelines for primarily renally cleared medications prescribed for older adults.
Related JoVE Video
A brief, intensive, clinically focused geriatrics course during the third year of medical school.
J Am Geriatr Soc
PUBLISHED: 01-17-2009
Show Abstract
Hide Abstract
During the next several decades, the aging of the "baby boom" generation in the United States will result in a dramatic increase in the number of patients aged 65 and older seeking medical care, but current projections suggest that the shortage of geriatrics-trained specialists will only worsen during this time period. As a result, the care of elderly patients will largely fall to other types of physicians. Consequently, it is imperative that medical school training include exposure to the basic skills needed to care safely for older adults. This goal is challenging, because the number of geriatric medicine faculty in most academic medical centers is small, and multiple other medical specialties are also vying for time in a busy medical school curriculum. Whether a 3-day course conducted during the third year of medical school could teach basic principles of geriatric medicine in a time- and manpower-effective manner was explored. It was found that even this brief exposure to geriatrics could have meaningful effects on student knowledge of and comfort with geriatrics.
Related JoVE Video
Provider management of and satisfaction with laboratory testing in the nursing home setting: results of a national internet-based survey.
J Am Med Dir Assoc
PUBLISHED: 01-08-2009
Show Abstract
Hide Abstract
To describe the management of and satisfaction with laboratory testing, and desirability of laboratory health information technology in the nursing home setting.
Related JoVE Video
Impact of a geriatric nursing home palliative care service on unnecessary medication prescribing.
Am J Geriatr Pharmacother
PUBLISHED: 01-06-2009
Show Abstract
Hide Abstract
There is a lack of studies concerning improvement of medication use in palliative care patients in nursing homes.
Related JoVE Video
Use of antipsychotics among older residents in VA nursing homes.
Med Care
Show Abstract
Hide Abstract
Antipsychotic medications are commonly prescribed to nursing home residents despite their well-established adverse event profiles. Because little is known about their use in Veterans Affairs (VA) nursing homes [ie, Community Living Centers (CLCs)], we assessed the prevalence and risk factors for antipsychotic use in older residents of VA CLCs.
Related JoVE Video
Adverse effects of analgesics commonly used by older adults with osteoarthritis: focus on non-opioid and opioid analgesics.
Am J Geriatr Pharmacother
Show Abstract
Hide Abstract
Osteoarthritis (OA) is the most common cause of disability in older adults, and although analgesic use can be helpful, it can also result in adverse drug events.
Related JoVE Video
Medicare Part D and potentially inappropriate medication use in the elderly.
Am J Manag Care
Show Abstract
Hide Abstract
Inappropriate medication use, which is common in older adults, may be responsive to out-of-pocket costs. We examined the impact of Medicare Part D on inappropriate medication use among Medicare beneficiaries.
Related JoVE Video
Antihypertensive drug class use and differential risk of urinary incontinence in community-dwelling older women.
J. Gerontol. A Biol. Sci. Med. Sci.
Show Abstract
Hide Abstract
Medication use is a potentially reversible cause of urinary incontinence (UI). The objective of this longitudinal cohort study was to evaluate whether self-reported UI in community-dwelling older women is associated with the use of different classes of antihypertensive agents.
Related JoVE Video
Facility-level variation in potentially inappropriate prescribing for older veterans.
J Am Geriatr Soc
Show Abstract
Hide Abstract
To describe facility-level variation in two measures of potentially inappropriate prescribing prevalent in Veterans Affairs (VA) facilities-exposure to high-risk medications in elderly adults (HRME) and drug-disease interactions (Rx-DIS)-and to identify facility characteristics associated with high-quality prescribing.
Related JoVE Video
Ethnic disparities in adherence to antihypertensive medications of medicare part D beneficiaries.
J Am Geriatr Soc
Show Abstract
Hide Abstract
To determine the level of adherence to medications and characteristics of Part D beneficiaries associated with higher levels of antihypertensive medication adherence.
Related JoVE Video
Prevalence of potentially preventable unplanned hospitalizations caused by therapeutic failures and adverse drug withdrawal events among older veterans.
J. Gerontol. A Biol. Sci. Med. Sci.
Show Abstract
Hide Abstract
Background. Studies of drug-related hospitalizations have focused on adverse drug reactions, but few data are available on therapeutic failures (TFs) and adverse drug withdrawal events (ADWEs) leading to hospitalization among community-dwelling older adults. Thus, we sought to describe the prevalence of unplanned hospitalizations caused by TFs and ADWEs. In addition, we evaluated factors associated with these events in a nationally representative sample of older Veterans. Methods. This study included 678 randomly selected unplanned hospitalizations of older (age ? 65 years) Veterans between December 1, 2003, and November 9, 2006. The main outcomes were hospitalizations caused by a TF and/or an ADWE as determined by a pair of health professionals from review of medication charts and application of the Therapeutic Failure Questionnaire and/or Naranjo ADWE algorithm, respectively. Preventability (ie, medication error) of the admission was also assessed. Results. Thirty-four TFs and eight ADWEs involving 54 drugs were associated with 40 (5.9%) Veterans hospitalizations; of these admissions, 90.0% (36/40) were rated as potentially preventable mostly due to medication nonadherence and suboptimal prescribing. The most common TFs that occurred were heart failure exacerbations (n = 8), coronary heart disease symptoms (n = 6), tachyarrhythmias (n = 3), and chronic obstructive pulmonary disease exacerbations (n = 3). Half (4/8) of the ADWEs that occurred were cardiovascular in nature. Multivariable logistic regression modeling indicated that black Veterans (adjusted odds ratio 2.92, 95% CI 1.25-6.80) were significantly more likely to experience a TF-related admission compared with white Veterans. Conclusions. TF-related unplanned hospitalizations occur more frequently than ADWE-related admissions among older Veterans. Almost all TFs and/or ADWEs are potentially preventable.
Related JoVE Video
Sources of regional variation in Medicare Part D drug spending.
N. Engl. J. Med.
Show Abstract
Hide Abstract
Sources of regional variation in spending for prescription drugs under Medicare Part D are poorly understood, and such variation may reflect differences in health status, use of effective treatments, or selection of branded drugs over lower-cost generics.
Related JoVE Video
Age-related changes in antidepressant pharmacokinetics and potential drug-drug interactions: a comparison of evidence-based literature and package insert information.
Am J Geriatr Pharmacother
Show Abstract
Hide Abstract
Antidepressants are among the most commonly prescribed psychotropic agents for older patients. Little is known about the best source of pharmacotherapy information to consult about key factors necessary to safely prescribe these medications to older patients.
Related JoVE Video

What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

How does it work?

We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.