Inappropriate prescribing to the oldest old patients admitted to hospital: prevalence, most frequently used medicines, and associated factors

Background: Scientific evidence on treatments of chronic diseases in patients 85 years old or older is very limited, as is available information on inappropriate prescription (IP) and its associated factors. The study aimed to describe medicine prescription, potentially inappropriate medicines (PIM) and potentially prescribing omissions (PPO) and their associated factors on this population. Methods: In the context of an observational, prospective and multicentric study carried out in elderly patients admitted to seven Spanish hospitals for a year, a sub-analysis of those aged 85 years and over was performed. To assess PIMs, the Beers and STOPP criteria were used, and to assess PPOs, the START and the ACOVE-3 criteria were used. To assess factors associated with IP, a multivariate logistic regression analysis was performed. Patients were selected randomly every week on consecutive days from the hospitalization lists. Results: A total of 336 patients were included in the sub-analysis with a median (Q1-Q3) age of 88 (8690) years. The median medicines taken during the month prior to admission was 10 (713). Forty-seven point two per cent of patients had at least one Beers-listed PIM, 63.3% at least one STOPP-listed PIM, 53.6% at least one START-listed PPO, and 59.4% at least one ACOVE-3-listed PPO. Use of benzodiazepines in patients who are prone to falls (18.3%) and omission of calcium and vitamin D supplements in patients with osteoporosis (13.3%) were the most common PIM and PPO, respectively. The main factor associated with the Beers-listed and the STOPP-listed PIM was consumption of 10 or more medicines (OR = 5.7, 95% CI 1.8-17.9 and OR = 13.4, 95% CI 4.0-44.0, respectively). The main factors associated with the START-listed PPO was a non-community dwelling origin (OR 2.3, 95% CI 1.0-5.0), and multimorbidity (OR1.8, 95% CI 1.0-3.1). Conclusions: Prescribed medicines and PIM and PPO prevalence were high among patients 85 years and over. Benzodiazepine use in those who are prone to falls and omission of calcium and vitamin D in those with osteoporosis were the most frequent PIM and PPO, respectively. Factors associated with PIM and PPO differed with polypharmacy being the most important factor associated with PIM.

Gens,humans i rock

El rock'n'roll, un dels estils musicals més influents del segle XX, es va gestar als EUA durant la dècada de 1940 a partir del blues, el rhythm'n'blues i el country. Joel vaig descobrir de forma conscient el 1979, quan tenia 14 anys. I el seu ritme em va captivar tant les neurones que continua sent el meu estil musical predilecte, amb el qual identifico bona part de les meves emocions.

Els Hot Five : Louis Armstrong, l'avantguardista

Els objectius d’aquest treball són: reivindicar la faceta de Louis Armstrong com a músic al capdavant de l’avantguarda musical dels anys vint als Estats Units, analitzar les claus per entendre el seu ascens a la fama a partir dels anys trenta i valorar la seva contribució a la història de la música afroamericana. El cos del treball consta de dues parts: la primera, una biografia de l’artista per esbossar el seu context històric i el seu perfil psicològic; i la segona, que és el centre del treball, una anàlisi de les peces Savoy Blues, Cornet Chop Suey i Gully Low Blues, totes elles pertanyents al període dels Hot Five (1925-1929).