28 research outputs found
THE STIGMA OF LOW OPIOID PRESCRIPTION IN THE HOSPITALIZED MULTIMORBID ELDERLY IN ITALY
No full textThe primary aim of this study was to evaluate the prevalence of opioid prescriptions in hospitalized geriatric patients. Other aims were to evaluate factors associated with opioid prescription, and whether or not there was consistency between the presence of pain and prescription. Opioid prescriptions were gathered from the REgistro POliterapie Societa‘ Italiana di Medicina Interna (REPOSI) data for the years 2008, 2010 and 2012. 1,380 in-patients, 65? years old, were enrolled in the first reg-istry run, 1,332 in the second and 1,340 in the third. The prevalence of opioid prescription was calculated at hospital admission and discharge. In the third run of the registry, the degree of pain was assessed by means of a numerical scale. The prevalence of patients prescribed with opioids at admission was 3.8 % in the first run, 3.6 % in the second and 4.1 % in the third, whereas at discharge rates were slightly higher (5.8, 5.3, and 6.6 %). The most frequently prescribed agents were mild opioids such as codeine and tramadol. The number of total prescribed drugs was posi-tively associated with opioid prescription in the three runs; in the third, dementia and a better functional status were inversely associated with opioid prescription. Finally, as many as 58 % of patients with significant pain at discharge were prescribed no analgesic at all. The conservative atti-tude of Italian physicians to prescribe opioids in elderly patients changed very little between hospital admission and discharge through a period of 5 years. Reasons for such a low opioid prescription should be sought in physicians’ and patients’ concerns and prejudices
The Drug Prescription Network: A System-Level View of Drug Co-Prescription in Community-Dwelling Elderly People
No full textNetworks are well suited to display and analyze complex systems that consist of numerous and interlinked elements. This study aimed at: (1) generating a series of drug prescription networks (DPNs) displaying co-prescription in community-dwelling elderly people; (2) analyzing DPN structure and organization; and (3) comparing various DPNs to unveil possible differences in drug co-prescription patterns across time and space. Data were extracted from the administrative prescription database of the Lombardy Region in northern Italy in 2000 and 2010. DPNs were generated, in which each node represents a drug chemical subclass, whereas each edge linking two nodes represents the co-prescription of the corresponding drugs to the same patient. At a global level, the DPN was a very dense and highly clustered network, whereas at the local level it was organized into anatomically homogeneous modules. In addition, the DPN was assortative by class, because similar nodes (representing drugs with the same anatomic, therapeutic, and pharmacologic annotation) connected to each other more frequently than expected, indicating that similar drugs are often co-prescribed. Finally, temporal changes in the co-prescription of specific drug sub-groups (for instance, proton pump inhibitors) translated into topological changes of the DPN and its modules. In conclusion, complementing more traditional pharmaco-epidemiology methods, the DPN-based method allows appreciatiation (and representation) of general trends in the co-prescription of a specific drug (e.g., its emergence as a heavily co-prescribed hub) in comparison with other drugs
Table 5. Results of multivariable analyses of the associations between biomarkers retained and the three subacute pain sites studied (n = 3,658).
No full text(DOCX)</p
Selected characteristics of the study sample (n = 4,742).
No full textSelected characteristics of the study sample (n = 4,742).</p
Specific biomarkers considered in main analyses (n = 4,742).
No full textSpecific biomarkers considered in main analyses (n = 4,742).</p
Selection of study participants.
No full textN.B: The number of participants with pain includes all pain sites included in NHANES 2003–2004. The question on pain includes all sites of musculoskeletal pain (shoulder, arm, low back, leg, neck, spine, hand, foot…).</p
Results of multivariable analyses of the associations between biomarkers retained and the three chronic pain<sup>a</sup> sites.
No full textstudied (n = 4,307).</p
Table 4. Results of multivariable analyses of the associations between biomarkers retained and the three acute pain sites studied (n = 3,834).
No full text(DOCX)</p
