Inappropriate prescription of allopurinol and febuxostat and risk of adverse events in the elderly: results from the REPOSI registry.
Purpose: To investigate the prevalence of xanthine oxidase (XO) inhibitors prescription at admission and discharge in elderly hospital in-patients, to analyze the appropriateness of their use in relation to evidence-based indications, to evaluate the predictors of inappropriate prescription at disch...
| Publicado en: | European Journal of Clinical Pharmacology Vol. 70; no. 12; pp. 1495 - 1504 |
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| Autores principales: | , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Dec2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103914493&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103914493 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00316970 NP9 jtl: European Journal of Clinical Pharmacology issn: 00316970 maglogo: N pubinfo: dt: Dec2014 vid: 70 iid: 12 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 103914493 99347226 10.1007/s00228-014-1752-4 NLM25228251 103914493 ppf: 1495 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Inappropriate prescription of allopurinol and febuxostat and risk of adverse events in the elderly: results from the REPOSI registry. aug: au: Pasina, L. Brucato, A. Djade, C. Di Corato, P. Ghidoni, S. Tettamanti, M. Franchi, C. Salerno, F. Corrao, S. Marengoni, A. Marcucci, M. Mannucci, P. Nobili, A. affil: Laboratory for Quality Assessment of Geriatric Therapies and Services, Drug Information Service for the Elderly, IRCCS - Istituto di Ricerche Farmacologiche 'Mario Negri', Via Giuseppe La Masa, 19 20156 Milan Italy sug: subj: Inappropriate Prescribing Allopurinol Administration and Dosage Gout Suppressants Administration and Dosage Allopurinol Adverse Effects Gout Suppressants Adverse Effects Registries, Disease Gout Drug Therapy Adverse Drug Event Human Cross Sectional Studies Italy Aged Descriptive Statistics Patient Discharge Scales Analysis of Variance Data Analysis Software Confidence Intervals Odds Ratio Aged, 80 and Over Male Female Aged: 65+ years Aged, 80 & over Male Female ab: Purpose: To investigate the prevalence of xanthine oxidase (XO) inhibitors prescription at admission and discharge in elderly hospital in-patients, to analyze the appropriateness of their use in relation to evidence-based indications, to evaluate the predictors of inappropriate prescription at discharge and the association with adverse events 3 months after hospital discharge. Methods: This cross-sectional study, based upon a prospective registry, was held in 95 Italian internal medicine and geriatric hospital wards. The sample included 4035 patients aged 65 years or older at admission and 3502 at discharge. The prescription of XO inhibitors was considered appropriate in patients with diagnosis of gout, gout nephropathy, uric acid nephrolithiasis, tophi, and chemotherapy-induced hyperuricemia. In order to evaluate the predictors of inappropriate prescription of XO inhibitors, we compared the characteristics of patients considered inappropriately treated with those appropriately not treated. Results: Among the 4035 patients eligible for the analysis, 467 (11.6 %) were treated with allopurinol or febuxostat at hospital admission and 461 (13.2 %) among 3502 patients discharged. At admission, 39 (8.6 %) of patients receiving XO inhibitors and 43 (9.4 %) at discharge were appropriately treated. Among those inappropriately treated, hyperuricemia, polytherapy, chronic renal failure, diabetes, obesity, ischemic cardiomyopathy, heart failure, and cardiac dysrhythmias were associated with greater prescription of XO inhibitors. Prescription of XO inhibitors was associated with a higher risk of adverse clinical events in univariate and multivariate analysis. Conclusions: Prevalence of inappropriate prescription of XO inhibitors remained almost the same at admission and discharge. Inappropriate use of these drugs is principally related to treatment of asymptomatic hyperuricemia and various cardiovascular diseases. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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