Debbie Rigby rounds up the latest in research news
A systematic review and expert consensus study has identified 12 implicit indicators for appropriate polypharmacy, including indication for drug, no effective non-pharmacological alternatives available, no clinically significant drug-drug interactions, effective for indication, and not likely to be sub-therapeutic or toxic, based on the dose, route and dosing interval for the age, renal and hepatic status of the patient. Importantly some patient-centred indicators are included such as patient is clear about the drug regimen and patient adheres to the drug schedule.
BMC Medicine 2018;16:91.
A Cochrane Review has demonstrated that first-line low-dose thiazides reduced mortality, stroke, and heart attack. No other drug class improved health outcomes better than low-dose thiazides. Beta-blockers and high-dose thiazides were inferior.
Cochrane Database of Systematic Reviews 2018, Issue 4. Art. No.: CD001841
Collaborative interventions between pharmacists and physicians were shown to improve medication adherence and Medication appropriateness Index (MAI) scores of the elderly patients in this randomised controlled trial. The authors conclude such services should be implemented in all hospitals, especially in countries where pharmacists are still not playing a substantial role in patient care.
Therapeutics and Clinical Risk Management 2018:14 1115–1125.
In 2 large retrospective cohorts of patients with diabetes mellitus, metformin use was not significantly associated with incident acidosis at estimated glomerular filtration rate (eGFR) greater than 30 mL/min/1.73 m2.
JAMA Intern Med. Published online June 4, 2018.