Debbie Rigby rounds up the latest in research news
In a large cohort of older adults in primary care, PPI prescription was associated with greater risk of pneumonia in the second year of treatment. During the second year after initiating treatment, PPIs were associated with 82% increased incidence of pneumonia (PERR‐adjusted hazard ratio=1.82, 95% confidence interval=1.27–2.54), accounting for pretreatment pneumonia rates. Estimates were similar across age and comorbidity subgroups.
Journal of the American Geriatrics Society 2018.
An overview of systematic reviews concludes that nonsteroidal medications, with or without paracetamol, offers the most favorable balance between benefits and harms, optimizing efficacy while minimizing acute adverse events. Medication and medication combinations that included opioids were among those associated most frequently with acute adverse events in both child and adult-aged patient populations.
Journal of the American Dental Association 2018;149(4):256-265.e3
Medication review can significantly decrease the use of antihypertensive drugs in nursing home patients without an effect on the systolic blood pressure over time. In this multicentre RCT conducted over 9 months antihypertensives were deprescribed to a significantly higher extent in the intervention group (n = 43, 32%) compared to control (n = 11, 10%). Whilst systolic blood pressure increased immediately, by 9 months blood pressure had reverted to baseline values. Deprescribing did not affect pulse and systolic pressure.
J Geriatr Cardiol. 2018 Apr; 15(4): 275–283.
In this study of 217 patients with overactive bladder, mirabegron 25mg once daily was shown to be safe and effective in older patients (80 years and older) with multiple comorbidities. Mirabegron is a selective b3-receptor agonist that causes detrusor muscle relaxation in the storage phase, increasing the bladder capacity. Mirabegron has significantly lower adverse effects than anticholinergics.
Geriatr Gerontol Int 2018.