Debbie Rigby takes a look at the latest in research relevant to pharmacy
A survey by 792 Australian adults and 609 parents of children with asthma shows significant cost-related underuse of medicines. Cost-related underuse was reported by 52.9% adults and 34.3% parents, predominantly decreasing or skipping doses to make medicines last longer. The authors conclude that urgent targeting of interventions to promote discussion of medicines and costs between doctor and patients, particularly young adult males, is needed.
Journal of Allergy and Clinical Immunology: In Practice 2019.
In a meta-analysis of 95 real-world studies NOACs appear to be at least as effective and safe as VKAs for stroke prevention in patients with NVAF. Rivaroxaban was associated with a 17% reduced risk of ischemic stroke and 31% reduced risk of intracranial haemorrhage. However, rivaroxaban was associated with a higher risk of gastrointestinal bleeding compared to warfarin in the meta-analysis.
Journal of Market Access & Health Policy 2019;7(1):1574541.
Caring for older adults with multiple chronic conditions (MCCs) is challenging. The MCC Action Steps described in this paper provide a continuous process for decision making that is tailored to each patient’s outcome goals, health trajectory, and healthcare preferences. The recommended MCC Actions include: (1) identify and communicate patients’ health priorities and health trajectory; (2) stop, start, or continue care based on health priorities, potential benefit vs harm and burden, and health trajectory; and (3) align decisions and care among patients, caregivers, and other clinicians with patients’ health priorities and health trajectory.
J Am Geriatr Soc 2019;67:665-73.
In this prospective cohort study of nearly 6000 women (mean age 79 years) participants with treated hypertension had a lower risk of falls compared with nonhypertensive women. Diastolic BP (but not systolic BP) was weakly associated with fall risk in women on antihypertensive treatment (<1% decrease in risk per mm Hg increase). The only class of antihypertensive medication associated with an increased risk of falls compared with all other types of antihypertensive drugs was β‐blockers.
J Am Geriatr Soc 2019;67:726–733.