Debbie Rigby rounds up the latest in research news

Pharmacist comprehensive review of treatment compared with STOPP-START criteria to detect potentially inappropriate prescription in older complex patients

A prospective multicentre observational study of 338 older patients has shown that a clinical pharmacist detected more PIP incidents (35%) than did STOPP-START criteria. The authors concluded that inclusion of a pharmacist in the multidisciplinary team facilitated the detection of PIP incidents, particularly in the institutionalised population and patients treated with high-level polypharmacy which were not detected by explicit STOPP-START criteria.

Eur J Hosp Pharm doi:10.1136/ejhpharm-2016-001054

 

Association of 3 Different Antihypertensive Medications With Hip and Pelvic Fracture Risk in Older Adults

Secondary analysis of the ALL-HAT trial published in 2002 has shown that the thiazide-like diuretic chlorthalidone was associated with a 21% significantly lower risk of hip and pelvic fractures compared with either lisinopril or amlodipine. Chlorthalidone significantly lowered the risk compared with lisinopril alone during approximately 4.9 years of follow-up. During 5 additional years of post-trial follow-up, fracture risk continued to be lower in users of chlorthalidone compared with lisinopril or amlodipine together or alone.

JAMA Intern Med. Published online November 21, 2016.

Invited commentary

 

Association between statin use and ischemic stroke or major hemorrhage in patients taking dabigatran for atrial fibrillation

Analysis of data from conducted 2 population-based, nested case–control studies involving Ontario residents 66 years of age and older receiving dabigatran etexilate, shows simvastatin is associated with a 46% higher risk of major hemorrhage relative to other statins. The authors suggest preferential use of the other statins in these patients.

CMAJ 2016. DOI:10.1503 /cmaj.160303
Medscape commentary

 

Should recommendations about starting inhaled corticosteroid treatment for mild asthma be based on symptom frequency: a post-hoc efficacy analysis of the START study

Low-dose inhaled corticosteroids (ICS) are highly effective for reducing asthma exacerbations and mortality. Guidelines recommend ICS treatment for patients with symptoms on more than 2 days per week. Post-hoc analysis of the 3 year inhaled Steroid Treatment As Regular Therapy (START) study, shows low-dose budesonide decreases the risk of severe asthma-related events, reduces lung function decline, and improves symptom control in patients with mild recent-onset asthma.

Lancet, Published: 29 November 2016.