Displaying publications 41 - 43 of 43 in total

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  1. Polypharmacy and potentially inappropriate medications among hospitalized older adults with COVID-19 in Malaysian tertiary hospitals
    Chang CT, Mohd Shariff SM, Abu Bakar NS, Ramzuzzaman NS, Lim CK, Lim EYJ, et al.
    J Pharm Policy Pract, 2023 Jan 12;16(1):2.
    PMID: 36635766 DOI: 10.1186/s40545-022-00504-1
    INTRODUCTION: Older adults are among the most vulnerable groups during the COVID-19 epidemic, contributing to a large proportion of COVID-19-related death. Medication review and reconciliation by pharmacist can help reduce the number of potentially inappropriate medications but these services were halted during COVID-19.

    AIM: To assess the prevalence and factors associated with inappropriate medicine use among older populations with COVID-19.

    METHODS: This was a cross-sectional, retrospective analysis of medications among hospitalized older adults with COVID-19. Potentially inappropriate medication use was categorized using the Beer's and STOPP criteria.

    RESULTS: Combining both criteria, 181 (32.7%) of the 553 patients were identified to have used at least one or more potentially inappropriate medication. A marginally higher number of inappropriate medications was documented using the Beers 2019 criteria (151 PIM in 124 patients) compared to STOPP criteria (133 PIMS in 104 patients). The long-term use of proton pump inhibitors (n = 68; 12.3%) and drugs which increases the risk of postural hypotension were the most commonly reported PIM (n = 41; 7.4%). Potentially inappropriate medication use was associated with previous history of hospital admission in the past 12 months (Odds ratio [OR]: 2.27; 95% CI 1.29-3.99) and higher number of discharge medications.

    CONCLUSIONS: Nearly, one in three older adults with COVID-19 had been prescribed a PIM, and the proportion of older adults with polypharmacy increased after discharge. This highlights the importance of having clinical pharmacist conducting medication reviews to identify PIMs and ensure medication appropriateness.

  2. Fulltext Comparing Beers, STOPP and MALPIP criteria in detecting potentially inappropriate medications, clinical outcomes, and cost impacts among older Malaysians: a cohort study
    Chang CT, Chan HK, Tan AY, Kamis SF, Yeo YL, Azman MA, et al.
    J Pharm Policy Pract, 2024;17(1):2436896.
    PMID: 39931506 DOI: 10.1080/20523211.2024.2436896
    Background: Potentially inappropriate medications (PIMs) are associated with adverse outcomes and higher healthcare costs in older adults. Explicit screening criteria like the Beers Criteria, STOPP criteria, and the Malaysian Potentially Inappropriate Prescribing (MALPIP) criteria served to identify PIMs, but comparative data are scarce. Aim: To evaluate the prevalence of PIMs identified by Beers 2019, STOPP version 2 and MALPIP criteria in Malaysian older adults and examine their predictive ability for adverse outcomes and cost-saving potential. Methods: A historical cohort study was conducted among older adults aged ≥ 60 years on five or more medications in four Malaysian tertiary hospitals. PIMs were identified using Beers, STOPP, and MALPIP criteria. Sensitivity, specificity and predictive abilities of these criteria were analysed against clinical outcomes. Monthly cost savings were calculated based on hypothetical deprescribing scenarios. Results: Among 1069 patients, the prevalence of PIMs was 89.1% using MALPIP, 51.3% with Beers, and 37.0% with STOPP criteria. A moderate concordance was seen between Beers and STOPP criteria (κ =  0.437), and the lowest agreement was observed between the STOPP and MALPIP (κ =  0.131). STOPP criteria significantly predicted hospital readmissions (p = 0.003), while Beers and MALPIP did not show significant predictive abilities across all outcomes. The most common PIMs identified were proton pump inhibitors (PPIs) and nonsteroidal anti-inflammatory drugs (NSAIDs). Deprescribing scenarios based on these criteria indicated potential monthly cost savings of MYR 4.83 to MYR 44.84 per patient, with the greatest savings associated with MALPIP criteria. Conclusion: MALPIP demonstrated the highest potential for cost savings, the highest sensitivity but the lowest specificity in PIM detection. Context-specific assessments and clinical judgment are crucial in optimising medication safety and efficacy in geriatric pharmacotherapy. Further research is needed to refine PIM criteria to better predict clinical outcomes and balance the benefits and risks of deprescribing in diverse healthcare settings.
  3. Fulltext Draft genome sequence of the rubber tree Hevea brasiliensis
    Rahman AY, Usharraj AO, Misra BB, Thottathil GP, Jayasekaran K, Feng Y, et al.
    BMC Genomics, 2013;14:75.
    PMID: 23375136 DOI: 10.1186/1471-2164-14-75
    Hevea brasiliensis, a member of the Euphorbiaceae family, is the major commercial source of natural rubber (NR). NR is a latex polymer with high elasticity, flexibility, and resilience that has played a critical role in the world economy since 1876.
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