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Comparing the Prevalence of Polypharmacy and Potential Drug-Drug Interactions in Nursing Homes and in the Community Dwelling Elderly of Emilia Romagna Region.

ABSTRACT: Backround: We aimed at assessing the prevalence of polypharmacy and potential drug-drug interactions (DDIs) with clinical relevance in elderly patient on Emilia Romagna area. Both outpatients and residents in nursing homes were assessed, with only partially overlapping strategies. Methods: We defined a list of 190 pairs of potentially interacting drugs, based on literature appraisal and availability of therapeutic alternatives. January-June 2018 data on drug use in patients over 65 years-old were collected from nine Local Health Authorities of Emilia Romagna: data on community-dwelling subjects were extracted from archives of reimbursed prescriptions, while drug use in a sample of nursing homes was recorded from clinical charts in one index day within the same semester. The frequency of polypharmacy (at least five or at least 10 concurrent drugs) and of each DDI was calculated. Results: In line with different rates of polypharmacy (80% vs 16%), the risk of exposure to at least one interaction was 53.7% in nursing homes and 26.4% in outpatients. Among DDIs, in nursing homes antidepressants-anxiolytics (11.9%) ranked first, followed by antidepressants-aspirin (7.4%). In outpatients, ACE-inhibitors-non-steroidal anti-inflammatory drugs (NSAIDs) reached 7.2% followed by the calcium channel blockers-α-blockers (2.4%). Discussion: Polypharmacy and risk of DDIs appeared very different in the two settings, due to both technical and clinical reasons. In order to reduce use of benzodiazepines, NSAIDs, antidepressants and relevant DDIs, 1) defining alternative options for pain relief in elderly outpatients, and 2) implementing non-pharmacological management of insomnia and anxiety in nursing homes should be prioritized.

SUBMITTER: Burato S

PROVIDER: S-EPMC7898059 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Comparing the Prevalence of Polypharmacy and Potential Drug-Drug Interactions in Nursing Homes and in the Community Dwelling Elderly of Emilia Romagna Region.

Burato Sofia S Leonardi Luca L Antonazzo Ippazio Cosimo IC Raschi Emanuel E Ajolfi Chiara C Baraghini Manuela M Chiarello Antonella A Delmonte Valentina V Di Castri Lucio L Donati Monia M Fadda Antonella A Fedele Daniela D Ferretti Alessandra A Gabrielli Laura L Gobbi Silvia S Lughi Sereno S Mazzari Martina M Pieraccini Fabio F Renzetti Alessandro A Russi Elsa E Scanelli Chiara C Zanetti Barbara B Poluzzi Elisabetta E

Frontiers in pharmacology 20210211

<b>Backround:</b> We aimed at assessing the prevalence of polypharmacy and potential drug-drug interactions (DDIs) with clinical relevance in elderly patient on Emilia Romagna area. Both outpatients and residents in nursing homes were assessed, with only partially overlapping strategies. <b>Methods:</b> We defined a list of 190 pairs of potentially interacting drugs, based on literature appraisal and availability of therapeutic alternatives. January-June 2018 data on drug use in patients over 65 ...[more]

PMID: 33628186

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Project description:BackgroundThis research was performed in an area belonging to the province of the city of Bologna (Emilia-Romagna region, Northern Italy). The purpose of the present survey was to record the local knowledge concerning traditional uses of wild food plants and related practices, such as gathering, processing, cooking, therapeutic uses, with the aim of preserving an important part of the local cultural heritage.MethodsThirty-nine people still retaining Traditional Local Knowledge (TLK) were interviewed between March-April 2012 and September-October 2013 by means of open and semi-structured ethnobotanical interviews. For each plant species mentioned, we recorded the botanical family, the English common name, the Italian common and/or folk names, the parts of the plant used, the culinary preparation, and the medicinal usage. The relative frequency of citation index (RFC), a tool that measures the local cultural importance of a plant species, was also included.ResultsThe folk plants mentioned by the respondents belonged to 33 botanical families, of which the Rosaceae (14 plants) and the Asteraceae (9 plants) were the most representative. The species with the highest RFC index (0.77) were Crepis vesicaria subsp. taraxacifolia (Thuill) Thell and Taraxacum officinale Weber. Eleven folk plants were indicated as having therapeutic effects. T. officinale Weber, C. vesicaria subsp. taraxacifolia (Thuill) Thell and Sonchus spp., which are used as food, were reported to be depurative, blood cleaning, refreshing, diuretic and laxative. The most commonly used species was Urtica spp, which was also the most frequently cited for medicinal uses.ConclusionsThe present survey documented the wild food plant traditional knowledge of an area belonging to the province of the city of Bologna (Emilia-Romagna region, Northern Italy). The general perception obtained is that on one side the TLK related to wild food plants has strongly been eroded, mainly due to immigration and urbanization phenomena, whereas on the other side these plants are revaluated today because they are perceived as healthy and also because they represent the preservation of biodiversity and a way of getting back to nature.

Project description:Simple Summary Salmonellae are enteric bacteria capable of infecting humans and both domestic and wild animals. Even if salmonellosis in humans is generally transmitted through food, the role of wildlife in the ecology of this bacteria is of increasing interest because of their potential role as reservoirs. In Italy, and in particular in the Apennines area, the interactions between wildlife and humans, pets and livestock are rising due to a growing wildlife population and this poses the problem of accidental Salmonella infections. The aim of this study was to investigate the presence of Salmonella subspecies and serotypes in wild carnivores (namely red fox, European badger and wolf) from the Emilia-Romagna Region between 2016 and 2022. Samples of the large intestine were cultured, and both serogroup and serotype identification were performed. A total of 67 strains were isolated, belonging to S. enterica subsp. enterica, S. salamae, S. diarizonae and S. houtenae. The most frequently isolated serotypes were S. veneziana and S. typhimurium. These findings highlight a prevalence of Salmonella spp. in line with other studies, showing once again the value of monitoring different possible sources of Salmonella infection. Abstract Salmonella is a pathogen of considerable health concern, given its zoonotic potential, and, in Italy, is the most frequently reported causative agent for foodborne outbreaks. Wild animals and in particular wild carnivores may be carriers of different Salmonella enterica subspecies and serotypes. Given their potential role as reservoirs, surveillance activities are necessary. This study aims to investigate the presence of different Salmonella subspecies and serotypes in wild carnivores in the Emilia-Romagna Region. A total of 718 fox (Vulpes vulpes), 182 badger (Meles meles) and 27 wolf (Canis lupus) carcasses, submitted between 2016–2022, were included for the present work. Gender and age data were collected along with geographical coordinates of carcass’ discovery site. Contents of the large intestine were sampled and cultured according to ISO 6579-1 and both serogroup and serotype identification were performed according to ISO/TR 6579-3:2014. Salmonella was retrieved from 42 foxes (6%), 21 badgers (12%) and 3 wolves (12%), respectively. Isolated Salmonella enterica strains belonged to 4 different subspecies and 25 different serotypes. S. veneziana and S. typhimurium were the most frequent serotypes found (11/67 and 10/67, respectively). In conclusion, zoonotic serotypes were found in all these species of wildlife, thus confirming their potential role in the ecology of Salmonella spp.

Dataset Information

Comparing the Prevalence of Polypharmacy and Potential Drug-Drug Interactions in Nursing Homes and in the Community Dwelling Elderly of Emilia Romagna Region.

Publications

Comparing the Prevalence of Polypharmacy and Potential Drug-Drug Interactions in Nursing Homes and in the Community Dwelling Elderly of Emilia Romagna Region.

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