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Potentially inappropriate medications with risk of cardiovascular adverse events in the elderly: A systematic review of tools addressing inappropriate prescribing

dc.contributor.authorAguiar, João Pedro
dc.contributor.authorBrito, Ana Mafalda
dc.contributor.authorMartins, Ana Paula
dc.contributor.authorLeufkens, Hubert G. M.
dc.contributor.authorCosta, Filipa Alves da
dc.date.accessioned2019-11-21T09:02:28Z
dc.date.available2019-11-21T09:02:28Z
dc.date.issued2019-06
dc.description.abstractWHAT IS KNOWN AND OBJECTIVE: In the last decades, many lists have been developed to screen for inappropriate prescribing. However, information on which potentially inappropriate medications (PIMs) could increase the cardiovascular risk in the elderly is not objectively presented. This review aimed to identify and quantify those PIMs by extracting information from published PIM-lists. METHODS: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA), a systematic review of PIM-lists was conducted. The search strategy was run in PubMed, MEDLINE and Google Scholar (1991-09/2017). All PIMs described in those lists were extracted and stratified by their potential cardiovascular risk (including major adverse cardiovascular events-MACE). The number of times each PIM was reported on those lists was also assessed. RESULTS AND DISCUSSION: We identified 724 papers, and 24 were retained. From those, a total of 17 PIMs to be avoided by the elderly and 21 drug-disease interactions were retrieved. The reporting of PIMs with risk of cardiovascular adverse events was 15.3%, whereas the reporting of those with MACE risk was 7.2%. PIMs most frequently described were tricyclic antidepressants (TCAs; 12/24), centrally acting antiadrenergic agents (11/24), NSAIDs (7/24), antiarrhythmics (Class I and III; 6/24), peripherally acting antiadrenergic agents (6/24) and antithrombotic agents (5/24). Most frequently described PIMs with MACE risk were NSAIDs (7/24), antiarrhythmics (Class I and III) (7/24), selective calcium channel blockers with vascular effects (6/24) and antipsychotics (4/24). WHAT IS NEW AND CONCLUSION: Data suggest that PIM-lists focus mainly on common adverse events and often poorly describe the potential consequence for MACE occurrence. This systematic review could help healthcare professionals in the identification and deprescribing of these medicines in older patients with high cardiovascular risk during medication review.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAguiar, JP, Brito, AM, Martins, AP, Leufkens, HGM, Alves da Costa, F. Potentially inappropriate medications with risk of cardiovascular adverse events in the elderly: A systematic review of tools addressing inappropriate prescribing. J Clin Pharm Ther. 2019; 44: 349– 360. https://doi.org/10.1111/jcpt.12811pt_PT
dc.identifier.doi10.1111/jcpt.12811pt_PT
dc.identifier.issn1365-2710
dc.identifier.urihttp://hdl.handle.net/10400.26/30237
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.relation.publisherversionhttps://doi.org/10.1111/jcpt.12811pt_PT
dc.subjectAdverse drug eventspt_PT
dc.subjectAgedpt_PT
dc.subjectCardiac and cerebrovascular riskpt_PT
dc.subjectInappropriate prescribingpt_PT
dc.subjectPotentially inappropriate medication listpt_PT
dc.titlePotentially inappropriate medications with risk of cardiovascular adverse events in the elderly: A systematic review of tools addressing inappropriate prescribingpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage360pt_PT
oaire.citation.startPage349pt_PT
oaire.citation.titleJournal of Clinical Pharmacy and Therapeuticspt_PT
oaire.citation.volume44(3)pt_PT
rcaap.embargofctPolítica de copyright da editorapt_PT
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT

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