Did the introduction of a prospective payment system for nursing home stays reduce the likelihood of pharmacological management of secondary ischaemic stroke?

Abstract:

BACKGROUND:Since 1998, a prospective payment system (PPS) for Medicare services provided by nursing homes in the US has been in operation. Concerns have been expressed that the PPS may affect the quality of care delivered to residents. This study evaluates the impact of the PPS on pharmacological secondary ischaemic stroke prevention in nursing homes. STUDY DESIGN:The nationally mandated Minimum Data Set and Online Survey Certification and Automated Record data system from 1997 and 2000 for four states were used. We conducted a quasi-experimental study comparing the pharmacological treatment rates for secondary stroke prevention in the pre-PPS period (1997) with those in the post-PPS period (2000) in residents who experienced an ischaemic stroke within 6 months (n1997 = 5008; n2000 = 5243) of living in nursing facilities (n1997 = 1226; n2000 = 1092) in Kansas, Maine, Mississippi or Ohio. The sample was stratified according to recommendations for use of warfarin. Logistic regression models adjusting for clustering effects of residents residing in homes using generalised estimating equations provided estimates of the PPS effect on use of antiplatelets and the use of warfarin. RESULTS:The unadjusted proportion of use of pharmacological agents for the secondary prevention of stroke was similar for warfarin in both time periods and increased for antiplatelets in 2000. Relative to the pre-PPS era, the likelihood of use of antiplatelets increased in the post-PPS era (adjusted odds ratio 1.26; 95% CI 1.15, 1.38); there was no effect on the use of warfarin. CONCLUSION:Although the lack of a PPS effect on pharmacological management of secondary ischaemic stroke is encouraging, there is still room for improvement in overall stroke management.

journal_name

Drugs Aging

journal_title

Drugs & aging

authors

Lapane KL,Hughes CM

doi

10.2165/00002512-200623010-00006

subject

Has Abstract

pub_date

2006-01-01 00:00:00

pages

61-9

issue

1

eissn

1170-229X

issn

1179-1969

pii

2316

journal_volume

23

pub_type

杂志文章
  • Drug therapy of prostatic cancer.

    abstract::While hormonal therapy has been the usual and appropriate treatment of advanced or metastatic prostatic cancer for the past 50 years, the recent development of new therapeutic agents as medical alternatives to orchidectomy has drastically altered the options and perspectives in the treatment of this disease. Estrogens...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-199101050-00003

    authors: Huben RP,Perrapato SD

    更新日期:1991-09-01 00:00:00

  • Drug-Drug Interactions and Prescription Appropriateness in Patients with COVID-19: A Retrospective Analysis from a Reference Hospital in Northern Italy.

    abstract:BACKGROUND:Patients hospitalised with severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2; coronavirus 2019 disease (COVID-19)] infection are frequently older with co-morbidities and receiving polypharmacy, all of which are known risk factors for drug-drug interactions (DDIs). The pharmacological burden may be ...

    journal_title:Drugs & aging

    pub_type: 杂志文章

    doi:10.1007/s40266-020-00812-8

    authors: Cattaneo D,Pasina L,Maggioni AP,Giacomelli A,Oreni L,Covizzi A,Bradanini L,Schiuma M,Antinori S,Ridolfo A,Gervasoni C

    更新日期:2020-12-01 00:00:00

  • Molecular rationale for the pharmacological treatment of Alzheimer's disease.

    abstract::Cerebral deposition of amyloid plaques containing amyloid beta-peptide (Abeta) has traditionally been considered the central feature of Alzheimer's disease (AD). Abeta is derived from amyloid precursor protein (APP), which is cleaved by several different proteases: alpha-, beta- and gamma-secretase. In the past decade...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200522001-00003

    authors: Zimmermann M,Gardoni F,Di Luca M

    更新日期:2005-01-01 00:00:00

  • CYP2D6 Metabolism in Frail Elderly Compared to Non-Frail Elderly: A Pilot Feasibility Study.

    abstract:BACKGROUND:Frailty is a clinical phenotype that is associated with adverse health outcomes. Since frail patients may be more prone for adverse drug events and about 15-20 % of commonly prescribed drugs are metabolized by CYP2D6, we hypothesized that CYP2D6 metabolism is decreased in frail patients compared with healthy...

    journal_title:Drugs & aging

    pub_type: 杂志文章

    doi:10.1007/s40266-015-0319-0

    authors: Opdam FL,Modak AS,Mooijaart SP,Louwerens M,de Waal MW,Gelderblom H,Guchelaar HJ

    更新日期:2015-12-01 00:00:00

  • Melatonin prolonged release: in the treatment of insomnia in patients aged ≥55 years.

    abstract::Melatonin prolonged release (PR) 2 mg is approved for the treatment of primary insomnia characterized by poor sleep quality in patients aged ≥55 years in the EU and elsewhere. Patients may receive treatment with melatonin PR for up to 13 weeks. Production of endogenous nocturnal melatonin, which helps regulate circadi...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.1007/s40266-012-0018-z

    authors: Lyseng-Williamson KA

    更新日期:2012-11-01 00:00:00

  • Age-related changes in male gonadal function. Implications for therapy.

    abstract::In contrast with women, who experience a complete and abrupt cessation of ovarian function during the menopause, aging men largely maintain their testicular androgen production. Nevertheless, most cross-sectional studies indicate that there is a partial decrease in testosterone levels with aging, although this has not...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-199711010-00005

    authors: Maas D,Jochen A,Lalande B

    更新日期:1997-07-01 00:00:00

  • Acute cough in the elderly: aetiology, diagnosis and therapy.

    abstract::Although the frequency of physician consultations and the sale of over-the-counter remedies establish the high prevalence of acute cough in the elderly, epidemiological studies have tended to be imprecise. However, respiratory tract infections in nose, larynx and/or bronchi, either viral or bacterial or both, are by f...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200421040-00003

    authors: Widdicombe J,Kamath S

    更新日期:2004-01-01 00:00:00

  • Epidemiology of suboptimal prescribing in older, community dwellers: a two-wave, population-based survey in Dicomano, Italy.

    abstract:BACKGROUND:Because of co-morbidity, older persons are often exposed to use of an excessive number of drugs, which per se implies also use of inappropriate drugs or of potentially interacting drugs ('suboptimal prescribing'). Time trends of suboptimal prescribing in older, community dwellers have been poorly investigate...

    journal_title:Drugs & aging

    pub_type: 杂志文章

    doi:10.2165/11319390-000000000-00000

    authors: Lapi F,Pozzi C,Mazzaglia G,Ungar A,Fumagalli S,Marchionni N,Geppetti P,Mugelli A,Di Bari M

    更新日期:2009-01-01 00:00:00

  • Transdermal treatment options for neurological disorders: impact on the elderly.

    abstract::As people grow old, their need for medications increases dramatically because of the higher incidence of chronic pain, diabetes mellitus, cardiovascular and neurological diseases in the elderly population. Furthermore, the elderly require special consideration with respect to drug delivery, drug interactions and adher...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200623050-00001

    authors: Priano L,Gasco MR,Mauro A

    更新日期:2006-01-01 00:00:00

  • Effect of antihypertensive agents on quality of life in the elderly.

    abstract::Management of hypertension in the elderly should take into account, in particular, the possible negative impact of antihypertensive drugs on the patient's quality of life, the deterioration of which may result in a loss of independence and reduced treatment compliance. Quality of life is recognised as a multifactorial...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200421060-00003

    authors: Fogari R,Zoppi A

    更新日期:2004-01-01 00:00:00

  • Comparative Effectiveness of Angiotensin II Receptor Blockers and Angiotensin-Converting Enzyme Inhibitors in Older Nursing Home Residents After Myocardial Infarction: A Retrospective Cohort Study.

    abstract:BACKGROUND:Evidence regarding differences in outcomes between angiotensin II receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) among older nursing home (NH) residents after acute myocardial infarction (AMI) is limited. OBJECTIVES:The purpose of our study was to estimate the post-AMI effects...

    journal_title:Drugs & aging

    pub_type: 杂志文章

    doi:10.1007/s40266-020-00791-w

    authors: Zullo AR,Riester MR,Erqou S,Wu WC,Rudolph JL,Steinman MA

    更新日期:2020-10-01 00:00:00

  • Potential of transdermal drug delivery in Parkinson's disease.

    abstract::There has been a growing recognition that pulsatile stimulation of dopamine receptors may be an important mechanism in the generation of the motor fluctuations that often develop and compromise the effectiveness of long-term levodopa administration in persons with Parkinson's disease (PD). This has prompted investigat...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200219080-00002

    authors: Pfeiffer RF

    更新日期:2002-01-01 00:00:00

  • Influenza vaccination in the elderly: impact on hospitalisation and mortality.

    abstract::Influenza causes substantial morbidity across the age spectrum. However, the elderly are especially vulnerable to the serious complications of influenza that might result in hospitalisation or death, and high rates of influenza-associated excess hospitalisation or death that exceed by several-fold the rates seen among...

    journal_title:Drugs & aging

    pub_type: 杂志文章,meta分析,评审

    doi:10.2165/00002512-200522060-00004

    authors: Nichol KL

    更新日期:2005-01-01 00:00:00

  • Sedative load and mortality among residents of long-term care facilities: a prospective cohort study.

    abstract:BACKGROUND:Older people are often prescribed multiple drugs with sedative properties. Most research has focused on specific classes of sedative and psychotropic drugs. The cumulative effect of taking multiple drugs with sedative properties has been termed 'sedative load'. Few previous studies have investigated the seda...

    journal_title:Drugs & aging

    pub_type: 临床试验,杂志文章

    doi:10.2165/11317080-000000000-00000

    authors: Taipale HT,Bell JS,Soini H,Pitkälä KH

    更新日期:2009-01-01 00:00:00

  • Effects of medication assessment as part of a comprehensive geriatric assessment on drug use over a 1-year period: a population-based intervention study.

    abstract::High drug consumption among the elderly and inappropriate prescribing practices increase the risk of adverse drug effects in this population. This risk may be decreased by conducting, for example, a medication review alone or as part of a comprehensive geriatric assessment (CGA); however, little is known about the fat...

    journal_title:Drugs & aging

    pub_type: 杂志文章,随机对照试验

    doi:10.2165/11536650-000000000-00000

    authors: Lampela P,Hartikainen S,Lavikainen P,Sulkava R,Huupponen R

    更新日期:2010-06-01 00:00:00

  • Rosuvastatin in elderly patients.

    abstract::A progressive accumulation of atherosclerotic lesions beginning early in life puts elderly persons at a greater absolute risk of cardiovascular disease and coronary events than other segments of the population. HMG-CoA reductase inhibitor (statin) therapy has been shown to be both efficacious and well tolerated in mos...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200724110-00005

    authors: Davidson MH

    更新日期:2007-01-01 00:00:00

  • Treatment of systemic fungal infections in older patients: achieving optimal outcomes.

    abstract::Systemic fungal infections are an increasing problem in older adults. For several of the endemic mycoses, this increase is the result of increased travel and leisure activities in areas endemic for these fungi. Immunosuppressive agents, care in an intensive care unit, and invasive devices all contribute to infection w...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200118050-00002

    authors: Kauffman CA,Hedderwick SA

    更新日期:2001-01-01 00:00:00

  • Felodipine. A review of the pharmacology and therapeutic use of the extended release formulation in older patients.

    abstract::Felodipine is a dihydropyridine calcium antagonist which may be administered once daily in an extended release (ER) formulation. As monotherapy in older patients with mild to moderate essential hypertension, felodipine ER once daily provides effective control of blood pressure (BP). The drug has also been effective, e...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-199202050-00002

    authors: Faulds D,Sorkin EM

    更新日期:1992-09-01 00:00:00

  • Cyproterone. A review of its pharmacology and therapeutic efficacy in prostate cancer.

    abstract::Cyproterone (cyproterone acetate) is a steroidal antiandrogenic agent that inhibits the action of adrenal and testicular androgens on prostatic cells. Additionally, its progestogenic activity causes a centrally mediated reduction in testicular secretion of androgens. Studies have demonstrated the effectiveness of cypr...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-199405010-00006

    authors: Barradell LB,Faulds D

    更新日期:1994-07-01 00:00:00

  • Determination of digoxin clearance in Japanese elderly patients for optimization of drug therapy: a population pharmacokinetics analysis using nonlinear mixed-effects modelling.

    abstract:BACKGROUND:Optimal use of digoxin in the elderly population requires information about the drug's pharmacokinetics and the influence of various factors on the drug's disposition. However, because of sampling restrictions, it is often difficult to perform traditional pharmacokinetic studies in elderly patients. OBJECTI...

    journal_title:Drugs & aging

    pub_type: 杂志文章

    doi:10.2165/11594230-000000000-00000

    authors: Yukawa M,Yukawa E,Suematsu F,Takiguchi T,Ikeda H,Aki H,Mimemoto M

    更新日期:2011-10-01 00:00:00

  • Information for physicians and pharmacists about drugs that might cause dry mouth: a study of monographs and published literature.

    abstract:BACKGROUND:Over three-quarters of the older population take medications that can potentially cause dry mouth. Physicians or pharmacists rarely inform patients about this adverse effect and its potentially severe damage to the teeth, mouth and general health. OBJECTIVES:The objectives of this study were to (1) identify...

    journal_title:Drugs & aging

    pub_type: 杂志文章

    doi:10.1007/s40266-013-0141-5

    authors: Nguyen CT,MacEntee MI,Mintzes B,Perry TL

    更新日期:2014-01-01 00:00:00

  • Pharmacology and therapeutic effects of dehydroepiandrosterone in older subjects.

    abstract::Man and higher primates have adrenals that secrete large amounts of dehydroepiandrosterone (DHEA) [prasterone] and its sulphate (DHEAS) [PB 008]. A remarkable feature of plasma DHEAS levels in humans is their great decrease with aging. Researchers have postulated that this age-related decline of DHEAS levels may expla...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200320130-00001

    authors: Legrain S,Girard L

    更新日期:2003-01-01 00:00:00

  • Estimating the Time to Benefit for Preventive Drugs with the Statistical Process Control Method: An Example with Alendronate.

    abstract:BACKGROUND:For physicians dealing with patients with a limited life expectancy, knowing the time to benefit (TTB) of preventive medication is essential to support treatment decisions. OBJECTIVE:The aim of this study was to investigate the usefulness of statistical process control (SPC) for determining the TTB in relat...

    journal_title:Drugs & aging

    pub_type: 杂志文章,随机对照试验

    doi:10.1007/s40266-016-0344-7

    authors: van de Glind EM,Willems HC,Eslami S,Abu-Hanna A,Lems WF,Hooft L,de Rooij SE,Black DM,van Munster BC

    更新日期:2016-05-01 00:00:00

  • Patients' Attitudes Towards Deprescribing Alpha-Blockers and Their Willingness to Participate in a Discontinuation Trial.

    abstract:OBJECTIVE:The objective of this study was to gain insights into the attitudes of men with lower urinary tract symptoms towards deprescribing alpha-blockers and to assess their willingness to participate in a planned discontinuation trial. METHODS:This was a cross-sectional questionnaire study. Men aged 30 years and ol...

    journal_title:Drugs & aging

    pub_type: 杂志文章

    doi:10.1007/s40266-019-00712-6

    authors: Edelman M,Jellema P,Hak E,Denig P,Blanker MH

    更新日期:2019-12-01 00:00:00

  • Optimal pharmacotherapeutic management of acute lymphoblastic leukaemia in the elderly.

    abstract::The main characteristic of acute lymphoblastic leukaemia (ALL) in the elderly is its dismal prognosis. However, other than a lower incidence of T-cell ALL and a greater likelihood of unfavourable chromosomal abnormalities, the clinical and biological characteristics of Philadelphia chromosome-negative (Ph-) ALL in the...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/11592850-000000000-00000

    authors: Rousselot P,Delannoy A

    更新日期:2011-09-01 00:00:00

  • Benzodiazepines and injurious falls in community dwelling elders.

    abstract:BACKGROUND:Benzodiazepines are frequently used medications in the elderly, in whom they are associated with an increased risk of falling, with sometimes dire consequences. OBJECTIVE:To estimate the impact of benzodiazepine-associated injurious falls in a population of elderly persons. METHOD:A nested case-control stu...

    journal_title:Drugs & aging

    pub_type: 杂志文章

    doi:10.2165/00002512-200825010-00007

    authors: Pariente A,Dartigues JF,Benichou J,Letenneur L,Moore N,Fourrier-Réglat A

    更新日期:2008-01-01 00:00:00

  • Topical Treatment of Localized Neuropathic Pain in the Elderly.

    abstract::The prevalence of neuropathic pain in the older population has been reported to be very high and is most commonly localized to a circumscribed area. Treatment failure is frequent in neuropathic pain and is accompanied by central side effects with recommended oral drugs acting on the central nervous system. A number of...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.1007/s40266-019-00739-9

    authors: Pickering G,Lucchini C

    更新日期:2020-02-01 00:00:00

  • Age-related changes in laboratory test results. Clinical implications.

    abstract::Many quantities assayed in clinical laboratories demonstrate age-related changes. Particularly important periods are early life, adolescence, old age, and after the menopause in females. The changes that occur until adulthood are well documented. Fewer data are available on elderly people even though they consume a la...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-199303030-00006

    authors: Fraser CG

    更新日期:1993-05-01 00:00:00

  • Lower Prescription Rates in Centenarians with Heart Failure and Heart Failure and Kidney Disease Combined: Findings from a Longitudinal Cohort Study of Very Old Patients.

    abstract:BACKGROUND:Centenarians are considered as models of successful aging and represent a special group of patients. The aim of this study was to analyze heart failure epidemiology and treatment trajectories in centenarians compared to nonagenarians (90-99 years of age) and octogenarians (80-89 years of age) with heart fail...

    journal_title:Drugs & aging

    pub_type: 杂志文章

    doi:10.1007/s40266-018-0581-z

    authors: Schmidt IM,Kreutz R,Dräger D,Zwillich C,Hörter S,Kuhlmey A,Gellert P

    更新日期:2018-10-01 00:00:00

  • Idiopathic thrombocytopenic purpura: a retrospective analysis in 139 patients of the influence of age on the response to corticosteroids, splenectomy and danazol.

    abstract:OBJECTIVE:To review the influence of age on the response of patients with idiopathic thrombocytopenic purpura (ITP) to corticosteroids, splenectomy and danazol. METHODS:We retrospectively reviewed a cohort of 139 consecutively treated patients with ITP diagnosed between 1985 and 1994. In particular, we analysed the th...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200320110-00005

    authors: Andrès E,Zimmer J,Noel E,Kaltenbach G,Koumarianou A,Maloisel F

    更新日期:2003-01-01 00:00:00