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Article: The anticholinergic burden: from research to practice.

Hilmer, Sarah N / Gnjidic, Danijela

2022 Volume 45, Issue 4, Page(s) 118–120

Abstract: Drugs with anticholinergic effects are known to cause adverse effects such as dry mouth, constipation and urinary retention. In older people drugs with anticholinergic effects may contribute to cognitive decline and a loss of functional capacity. Many ... ...

Abstract	Drugs with anticholinergic effects are known to cause adverse effects such as dry mouth, constipation and urinary retention. In older people drugs with anticholinergic effects may contribute to cognitive decline and a loss of functional capacity. Many drugs that are not in the anticholinergic drug class also have anticholinergic effects. They include antidepressants, antipsychotics and antihistamines. Taking multiple drugs with anticholinergic effects creates an anticholinergic burden. It is important that clinicians identify which patients are at risk. There are several tools to assess the anticholinergic burden. Clinicians can use these tools to make a pharmacological risk assessment when reviewing a patient's medicines. This can assist decisions about continuing or stopping drugs with anticholinergic effects. Deprescribing drugs with anticholinergic effects has several potential benefits in older people. In addition to reversing adverse effects, deprescribing may prevent problems such as falls.
Language	English
Publishing date	2022-08-01
Publishing country	Australia
Document type	Journal Article ; Review
ZDB-ID	1075442-8
ISSN	0312-8008
ISSN	0312-8008
DOI	10.18773/austprescr.2022.031
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Zs.A 3233: Show issues

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Article ; Online: Comment on: "Patient Perceptions of Opioids and Benzodiazepines and Attitudes Toward Deprescribing".

Langford, Aili V / Schneider, Carl R / Reeve, Emily / Doctor, Jason N / Gnjidic, Danijela

Drugs & aging

2024 Volume 41, Issue 1, Page(s) 77–78

MeSH term(s)	Humans ; Benzodiazepines/adverse effects ; Deprescriptions ; Analgesics, Opioid/adverse effects ; Health Knowledge, Attitudes, Practice
Chemical Substances	Benzodiazepines (12794-10-4) ; Analgesics, Opioid
Language	English
Publishing date	2024-01-02
Publishing country	New Zealand
Document type	Letter ; Comment
ZDB-ID	1075770-3
ISSN	1179-1969 ; 1170-229X
ISSN (online)	1179-1969
ISSN	1170-229X
DOI	10.1007/s40266-023-01086-6
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Zs.A 3481: Show issues

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Article ; Online: Potential factors that can affect the performance of undergraduate pharmacy research students: a descriptive study.

Gnjidic, Danijela / da Costa, Narelle / Wheate, Nial J

BMC medical education

2023 Volume 23, Issue 1, Page(s) 32

Abstract: Objective: This descriptive study aimed to examine whether student past coursework performance, student or research supervisor characteristics, and the type of research project are related to the overall academic performance of a pharmacy student ... ...

Abstract	Objective: This descriptive study aimed to examine whether student past coursework performance, student or research supervisor characteristics, and the type of research project are related to the overall academic performance of a pharmacy student completing an honours research program. Methods: Data on undergraduate honours students who completed a Bachelor of Pharmacy degree at The University of Sydney, Sydney, Australia, between Jan 2015 and Dec 2020 was collected. This included socio-demographic characteristics, type of project undertaken, and academic outputs. Data was also collected on each supervisor's academic role, level of experience, research area, and where they completed their PhD. Descriptive statistics were used to describe the study cohort and correlation analysis and unpaired t-tail analyses were conducted using SPSS software. Results: This five year study included 130 students of which 67% were female and 60% were domestic students. Each student was supervised by one of 48 individual academics who were a mix of early- (31%), mid-career (29%), and experienced researchers (40%) for pharmaceutical science (50%), clinical (45%), and education (5%) projects. Just less than half (49%) of students published one peer-reviewed journal article. Female students outperformed male students (p = 0.031) with female students also twice as likely (15%) to receive a university medal eligible mark compared with male students (7.0%). Similarly, domestic students were twice as likely (15%) to receive a university medal eligible mark when compared with international students (7.7%). Students who undertook a pharmaceutical science-based project outperformed education-based project students (p = 0.0235). Students who had published at least one peer-reviewed journal article outperformed those who had not published (p = 0.0014). Conclusion: Factors that affected honours performance were student gender, residential status, type of project undertaken, and whether a student had published a peer-reviewed journal article.
MeSH term(s)	Humans ; Male ; Female ; Pharmacy Research ; Australia ; Educational Status ; Students, Pharmacy ; Pharmaceutical Preparations
Chemical Substances	Pharmaceutical Preparations
Language	English
Publishing date	2023-01-17
Publishing country	England
Document type	Journal Article
ZDB-ID	2044473-4
ISSN	1472-6920 ; 1472-6920
ISSN (online)	1472-6920
ISSN	1472-6920
DOI	10.1186/s12909-023-04018-5
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Article ; Online: Deprescribing: What do we know, and where to next?

Gnjidic, Danijela / Reeve, Emily

British journal of clinical pharmacology

2020 Volume 87, Issue 3, Page(s) 722–724

MeSH term(s)	Deprescriptions ; Humans ; Inappropriate Prescribing ; Polypharmacy
Language	English
Publishing date	2020-08-26
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	188974-6
ISSN	1365-2125 ; 0306-5251 ; 0264-3774
ISSN (online)	1365-2125
ISSN	0306-5251 ; 0264-3774
DOI	10.1111/bcp.14525
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Zs.A 1118: Show issues

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Article ; Online: Strategies for Identifying Patients for Deprescribing of Blood Pressure Medications in Routine Practice: An Evidence Review.

Sheppard, James P / Benetos, Athanase / Bogaerts, Jonathan / Gnjidic, Danijela / McManus, Richard J

Current hypertension reports

2024

Abstract: Purpose of review: To summarise the evidence regarding which patients might benefit from deprescribing antihypertensive medications.: Recent findings: Older patients with frailty, multi-morbidity and subsequent polypharmacy are at higher risk of ... ...

Abstract	Purpose of review: To summarise the evidence regarding which patients might benefit from deprescribing antihypertensive medications. Recent findings: Older patients with frailty, multi-morbidity and subsequent polypharmacy are at higher risk of adverse events from antihypertensive treatment, and therefore may benefit from antihypertensive deprescribing. It is possible to examine an individual's risk of these adverse events, and use this to identify those people where the benefits of treatment may be outweighed by the harms. While such patients might be considered for deprescribing, the long-term effects of this treatment strategy remain unclear. Evidence now exists to support identification of those who are at risk of adverse events from antihypertensive treatment. These patients could be targeted for deprescribing interventions, although the long-term benefits and harms of this approach are unclear. Perspectives: Randomised controlled trials are still needed to examine the long-term effects of deprescribing in high-risk patients with frailty and multi-morbidity.
Language	English
Publishing date	2024-02-02
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2057367-4
ISSN	1534-3111 ; 1522-6417
ISSN (online)	1534-3111
ISSN	1522-6417
DOI	10.1007/s11906-024-01293-5
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Zs.A 5522: Show issues

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Article ; Online: Comparison of polypharmacy and potentially inappropriate medication use in older adults with and without dementia receiving residential medication management reviews.

Sawan, Mouna J / Clough, Alexander / Hillen, Jodie / Soulsby, Natalie / Gnjidic, Danijela

Australasian journal on ageing

2024

Abstract: Objectives: Among residents who had a residential medication management review (RMMR), there is a lack of studies assessing exposure to polypharmacy and potentially inappropriate medications (PIMs) in people with dementia. This study compared the ... ...

Abstract	Objectives: Among residents who had a residential medication management review (RMMR), there is a lack of studies assessing exposure to polypharmacy and potentially inappropriate medications (PIMs) in people with dementia. This study compared the exposure to polypharmacy and PIMs in residents with dementia and without dementia receiving RMMR. Methods: A retrospective analysis was performed using data of 16,261 residents living in 343 Australian residential aged care facilities who had an RMMR in 2019. Medication use was assessed as polypharmacy (defined as ≥9 medications) and use of ≥1 PIMs using the 2019 updated Beers criteria. Dementia diagnosis was determined with ICD-10 coding from medical records. Descriptive analyses reported resident demographics and patterns of medication use. Pearson's χ Results: Among 16,261 residents, 6781 (42%) had dementia. Residents with dementia were significantly more likely to be exposed to polypharmacy and PIMs, compared to those without dementia (74% vs. 70% and 83% vs. 73%, p < .001 respectively). Residents with dementia had 1.31 times the odds of exposure to polypharmacy (adjusted OR: 1.31, 95% CI: 1.22-1.41, p < .001) and 1.88 times the odds of being prescribed ≥1 PIMs than people without dementia (adjusted OR: 1.88, 95% CI: 1.73-2.04, p < .001). Conclusions: In a study of residents receiving RMMR, polypharmacy and PIMs were highly common, and those with dementia were more likely to be exposed to inappropriate polypharmacy. There is a need for targeted deprescribing strategies to immediately address inappropriate prescribing in residents, particularly those living with dementia.
Language	English
Publishing date	2024-04-06
Publishing country	Australia
Document type	Journal Article
ZDB-ID	1457406-8
ISSN	1741-6612 ; 0726-4240 ; 1440-6381
ISSN (online)	1741-6612
ISSN	0726-4240 ; 1440-6381
DOI	10.1111/ajag.13316
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Zs.A 5001: Show issues

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Article ; Online: The Carer Assessment of MedicaTion Management GuidanCe for People With Dementia at Hospital Discharge (CATCH) Tool: Exploratory Factor Analysis.

Sawan, Mouna / Clough, Alexander / Mirzaei, Ardalan / Widjaja, Gabrielle J / Schneider, Carl / Jeon, Yun-Hee / Chen, Timothy / Hilmer, Sarah N / Gnjidic, Danijela

Alzheimer disease and associated disorders

2024 Volume 38, Issue 1, Page(s) 59–64

Abstract: Purpose: The Carer Assessment of medicaTion management guidanCe for people with dementia at Hospital discharge (CATCH) tool was developed to examine the carer's experiences of medication management guidance delivery at discharge. This study explored its ...

Abstract	Purpose: The Carer Assessment of medicaTion management guidanCe for people with dementia at Hospital discharge (CATCH) tool was developed to examine the carer's experiences of medication management guidance delivery at discharge. This study explored its factor structure, characterized carers' experiences at discharge, and identified predictors of carer preparedness to manage medications at discharge. Methods: A cross-sectional survey of carers across Australia was distributed. Survey responses were analyzed descriptively, and exploratory factor and regression analyses were performed. Results: A total of 185 survey responses were completed. Exploratory factor analysis revealed 2 factors in the CATCH tool: (1) shared and supported decision-making in medication management (16 items loading 0.47 to 0.93); 2) provision of medication management guidance that is easy to understand (4 items loading (0.48 to 0.82). Internal consistency was acceptable (Cronbach alpha >0.8). Almost 18% of participants stated that they were not included in decisions about medications for people with dementia. The carer reported that the measure of how guidance is provided was positively related to their confidence in the management of medications postdischarge and satisfaction ( P < 0.05 for both). Conclusions: The CATCH tool can give the patient and carer an opportunity to provide feedback on key elements of medication management guidance delivered at discharge.
MeSH term(s)	Humans ; Patient Discharge ; Caregivers ; Medication Therapy Management ; Aftercare ; Cross-Sectional Studies ; Dementia/drug therapy ; Hospitals
Language	English
Publishing date	2024-01-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	1002700-2
ISSN	1546-4156 ; 0893-0341
ISSN (online)	1546-4156
ISSN	0893-0341
DOI	10.1097/WAD.0000000000000602
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Zs.A 2569: Show issues

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Article ; Online: Availability and evaluation of medication management resources for carers of people with dementia: a scoping review with an environmental scan.

Widjaja, Gabrielle J / Gnjidic, Danijela / Clough, Alexander J / Watson, Karen / Hepburn, Kenneth / Sawan, Mouna J

Expert review of clinical pharmacology

2023 Volume 16, Issue 3, Page(s) 195–205

Abstract: Introduction: There is a need for resources to guide informal carers in medication management for people with dementia. Availability of resources on medication management guidance has yet to be explored.: Areas covered: A systematic search of MEDLINE, ...

Abstract	Introduction: There is a need for resources to guide informal carers in medication management for people with dementia. Availability of resources on medication management guidance has yet to be explored. Areas covered: A systematic search of MEDLINE, Embase, CINAHL and PsycINFO was performed in May 2022 to identify and evaluate resources for carers of people with dementia that provide guidance in medication management. Google and known repositories were also searched. Readability of text-based resources was examined using the Flesch-Kincaid reading level, the Flesch reading ease and the Gunning-Fog index. Resources were further evaluated using the Patient Education Material Assessment Tool (PEMAT or PEMAT-A/V). Expert opinion: Fifteen resources were identified, which largely focused on medication administration with limited discussion of shared decision-making. Current resources do not appear to have included people living with dementia or their carers in their development and did not address high-risk care settings. Codesign of resources with carers and people with dementia would ensure that resources are comprehensive and target their needs. Future research should therefore focus on development of readily available and understandable resources that provide medication management guidance for carers across different health settings, to comprehensively address the multi-faceted nature of dementia.
MeSH term(s)	Humans ; Caregivers ; Medication Therapy Management ; Dementia
Language	English
Publishing date	2023-02-26
Publishing country	England
Document type	Review ; Journal Article
ISSN	1751-2441
ISSN (online)	1751-2441
DOI	10.1080/17512433.2023.2181158
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Article ; Online: Survey content validation evaluating the dissemination and implementation of deprescribing guidelines.

Cheng, Chun Hei Justin / Langford, Aili V / Gnjidic, Danijela / Farrell, Barbara J / Schneider, Carl R

Basic & clinical pharmacology & toxicology

2023 Volume 134, Issue 1, Page(s) 63–71

Abstract: Background: Policies, protocols and processes within organisations can facilitate or hinder guideline adoption. There is limited knowledge on the strategies used by organisations to disseminate and implement evidence-based deprescribing guidelines or ... ...

Abstract	Background: Policies, protocols and processes within organisations can facilitate or hinder guideline adoption. There is limited knowledge on the strategies used by organisations to disseminate and implement evidence-based deprescribing guidelines or their impact. Methods: We aimed to develop an online survey targeting key organisations involved in deprescribing guideline endorsement, dissemination, modification or translation internationally. Survey questions were drafted, mirroring the six components of the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework. Content validation was undertaken and established by a panel of clinicians, researchers and implementation experts. Results: A 52-item survey underwent two rounds of content validation. The minimum threshold (I-CVI > 0.78) for relevance and importance was met for 39 items (75%) in the first round and 44 of 48 items (92%) in the second round. The expert panel concluded that the adoption, implementation and effectiveness survey sections were largely relevant and important to this topic, whereas the reach and maintenance sections were harder to understand and may be less pertinent to the research question. Conclusions: A 44-item survey investigating dissemination and implementation strategies for deprescribing guidelines has been developed and its content validated. Widespread survey distribution may identify effective strategies and inform dissemination and implementation planning for newly developed guidelines.
MeSH term(s)	Deprescriptions ; Surveys and Questionnaires
Language	English
Publishing date	2023-07-11
Publishing country	England
Document type	Journal Article
ZDB-ID	2134679-3
ISSN	1742-7843 ; 1742-7835
ISSN (online)	1742-7843
ISSN	1742-7835
DOI	10.1111/bcpt.13922
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Article ; Online: Achieving sustainable healthcare through deprescribing.

Gnjidic, Danijela / Johansson, Minna / Meng, Dina Muscat / Farrell, Barbara / Langford, Aili / Reeve, Emily

The Cochrane database of systematic reviews

2022 Volume 10, Page(s) ED000159

MeSH term(s)	Delivery of Health Care ; Deprescriptions ; Health Facilities ; Humans ; Polypharmacy ; Public Health
Language	English
Publishing date	2022-10-04
Publishing country	England
Document type	Editorial
ISSN	1469-493X
ISSN (online)	1469-493X
DOI	10.1002/14651858.ED000159
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