Drug safety profiles in geriatric patients with Parkinson’s disease using the FORTA (Fit fOR The Aged) classification: results from a mono-centric retrospective analysis

Greten, Stephan; Müller-Funogea, J I; Wegner, Florian; Höglinger, Günter U.; Simon, N.; Junius-Walker, Ulrike; Gerbel, Svetlana; Krause, Olaf; Klietz, Martin

doi:10.1007/s00702-020-02276-x

Cited by 15 publications

(15 citation statements)

References 92 publications

(111 reference statements)

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“…Geriatric and PD patients in our study had a mean number of 10.1 ± 4.3 comorbidities. Similar data were obtained in comparable studies before [ 13 , 21 , 22 ]. These results underline the high risk of these patients for recurrent and acute visits to hospitals [ 5 ].…”

Section: Discussionsupporting

confidence: 91%

“…Adding to this, general practitioners regularly change medication schemes shortly after discharge from the hospital [ 11 ]. Drug safety issues due to polypharmacy and the resulting hazard of drug interactions were reported frequently, especially for geriatric multimorbid patients [ 4 , 12 , 13 ]. A data management system like the emergency box has the potential to discover and solve drug interaction problems in acute and inpatient care.…”

Section: Discussionmentioning

confidence: 99%

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Patient Safety in a Box: Implementation and Evaluation of the Emergency Box in Geriatric and Parkinson Patients

Krey

Lange

Tran

et al. 2021

JCM

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In an industrial society, the proportion of geriatric people increases with rising age. These people are likely to use polypharmacy and experience medical emergencies. However, their emergency care can be complicated by unclear comorbidities and medication. The aim of this prospective interventional study was to assess the demand for a drug safety tool in clinical practice and to analyze whether the emergency box can improve acute care in a geriatric cohort. Therefore, emergency room (ER) doctors in a German tertiary hospital recorded the number of geriatric patients lacking medical information and its impact on diagnostics/treatment. Furthermore, the emergency box was distributed to patients on the neurological ward and their current drug safety concepts were assessed. After 6 months, we evaluated in a follow-up whether the tool was helpful in emergency cases. Our study revealed that 27.4% (n = 28) of the patients came to the ER without their medical information, which caused a relevant delay or possible severe complications in 11.8% (n = 12). The emergency box was perceived as easily manageable and 87.9% (n = 109) of the participants wanted to keep it after the study. Subjectively, participants benefitted in emergencies. In conclusion, the emergency box is a cheap tool that is easy to use. It can save valuable time in emergencies and increases the safety of geriatric patients.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Patient Safety in a Box: Implementation and Evaluation of the Emergency Box in Geriatric and Parkinson Patients

Krey

Lange

Tran

et al. 2021

JCM

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“…Patients with clinical conditions interfering with MRI diagnostics, like severe head tremor, dystonia or dyskinesia, had to be excluded as well. PD patients with severe comorbidities were also excluded from our study ( Klietz et al, 2019b ; Greten et al, 2020 ).…”

Section: Methodsmentioning

confidence: 99%

Cerebral Microstructural Alterations in Patients With Early Parkinson’s Disease Detected With Quantitative Magnetic Resonance Measurements

Klietz

Elaman

Mahmoudi

et al. 2021

Front. Aging Neurosci.

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Objective: Parkinson’s disease (PD) is the second most common neurodegenerative disease in the elderly. In early stages of PD, patients typically display normal brain magnet resonance imaging (MRI) in routine screening. Advanced imaging approaches are necessary to discriminate early PD patients from healthy controls. In this study, microstructural changes in relevant brain regions of early PD patients were investigated by using quantitative MRI methods.Methods: Cerebral MRI at 3T was performed on 20 PD patients in early stages and 20 age and sex matched healthy controls. Brain relative proton density, T1, T2, and T2′ relaxation times were measured in 14 regions of interest (ROIs) in each hemisphere and compared between patients and controls to estimate PD related alterations.Results: In comparison to matched healthy controls, the PD patients revealed decreased relative proton density in contralateral prefrontal subcortical area, upper and lower pons, in ipsilateral globus pallidus, and bilaterally in splenium corporis callosi, caudate nucleus, putamen, thalamus, and mesencephalon. The T1 relaxation time was increased in contralateral prefrontal subcortical area and centrum semiovale, putamen, nucleus caudatus and mesencephalon, whereas T2 relaxation time was elevated in upper pons bilaterally and in centrum semiovale ipsilaterally. T2′ relaxation time did not show significant changes.Conclusion: Early Parkinson’s disease is associated with a distinct profile of brain microstructural changes which may relate to clinical symptoms. The quantitative MR method used in this study may be useful in early diagnosis of Parkinson’s disease. Limitations of this study include a small sample size and manual selection of the ROIs. Atlas-based or statistical mapping methods would be an alternative for an objective evaluation. More studies are necessary to validate the measurement methods for clinical use in diagnostics of early Parkinson’s disease.

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“…Hence, longitudinal prospective interventional studies are needed to determine the effect of specific potentially multidimensional interventions on the caregiver burden of female and male caregivers in the future. This study also did not evaluate patients' comorbidities and medications [48,49].…”

Section: Limitationsmentioning

confidence: 99%

One Year Trajectory of Caregiver Burden in Parkinson’s Disease and Analysis of Gender-Specific Aspects

et al. 2021

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Parkinson’s disease (PD) is a slowly progressive neurodegenerative movement disorder that leads to impairments in activities of daily living. In addition to reducing patients’ quality of life, this disease also affects caregivers’ well-being. Until recently, caregiver burden was mainly assessed by generic questionnaires, which do not take the characteristics of the chronic disease into consideration. In the case of PD, this issue has been addressed by the introduction of the “Parkinson’s disease caregiver burden” questionnaire (PDCB). Data on longitudinal trajectories of caregiver burden are still missing in the literature. In this study, we assessed the one-year trajectory of caregiver burden by the PDCB as a disease-specific questionnaire. Further, gender-specific aspects of caregiver burden were analyzed by applying a caregiver task questionnaire. PDCB total score (n = 84 patients and caregivers) did not significantly change from baseline (30.4) to one year at follow-up (31.5). No significant difference was detected between female and male caregivers in global burden and-specific caregiver tasks. Our data showed only a mild increase of caregiver burden in the timeframe of one year. Gender-specific differences do not seem to impact-specific caregiver tasks in the presented study population.

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Drug safety profiles in geriatric patients with Parkinson’s disease using the FORTA (Fit fOR The Aged) classification: results from a mono-centric retrospective analysis

Cited by 15 publications

References 92 publications

Patient Safety in a Box: Implementation and Evaluation of the Emergency Box in Geriatric and Parkinson Patients

Patient Safety in a Box: Implementation and Evaluation of the Emergency Box in Geriatric and Parkinson Patients

Cerebral Microstructural Alterations in Patients With Early Parkinson’s Disease Detected With Quantitative Magnetic Resonance Measurements

One Year Trajectory of Caregiver Burden in Parkinson’s Disease and Analysis of Gender-Specific Aspects

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