Polypharmacy and malnutrition

Zadák, Z; Hyspler, R.; Tichá, Alena; Vlcek, Jirí

doi:10.1097/mco.0b013e32835b612e

Cited by 54 publications

(60 citation statements)

References 13 publications

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“…It is difficult to separate whether polypharmacy worsens malnutrition or whether these 2 occurrences coexist in the vulnerable population of the elderly, with or without medical morbidity, and social deprivation factors like food insecurity. 23,44 It should be noted, however, that medications have common side effects that may be easily overlooked, such as dyspepsia or gastrointestinal intolerance. Furthermore, certain commonly prescribed medications have side effects affecting nutritional status such as anorexia, early satiety, reduced ability to eat, dysphagia, constipation, and diarrhea.…”

Section: Promoting Dietary Intake and Setting Reasonable Goalsmentioning

confidence: 98%

“…In addition, in elderly patients Nutrition in the Geriatric Surgical Patient who take multiple medications (often up to 10 or more), possible side effects may be difficult to identify and may be superimposed by drug interactions. 44 A thorough review of symptoms may help capture missed gastrointestinal disturbances or side effects of medications in an elderly individual.…”

Section: Promoting Dietary Intake and Setting Reasonable Goalsmentioning

confidence: 99%

“…Routine assessment for signs and symptoms of depression are extremely important. 44 In addition, a thorough physical examination of the skin, hair, oral mucosa, and tongue may provide critical information about the hydration and nutrition status of the geriatric patient. 45 …”

Section: Assessing Nutritional Risk In the Geriatric Surgical Patientmentioning

confidence: 99%

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Management of the Gastrointestinal Tract and Nutrition in the Geriatric Surgical Patient

Nohra

Bochicchio

2015

Surgical Clinics of North America

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Section: Promoting Dietary Intake and Setting Reasonable Goalsmentioning

confidence: 98%

Section: Promoting Dietary Intake and Setting Reasonable Goalsmentioning

confidence: 99%

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Management of the Gastrointestinal Tract and Nutrition in the Geriatric Surgical Patient

Nohra

Bochicchio

2015

Surgical Clinics of North America

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“…Many of these are at play in the elderly in particular given their generally high use of medication. 37 The absorption, distribution, metabolism and excretion of specific nutrients can also be influenced by drugs. When the detrimental effects on specific nutrients are acknowledged as significant, they may be addressed by supplementation (e.g.…”

Section: Types Of Drug and Nutrition Interactionsmentioning

confidence: 99%

Drug and nutrition interactions: not just food for thought

Boullata

2013

J Clin Pharm Ther

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Summary What is known and objective The management of drug‐drug interactions – from recognition of the interaction potential, to addressing the negative consequences – are well‐recognized and avoided, or rapidly addressed when identified clinically. Drug‐nutrition interactions are no less important than drug‐drug interactions in patient care. Unfortunately, beyond those caused by food, these interactions are less commonly recognized or identified and managed. This article will re‐introduce the topic of drug‐nutrition interactions to clinicians. Comment Although many clinicians are acutely aware of and vigilant for potential drug‐drug interactions, most are less aware of the possibility of drug‐nutrition interactions beyond classic food‐drug interactions. Interaction can occur between a drug and a nutrient, multiple nutrients, food in general, specific foods or components, or nutrition status. An interaction is considered clinically significant if it alters therapeutic drug response and/or compromises nutrition status. Mechanistically the interactions may be physicochemical reactions, actions at membrane transporters or metabolizing enzymes, or an influence on physiologic function. Appreciating the many types of drug‐nutrition interactions will aid the clinician and have the potential to influence patient outcome. What is new and conclusion Ongoing advances in knowledge about drug and nutrition interactions have potential to improve patient care. Drug‐nutrition interactions need to be better recognized, understood on a mechanistic basis, predicted, and managed as necessary.

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“…Malnutrition causes infection and is associated with poor rehabilitation outcomes (14). Aging causes an altered drug metabolism as a consequence of the deterioration of organ function and bioavailability, thereby leading to malnutrition (15).…”

mentioning

confidence: 99%

Effect of Long-Term Proton Pump Inhibitor Therapy on Nutritional Status in Elderly Hospitalized Patients

Nakamichi

Wakabayashi

2016

J Nutr Sci Vitaminol

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SummaryThe purpose was to investigate the association between proton pump inhibitor (PPI) therapy and nutritional status in elderly hospitalized patients. Participants were 190 elderly patients admitted to the long-term care wards, convalescence rehabilitation wards, and community integrated care wards in January 2015. Nutritional status was assessed using the mini nutritional assessment short-form (MNA-SF). The PPI use group was compared with the PPI non-use group regarding nutrition status. Logistic regression analysis was used to examine whether the period of PPI therapy was associated independently with malnutrition following adjustment for covariates including gender, age, and serum albumin level. Forty-one patients were male (22%) and 149 patients were female (78%), with a mean age of 85.468.4. Fifty-three patients (28%) took PPIs (with a median prescription period of 91 d, ranging from 51 to 227). With a MNA-SF score of 7 points or lower designated as malnutrition, there was no significant difference in nutritional status between the PPI and non-PPI groups (p50.172). The median MNA-SF scores in the PPI and non-PPI groups were 9 vs 7 points, respectively. Logistic regression analysis showed that long-term PPI therapy (odds ratio, 0.994; 95% confidence interval 0.990-0.999) was significantly associated with improved nutritional status. The presence or absence of PPI therapy is not associated with malnutrition in elderly hospitalized patients. Longer-term PPI therapy may improve nutritional status.

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Polypharmacy and malnutrition

Cited by 54 publications

References 13 publications

Management of the Gastrointestinal Tract and Nutrition in the Geriatric Surgical Patient

Management of the Gastrointestinal Tract and Nutrition in the Geriatric Surgical Patient

Drug and nutrition interactions: not just food for thought

Effect of Long-Term Proton Pump Inhibitor Therapy on Nutritional Status in Elderly Hospitalized Patients

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