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Aim Polypharmacy is a highly prevalent geriatric syndrome, and hospitalizations can worsen it. The aim of the present study was to analyze the influence of hospitalization on polypharmacy and indicators of quality of prescribing, and their possible association with health outcomes. Methods A retrospective study of 200 patients discharged from an acute geriatric unit was carried out. Indicators of quality of prescription were registered at admission and discharge: polypharmacy defined as ≥5 medications, hyperpolypharmacy (≥10), potentially inappropriate prescribing by Beers and Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria, potentially prescribing omissions by Screening Tool to Alert doctors to the Right Treatment (START) criteria, drug interactions and anticholinergic burden measured with the Anticholinergic Risk Scale. Mortality, emergency room visits and hospital admissions occurring during 6 months after discharge were also registered. Results The total number of drugs increased at discharge (9.1 vs 10.1, P

Resumen Introduccion Adalimumab es un anticuerpo monoclonal IgG1 humano que se une al factor de necrosis tumoral-α implicado en la patogenia de la psoriasis. Se realizo un estudio retrospectivo para caracterizar a los pacientes con psoriasis que precisaron tratamiento con adalimumab, y evaluar la efectividad y seguridad de dicho tratamiento en la practica clinica diaria. Pacientes y metodos Se revisaron las historias clinicas de 30 pacientes con psoriasis moderada-severa tratados con adalimumab desde enero de 2008 hasta abril de 2011. Resultados Trece hombres y 17 mujeres con psoriasis precisaron tratamiento con adalimumab; 16 de ellos presentaban alguna comorbilidad, siendo las mas frecuentes: hipertension, obesidad, artritis y dislipidemia. Todos los pacientes presentaron mejoria del PASI, BSA y PGA (p Conclusion Adalimumab ha demostrado ser un tratamiento muy efectivo y seguro para nuestros pacientes con psoriasis, quienes presentaban las comorbilidades mas frecuentemente asociadas a esta enfermedad, y en los que habian fallado otras terapias sistemicas y biologicas previas. El porcentaje de respuesta PASI 90 y PASI 100 ha sido superior al obtenido en los ensayos clinicos pivotales. Adalimumab presento un porcentaje de supervivencia del 70% a las 89 semanas de tratamiento.

Polypharmacy is a highly prevalent geriatric syndrome, and hospitalizations can worsen it. The aim of the present study was to analyze the influence of hospitalization on polypharmacy and indicators of quality of prescribing, and their possible association with health outcomes.A retrospective study of 200 patients discharged from an acute geriatric unit was carried out. Indicators of quality of prescription were registered at admission and discharge: polypharmacy defined as ≥5 medications, hyperpolypharmacy (≥10), potentially inappropriate prescribing by Beers and Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria, potentially prescribing omissions by Screening Tool to Alert doctors to the Right Treatment (START) criteria, drug interactions and anticholinergic burden measured with the Anticholinergic Risk Scale. Mortality, emergency room visits and hospital admissions occurring during 6 months after discharge were also registered.The total number of drugs increased at discharge (9.1 vs 10.1, P 0.001), without increasing chronic medications (8.5 vs 8.3, P = 0.699). No significant variations were observed in the prevalence of polypharmacy (86.5% vs 82.2%), potentially inappropriate prescribing (68.5% vs 71.5%), potential prescribing omissions (58% vs 58%) or drug interactions (82.5% vs 83.5%). Patients with anticholinergic drugs tended to increase, not reaching statistical significance (39.5% vs 44.5%; P = 0.064). Polypharmacy was associated with emergency room visits (OR 2.62, 95% CI 1.07-6.40; P = 0.034), and hyperpolypharmacy with hospitalizations (OR 2.49, 95% CI 1.25-4.93; P = 0.009).After hospitalization in an acute geriatric unit, the prevalence of polypharmacy, potentially inappropriate prescribing, potential prescribing omissions, interactions or anticholinergic drugs is still very high. Polypharmacy is a risk factor for hospitalization and emergency room visits. Measuring indicators of quality of prescription might be useful to design interventions to optimize pharmacotherapy and improve health outcomes in elderly acute patients. Geriatr Gerontol Int 2017; 17: 2354-2361.