{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:10:07Z","timestamp":1788304207183,"version":"build-2803163510"},"reference-count":35,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T00:00:00Z","timestamp":1708905600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geriatrics"],"abstract":"<jats:p>Polypharmacy is an important issue in older patients affected by dementia because they are very vulnerable to the side effects of drugs\u2019. Between October 2021 and September 2022, we randomly assessed 205 old-aged outpatients. The study was carried out in a Center for Dementia in collaboration with a university center. The primary outcomes were: (1) deprescribing inappropriate drugs through the Beers and STOPP&amp;START criteria; (2) assessing duplicate drugs and the risk of iatrogenic damage due to drug\u2013drug and drug\u2013disease interactions. Overall, 69 men and 136 women (mean age 82.7 \u00b1 7.4 years) were assessed. Of these, 91 patients were home care patients and 114 were outpatient. The average number of the drugs used in the sample was 9.4 drugs per patient; after the first visit and the consequent deprescribing process, the average dropped to 8.7 drugs per patient (p = 0.04). Overall, 74 potentially inappropriate drugs were used (36.1%). Of these, long half-life benzodiazepines (8.8%), non-steroidal anti-inflammatory drugs (3.4%), tricyclic antidepressants (3.4%), first-generation antihistamines (1.4%), anticholinergics (11.7%), antiplatelet drugs (i.e., ticlopidine) (1.4%), prokinetics in chronic use (1.4%), digoxin (&gt;0.125 mg\/day) (1.4%), antiarrhythmics (i.e., amiodarone) (0.97%), and \u03b1-blockers (1.9%) were included. The so-called \u201cduplicate\u201d drugs were overall 26 (12.7%). In total, ten potentially dangerous prescriptions were found for possible interactions (4.8%). We underline the importance of checking all the drugs taken periodically and discontinuing drugs with the lowest benefit-to-harm ratio and the lowest probability of adverse reactions due to withdrawal. Computer tools and adequately trained teams (doctors, nurses, and pharmacists) could identify, treat, and prevent possible drug interactions.<\/jats:p>","DOI":"10.3390\/geriatrics9020028","type":"journal-article","created":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T10:40:17Z","timestamp":1708944017000},"page":"28","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Deprescribing in Older Poly-Treated Patients Affected with Dementia"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4277-3426","authenticated-orcid":false,"given":"Pietro","family":"Gareri","sequence":"first","affiliation":[{"name":"Department of Frailty, Center for Cognitive Disorders and Dementia (CDCD) Catanzaro Lido\u2014ASP Catanzaro, Magna Graecia University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0858-7902","authenticated-orcid":false,"given":"Luca","family":"Gallelli","sequence":"additional","affiliation":[{"name":"Unit of Clinical Pharmacology and Pharmacovigilance, \u201cRenato Dulbecco\u201d University Hospital, 88100 Catanzaro, Italy"},{"name":"Department of Health Science, Magna Graecia University, 88100 Catanzaro, Italy"},{"name":"Research Center FAS@UMG, Department of Health Science, Magna Graecia University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Gareri","sequence":"additional","affiliation":[{"name":"Department of Health Science, Magna Graecia University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Rania","sequence":"additional","affiliation":[{"name":"Unit of Clinical Pharmacology and Pharmacovigilance, \u201cRenato Dulbecco\u201d University Hospital, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Palleria","sequence":"additional","affiliation":[{"name":"Department of Health Science, Magna Graecia University, 88100 Catanzaro, Italy"},{"name":"Research Center FAS@UMG, Department of Health Science, Magna Graecia University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7629-6579","authenticated-orcid":false,"given":"Giovambattista","family":"De Sarro","sequence":"additional","affiliation":[{"name":"Unit of Clinical Pharmacology and Pharmacovigilance, \u201cRenato Dulbecco\u201d University Hospital, 88100 Catanzaro, Italy"},{"name":"Department of Health Science, Magna Graecia University, 88100 Catanzaro, Italy"},{"name":"Research Center FAS@UMG, Department of Health Science, Magna Graecia University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,26]]},"reference":[{"key":"ref_1","unstructured":"Putignano, S., Cester, A., and Gareri, P. (2012). Geriatria Nel Territorio\u2014Un Metodo Per i Vecchi, Per i Medici e Per il Futuro, Critical Medicine Publishing s.r.l."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1007\/s40471-021-00274-5","article-title":"An Update on Medication Use in Older Adults: A Narrative Review","volume":"8","author":"Barry","year":"2021","journal-title":"Curr. Epidemiol. Rep."},{"key":"ref_3","unstructured":"ISMP Canada Safety Bulletin (2018). Deprescribing: Managing Medications to Reduce Polypharmacy, ISMP."},{"key":"ref_4","unstructured":"Parsons, C. (2016). Therapeutic Advances in Drug Safety, SAGE Publications Inc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1221069","DOI":"10.3389\/fphar.2023.1221069","article-title":"Global prevalence of polypharmacy and potentially inappropriate medication in older patients with dementia: A systematic review and meta-analysis","volume":"14","author":"Zhao","year":"2023","journal-title":"Front. Pharmacol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"American Geriatrics Society, New York (2019). Updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J. Am. Geriatr. Soc., 67, 674\u2013694.","DOI":"10.1111\/jgs.15767"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1111\/jcpt.12059","article-title":"Application of the STOPP\/START criteria: A systematic review of the prevalence of potentially inappropriate prescribing in older adults, and evidence of clinical, humanistic and economic impact","volume":"38","author":"Sketris","year":"2013","journal-title":"J. Clin. Pharm. Ther."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Fahrni, M.L., Azmy, M.T., Usir, E., Aziz, N.A., and Hassan, Y. (2019). Inappropriate prescribing defined by STOPP and START criteria and its association with adverse drug events among hospitalized older patients: A multicentre, prospective study. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0219898"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1001\/jamainternmed.2015.0324","article-title":"Reducing inappropriate polypharmacy: The process of deprescribing","volume":"175","author":"Scott","year":"2015","journal-title":"JAMA Intern. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1979","DOI":"10.1007\/s11255-017-1682-z","article-title":"Estimating renal function in old people: An in-depth review","volume":"49","author":"Raman","year":"2017","journal-title":"Int. Urol. Nephrol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.1007\/s40520-020-01719-5","article-title":"The risk of polypharmacy and potentially inappropriate drugs in residential care dementia patients: Tips from the PharE study","volume":"33","author":"Gareri","year":"2021","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1111\/j.1532-5415.1995.tb06377.x","article-title":"Validation of the Cumulative Illness Rating Scale in a geriatric residential population","volume":"43","author":"Parmelee","year":"1995","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1111\/j.1600-0404.1994.tb02724.x","article-title":"Staging the severity of dementia: Comparison of clinical (CDR, DSM-III-R), functional (ADL, IADL) and cognitive (MMSE) scales","volume":"90","author":"Juva","year":"1994","journal-title":"Acta Neurol. Scand."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1038\/clpt.1981.154","article-title":"A method for estimating the probability of adverse drug reactions","volume":"30","author":"Naranjo","year":"1981","journal-title":"Clin. Pharmacol. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"290","DOI":"10.3163\/1536-5050.104.4.007","article-title":"Evaluation of resources for analyzing drug interactions","volume":"104","author":"Patel","year":"2016","journal-title":"J. Med. Libr. Assoc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1016\/S1359-6446(01)01892-X","article-title":"Pharmacogenetics of the human drug-transporter gene MDR1: Impact of polymorphisms on pharmacotherapy","volume":"6","author":"Brinkmann","year":"2001","journal-title":"Drug Discov. Today"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.clpt.2003.09.012","article-title":"Polymorphisms in human MDR1 (P-glycoprotein): Recent advances and clinical relevance","volume":"75","author":"Marzolini","year":"2004","journal-title":"Clin. Pharmacol. Ther."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1177\/0091270006292249","article-title":"Effect of conjugated equine estrogens on oxidative metabolism in middle-age and elderly postmenopausal women","volume":"46","author":"Frye","year":"2006","journal-title":"J. Clin. Pharmacol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"353","DOI":"10.2165\/00002512-200017050-00003","article-title":"Differential pharmacokinetics of digoxin in elderly patients","volume":"17","author":"Hanratty","year":"2000","journal-title":"Drugs Aging"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.1345\/aph.1A484","article-title":"Drug-Drug interactions in the elderly","volume":"36","author":"Bjorkman","year":"2002","journal-title":"Ann. Pharmacother."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"879","DOI":"10.2165\/00002512-200219110-00005","article-title":"Potential interactions between herbal medicines and conventional drug therapies used by older adults attending a memory clinic","volume":"19","author":"Dergal","year":"2002","journal-title":"Drugs Aging"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1930","DOI":"10.1111\/j.1532-5415.2005.00474.x","article-title":"Potential for alcohol and prescription drug interactions in older people","volume":"53","author":"Pringle","year":"2005","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1038\/clpt.1993.7","article-title":"The pharmacokinetic and pharmacodynamic interaction between propafenone and lidocaine","volume":"53","author":"Ujhelyi","year":"1993","journal-title":"Clin. Pharmacol. Ther."},{"key":"ref_24","first-page":"2","article-title":"A Fatal Case of Triple Whammy in an Elderly Patient","volume":"4","author":"Gareri","year":"2015","journal-title":"J. Gerontol. Geriatr. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e2022666","DOI":"10.1590\/1516-3180.2022.0666.r1.190523","article-title":"Potentially inappropriate medications with older people in intensive care and associated factors: A historic cohort study","volume":"142","author":"Sichieri","year":"2023","journal-title":"Sao Paulo Med. J."},{"key":"ref_26","first-page":"588","article-title":"Parenteral amiodarone-induced hepatoxicity: When being earnest is an added value","volume":"178","author":"Gareri","year":"2019","journal-title":"Gazz. Medica Ital.\u2014Arch. Per Le Sci. Med."},{"key":"ref_27","first-page":"354","article-title":"Deprescribing proton pump inhibitors: Evidence-based clinical practice guideline","volume":"63","author":"Farrell","year":"2017","journal-title":"Can. Fam. Phys."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"l1580","DOI":"10.1136\/bmj.l1580","article-title":"Estimates of all cause mortality and cause specific mortality associated with proton pump inhibitors among US veterans: Cohort study","volume":"365","author":"Xie","year":"2019","journal-title":"BMJ"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1097\/JCP.0b013e3182a6096e","article-title":"Use and safety of antipsychotics in behavioral disorders in elderly people with dementia","volume":"34","author":"Gareri","year":"2014","journal-title":"J. Clin. Psychopharmacol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1177\/070674370705201004","article-title":"Pharmacological management of neuropsychiatric symptoms of Alzheimer disease","volume":"52","author":"Hermann","year":"2007","journal-title":"Can. J. Psychiatry"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1038\/nrneurol.2009.39","article-title":"Management of agitation and aggression associated with Alzheimer disease","volume":"5","author":"Ballard","year":"2009","journal-title":"Nat. Rev. Neurol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2407","DOI":"10.1517\/14656560903200659","article-title":"Atypical antipsychotics in the elderly: A review of therapeutic trends and clinical outcomes","volume":"10","author":"Burke","year":"2009","journal-title":"Expert. Opin. Pharmacother."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2870","DOI":"10.1056\/NEJMsb042458","article-title":"Potential pitfalls of disease-specific guidelines for patients with multiple conditions","volume":"351","author":"Tinetti","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.maturitas.2016.06.006","article-title":"Deprescribing in older people","volume":"91","author":"Page","year":"2016","journal-title":"Maturitas"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"571","DOI":"10.2174\/092986710790416326","article-title":"Age-related pharmacokinetic and pharmacodynamic changes and related risk of adverse drug reactions","volume":"17","author":"Corsonello","year":"2010","journal-title":"Curr. Med. Chem."}],"container-title":["Geriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3417\/9\/2\/28\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:05:13Z","timestamp":1760105113000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3417\/9\/2\/28"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,26]]},"references-count":35,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,4]]}},"alternative-id":["geriatrics9020028"],"URL":"https:\/\/doi.org\/10.3390\/geriatrics9020028","relation":{},"ISSN":["2308-3417"],"issn-type":[{"value":"2308-3417","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,26]]}}}