ArticleJournal of the American Geriatrics Society2020
COVID-SAFER: Deprescribing Guidance for Hydroxychloroquine Drug Interactions in Older Adults.
Article in Journal of the American Geriatrics Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 4 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Chemoprophylaxis trial designs in epidemics: insights from a systematic review of COVID-19 study registrations.Trials · 2021Pooled it
- A systematic review and meta-analysis on chloroquine and hydroxychloroquine as monotherapy or combined with azithromycin in COVID-19 treatment.Scientific reports · 2020Pooled it
- Meta-analysis on outcome-worsening comorbidities of COVID-19 and related potential drug-drug interactions.Pharmacological research · 2020Pooled it
- Polypharmacy among COVID-19 patients: A systematic review.Journal of the American Pharmacists Association : JAPhAPooled it
- Hydroxychloroquine in Nonhospitalized Adults With Early COVID-19 : A Randomized Trial.Annals of internal medicine · 2020Trial
- Drug-Drug Interactions of Hydroxychloroquine and Chloroquine in Older Patients with COVID-19 during the First Pandemic Waves: The GeroCovid Observational Study.Reports (MDPI) · 2024Article
- Activation of PXR causes drug interactions with Paxlovid in transgenic mice.Acta pharmaceutica Sinica. B · 2023Article
- Benefit versus toxicity risk of digoxin in patients with COVID-19.European journal of hospital pharmacy : science and practice · 2022Article
- Enabling Healthy Aging to AVOID Frailty in Community Dwelling Older Canadians.Canadian geriatrics journal : CGJ · 2022Article
- Safety of Short-Term Treatments with Oral Chloroquine and Hydroxychloroquine in Patients with and without COVID-19: A Systematic Review.Pharmaceuticals (Basel, Switzerland) · 2022Review
- Use of hydroxychloroquine and azithromycin combination to treat the COVID-19 infection.World journal of experimental medicine · 2022Review
- Potentially inappropriate medications based on TIME criteria and risk of in-hospital mortality in COVID-19 patients.Revista da Associacao Medica Brasileira (1992) · 2022Article
- Adverse drug event risk assessment by the virtual addition of COVID-19 repurposed drugs to Medicare and commercially insured patients' drug regimens: A drug safety simulation study.Clinical and translational science · 2021Observational
- [Mortality in schizophrenia: Towards a new health scandal? COVID-19 and schizophrenia].Annales medico-psychologiques · 2021Article
- Older people at the beginning of the COVID-19 pandemic: A scoping review.Journal of health monitoring · 2021Article
- Implementing Delirium Prevention in the Era of COVID-19.Journal of Alzheimer's disease : JAD · 2021Review
- Safety of Hydroxychloroquine Among Outpatient Clinical Trial Participants for COVID-19.Open forum infectious diseases · 2020Article
- Risk of Adverse Drug Events Following the Virtual Addition of COVID-19 Repurposed Drugs to Drug Regimens of Frail Older Adults with Polypharmacy.Journal of clinical medicine · 2020Article
- The Double Burden of the COVID-19 Pandemic and Polypharmacy on Geriatric Population - Public Health Implications.Therapeutics and clinical risk management · 2020Review
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
BACKGROUND/
objectivesSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes high morbidity and mortality in older adults with chronic illnesses. Several trials are currently underway evaluating the antimalarial drug hydroxychloroquine as a potential treatment for acute infection. However, polypharmacy predisposes patients to increased risk of drug-drug interactions with hydroxychloroquine and may render many in this population ineligible to participate in trials. We aimed to quantify the degree of polypharmacy and burden of potentially inappropriate medications (PIMs) that older hospitalized adults are taking that would interact with hydroxychloroquine.
methodsWe reanalyzed data from the cohort of patients 65 years and older enrolled in the MedSafer pilot study. We first identified patients taking medications with potentially harmful drug-drug interactions with hydroxychloroquine that might exclude them from participation in a typical 2019 coronavirus disease (COVID-19) therapeutic trial. Next, we identified medications that were flagged by MedSafer as potentially inappropriate and crafted guidance around medication management if contemplating the use of hydroxychloroquine.
resultsThe cohort contained a total of 1,001 unique patients with complete data on their home medications at admission. Of these 1,001 patients, 590 (58.9%) were receiving one or more home medications that could potentially interact with hydroxychloroquine, and of these, 255 (43.2%) were flagged as potentially inappropriate by the MedSafer tool. Common classes of PIMs observed were antipsychotics, cardiac medications, and antidiabetic agents.
conclusionThe COVID-19 pandemic highlights the importance of medication optimization and deprescribing PIMs in older adults. By acting now to reduce polypharmacy and use of PIMs, we can better prepare this vulnerable population for inclusion in trials and, if substantiated, pharmacologic treatment or prevention of COVID-19. J Am Geriatr Soc 68:1636-1646, 2020.
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