DDI Domination Directory International Issue 66 Brittany Andrews Like New

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Gnjidic D, Tinetti M, Allore HG. Assessing medication burden and polypharmacy: finding the perfect measure. Expert Rev Clin Pharmacol. 2017;10:345–7. https://doi.org/10.1080/17512433.2017.1301206. Fig. 9 Heat maps of the atom similarity matrix for compounds (a) glycopyrronium, (b) procyclidine, (c) dyclonine, and (d) benzatropine. The atoms in the compounds are automatically grouped into clusters during the learning process where the corresponding substructures for clusters are highlighted in the drugs. where ⊙ represents dot product, is a weight vector for step t, and σ is an activation function. We chose the tanh function as the activation function, because it works fairly well in practice. To make coefficients easily comparable across different steps, we normalize e ( t) across all steps using the softmax function This systematic review had two aims. First, we aimed to explore how COC, polypharmacy and MARO are defined, operationalized, and measured in the included studies. Second, we aimed to investigate the relationship between COC and polypharmacy and MARO. 4.1 Methodological Findings: Measuring COC where , is a learnable representation of interaction type r, σ is the sigmoid function, and ∥ represents concatenation. The learning process of the model can be achieved by minimizing the cross-entropy loss function, 36 which is given as follows:

Saultz JW. Defining and measuring interpersonal continuity of care. Ann Fam Med. 2003;1:134–43. https://doi.org/10.1370/afm.23. For 6 of the 26 studies included in the data set, no information about ethnicity was available. Therefore, for the 223 subjects from these six studies, the imputed ethnicity was ‘non-Hispanic’ (the most frequent value among the subjects with ethnicity information). The CYP2C9 genotype was missing for 84 of the subjects and was imputed as ‘extensive metaboliser’ (EM). For CYP2C19 and CYP2D6, 13 and 12 subjects had missing data, respectively; these were imputed as ‘extensive metaboliser’ (EM). For the continuous covariates, the following were missing: ALAT (6 subjects), ASAT (6 subjects) and bilirubin (18 subjects). All missing continuous covariates were imputed using the median value. One conclusion of the present study is that, at least in mice, each NRTI combination should be considered a distinct treatment rather than the sum of two individual treatments. First, there were unexpected differences in plasma NRTI concentrations after single or dual treatments. Indeed, plasma AZT concentrations were lower when AZT and 3TC were coadministered, and plasma d4T concentrations were lower when d4T was administered with either 3TC or ddI than when either AZT or d4T was given alone (Table ​ (Table1). 1). However, the mixing of two drugs in the drinking water caused no precipitate, and the volumes ingested daily by the animals were identical for all treatments. Although more investigations are needed, these observations suggest that the intestinal absorption and/or pharmacokinetics of thymidine analogues (AZT and d4T) might be modified by the concomitant administration of some other NRTIs, at least in mice. Since such drug interactions have not been reported in humans, they might be mouse specific. Species differences are known with AZT, which undergoes glucuronidation in humans but not in mice (see Results and reference 1). Cheng S-H, Chen C-C. Effects of continuity of care on medication duplication among the elderly. Med Care. 2014;52:149–56. https://doi.org/10.1097/MLR.0000000000000042. Holmes HM, Luo R, Kuo Y-F, Baillargeon J, Goodwin JS. Association of potentially inappropriate medication use with patient and prescriber characteristics in Medicare Part D. Pharmacoepidemiol Drug Saf. 2013;22:728–34. https://doi.org/10.1002/pds.3431.Nos países e regiões lusófonos [ editar | editar código-fonte ] Angola [ editar | editar código-fonte ] Johansson T, Abuzahra ME, Keller S, Mann E, Faller B, Sommerauer C, et al. Impact of strategies to reduce polypharmacy on clinically relevant endpoints: a systematic review and meta-analysis. Br J Clin Pharmacol. 2016;82:532–48. https://doi.org/10.1111/bcp.12959. DDI stands for "Direct-Dial-In", and these numbers enable callers to reach a specific extension without speaking to a switchboard or using an automated menu system. Green JL, Hawley JN, Rask KJ. Is the number of prescribing physicians an independent risk factor for adverse drug events in an elderly outpatient population? Am J Geriatr Pharmacother. 2007;5:31–9. https://doi.org/10.1016/j.amjopharm.2007.03.004. The interindividual variability for the pharmacokinetic parameter affected by the covariate was lower compared to the model without the covariate relationship.

Z. Yang, W. Zhong, L. Zhao and C. Y.-C. Chen, J. Phys. Chem. Lett., 2021, 12, 4247–4261 CrossRef CAS PubMed . Chu H-Y, Chen C-C, Cheng S-H. Continuity of care, potentially inappropriate medication, and health care outcomes among the elderly: evidence from a longitudinal analysis in Taiwan. Med Care. 2012;50:1002–9. https://doi.org/10.1097/MLR.0b013e31826c870f. where (·) indicates element-wise multiplication. As opposed to the global mean/sum pooling that considers every substructure equally important, the SSIM utilizes the structure information of d x to enhance the representation of d y by assigning higher scores to important substructures in d y and vice versa. The graph-level representation of d x ( i.e., ) can be calculated by using computational steps similar to those described in eqn (8)–(11). Facchinetti G, D’Angelo D, Piredda M, Petitti T, Matarese M, Oliveti A, de Marinis MG. Continuity of care interventions for preventing hospital readmission of older people with chronic diseases: a meta-analysis. Int J Nurs Stud. 2020;101:103396. https://doi.org/10.1016/j.ijnurstu.2019.103396.

Drug–drug interaction prediction Given a DDI tuple ( d x, d y, r), the DDI prediction can be expressed as the joint probability as follows: Fig. 10 Visualization of the key substructures for DDIs between dicoumarol and the other seven drugs. The center of the most important substructure and its receptive field are shown as blue and orange colors respectively. H. Yu, K.-T. Mao, J.-Y. Shi, H. Huang, Z. Chen, K. Dong and S.-M. Yiu, BMC Syst. Biol., 2018, 12, 101–110 CrossRef PubMed . Uijen AA, Heinst CW, Schellevis FG, van den Bosch WJHM, van de Laar FA, Terwee CB, Schers HJ. Measurement properties of questionnaires measuring continuity of care: a systematic review. PLoS ONE. 2012;7:e42256. https://doi.org/10.1371/journal.pone.0042256. A. Mayr, G. Klambauer, T. Unterthiner, M. Steijaert, J. K. Wegner, H. Ceulemans, D.-A. Clevert and S. Hochreiter, Chem. Sci., 2018, 9, 5441–5451 RSC .

Sponsler KC, Neal EB, Kripalani S. Improving medication safety during hospital-based transitions of care. CCJM. 2015;82:351–60. https://doi.org/10.3949/ccjm.82a.14025.Similar conclusions can be drawn from an analysis of the data types used by the included studies. A large majority of studies used claims data or similar data types to measure continuity, allowing researchers to reach very large sample sizes and compute objective standard and objective non-standard measures. However, COC indices based on claims data cannot fully capture the multiple dimensions of COC [ 33, 76]. A small number of studies used survey data to measure continuity. While survey data alone is also inadequate to capture all three dimensions of continuity [ 77], future studies should use appropriate survey-based measures to complement claims-based measures to capture COC in all its facets [ 76]. This is particularly important when investigating the association between COC and polypharmacy or MARO, as research has shown discrepancies between COC measured through survey data and claims data [ 78]. 4.2 Methodological Findings: Measuring Polypharmacy and MARO Delgado J, Evans PH, Gray DP, Sidaway-Lee K, Allan L, Clare L, et al. Continuity of GP care for patients with dementia: impact on prescribing and the health of patients. Br J Gen Pract. 2022;72:e91–8. https://doi.org/10.3399/BJGP.2021.0413. Lu CY, Roughead E. Determinants of patient-reported medication errors: a comparison among seven countries. Int J Clin Pract. 2011;65:733–40. https://doi.org/10.1111/j.1742-1241.2011.02671.x. Non-linear mixed effect modelling quantitatively estimates the magnitude of unexplained variability in the population of interest. Identification of factors contributing to this variability and exploration of their relationship to exposure is an important component of the population pharmacokinetic approach and can be used to support dosing recommendations.

Regarding the operationalization of PIM, different versions of the Beers criteria [ 71] were applied [ 46, 47, 64]. Other instruments were used, such as the Japanese STOPP-J list [ 59], the Norwegian General Practice (NORGEP) criteria, which are based on the Beers criteria [ 56], the German PRISCUS list [ 49], and the STOPP/START criteria [ 52]. PIM was always analyzed by using a binary (yes vs no) variable. Concerning DDI, the outcome variable was dichotomized (yes vs no) in all but one included study, which treated DDI as a continuous variable [ 45]. PIDC, as used by Tamblyn et al. [ 61], is a combination of PIM and DDI, identified by an expert review. Duplicated medications were used as outcomes by Cheng and Chen [ 43] and Chu et al. [ 44]. ADE were defined as either the presence of an ADE-specific code [ 58] or as a binary (yes vs no) outcome self-reported by the study participants [ 63]. One study [ 60] measured unnecessary drug use based on the Medication Appropriateness Index [ 72]. Finally, overdose as an outcome was defined as the occurrence of one or more medical claims containing a diagnosis code for opioid or benzodiazepine poisoning on a person-day of opioid-benzodiazepine overlap [ 51] (Table S2, see ESM). 3.3 Association Between COC and Polypharmacy With an absolute bioavailability of 75% and with a population mean oral clearance of 33 L/hr (from the base model), the average systemic clearance is around 25 L/hr. The sum of the population mean of the central and peripheral volumes of distribution after oral administration, that is, V2/ F + V3/ F, is 2.60 × 10 3 L, which gives a volume of distribution of 1.9 × 10 3 L assuming a bioavailability of 75%. Pereira Gray DJ, Sidaway-Lee K, White E, Thorne A, Evans PH. Continuity of care with doctors-a matter of life and death? A systematic review of continuity of care and mortality. BMJ Open. 2018;8:e021161. https://doi.org/10.1136/bmjopen-2017-021161.Tsuji-Hayashi Y, Fukuhara S, Green J, Kurokawa K. Use of prescribed drugs among older people in Japan: association with not having a regular physician. J Am Geriatr Soc. 1999;47:1425–9. https://doi.org/10.1111/j.1532-5415.1999.tb01561.x. Beadles CA, Voils CI, Crowley MJ, Farley JF, Maciejewski ML. Continuity of medication management and continuity of care: conceptual and operational considerations. SAGE Open Med. 2014;2:2050312114559261. https://doi.org/10.1177/2050312114559261. where and are two weight matrices. s ( y) i can be viewed as the importance for substructure centering at i-th atom of d y. The overall computational steps for s ( y) i are depicted in Fig. 4. Finally, the graph-level representation of d y can be computed by the following: CYP2D6-inferred metabolic status was shown to have a significant impact on CL/ F, where extensive metabolisers in general had 1.9 times the CL/ F of poor metabolisers. This is in line with a drug–drug interaction study with vortioxetine and bupropion (a CYP2D6 inhibitor), in which the CL/ F of vortioxetine was reduced approximately by half when co-administered with bupropion 6. For CYP2C19, EMs had on average 1.4 times the CL/ F of PMs. However, in a drug–drug interaction study, no effects on vortioxetine steady-state exposure were observed with co-administration of a single dose of omeprazole (a CYP2C19 inhibitor) 12. The population pharmacokinetic meta-analysis performed was in healthy individuals. It should be noted that due to sometimes narrow inclusion criteria in clinical pharmacology studies, the intrinsic and extrinsic factors of the population studied do not always fully reflect the ones in the patient population.