Correction to: Deprescribing potential of commonly used medications among community-dwelling older adults: insights from a pharmacist’s geriatric assessment (Scientific Reports, (2024), 14, 1, (6235), 10.1038/s41598-024-56780-1)

Correction to: Scientific Reportshttps://doi.org/10.1038/s41598-024-56780-1, published online 14 March 2024 The original version of this Article contained an error in the Funding section. “All the research work was funded by the EuroAgeism H2020 project (ESR7 project), supported by the European Union research and innovation program under the Grant Agreement of the Marie Skłodowska-Curie Foundation Number MSCF-ITN-764632. Research works of Assoc. Prof. Daniela Fialová, PharmD, Ph.D. and members of her research team were supported by the Grants: InoMed, Reg. No CZ.02.1.01/0.0/0.0/18_069/0010046, the European Horizon 2020 I-CARE4OLD Grant No 965341, START/MED/093 EN.02.2.69/0.0/0.0/19_073/0016935, SVV 260 551 Grant and Cooperatio research program of the Faculty of Pharmacy, Charles University (Research Unit: “Ageing, Polypharmacotherapy and Changes in Therapeutic Value of Drugs in the Aged’’, KSKF-I.), and NETPHARM project CZ.02.01.01/00/22_008/0004607. The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.” now reads: “Publication of this work was supported by the I-CARE4OLD project that has received funding from the European Union’s Horizon 2020 research and innovation programme under the grant agreement No. 96534. Views and opinions expressed are however those of the authors only and do not necessarily reflect those of the European Union. Neither the European Union nor the granting authority can be held responsible for them. More information on the I-CARE4OLD project can be found at http://www.icare4old.eu and https://cordis.europa.eu/project/id/965341. Except secondary analyses and works on the publication, data collection and teamwork were funded also by the EuroAgeism H2020 project (ESR7 project), supported by the European Union research and innovation program under the Grant Agreement of the Marie Skłodowska-Curie Foundation Number MSCF-ITN-764632. Research works of Assoc. Prof. Daniela Fialová, PharmD, Ph.D. and members of her research team were supported by grants: START/MED/093 EN.02.2.69/0.0/0.0/19_073/0016935, SVV 260 551, Cooperatio research program of the Faculty of Pharmacy, Charles University (Research Unit: “Ageing, Polypharmacotherapy and Changes in Terapeutic Value of Drugs in the Aged’’, KSKF-I.), and NETPHARM project CZ.02.01.01/00/22_008/0004607.” The original Article has been corrected.Link to the corrected article:[ https://farfar.pharmacy.bg.ac.rs/handle/123456789/5571

Deprescribing potential of commonly used medications among community-dwelling older adults: insights from a pharmacist’s geriatric assessment

Pharmacist’s geriatric assessment can provide valuable insights into potential deprescribing targets, while including important information on various health-related domains. Data collected from a geriatric assessment questionnaire, for 388 patients, from the Croatian cohort of the EuroAgeism H2020 ESR 7 international project, along with guideline-based deprescribing criteria, were used to analyse potentially inappropriate prescribing of four medication groups (benzodiazepines (BZN), proton pump inhibitors (PPI), opioids, and non-steroidal anti-inflammatory drugs (NSAID)), and to assess the deprescribing potential. Binary logistic regression was used to explore the effects of age, gender, number of medicines and diagnoses, self-reported health, frailty score, and healthcare utilization on the likelihood of needing deprescribing. More than half of participants (n = 216, 55.2%) are candidates for deprescribing, with 31.1% of PPI, 74.8% of NSAID, 75% of opioid, and 96.1% of BZN users meeting at least one criterion. Most common criteria for deprescribing were inappropriately long use and safety concerns. Women (aOR = 2.58; p < 0.001), those reporting poor self-reported health (aOR = 5.14; p < 0.001), and those exposed to polypharmacy (aOR = 1.29; p < 0.001) had higher odds of needing to have medicines deprescribed. The high rate of deprescribing potential warrants prompt action to increase patient safety and decrease polypharmacy. Pharmacist’s geriatric assessment and deprescribing-focused medication review could be used to lead a personalised approach.https://farfar.pharmacy.bg.ac.rs/handle/123456789/562

Author Correction: Prevalence of potentially inappropriate prescribing in older adults in Central and Eastern Europe: a systematic review and synthesis without meta‑analysis

Link to the corrected article: [https://farfar.pharmacy.bg.ac.rs/handle/123456789/4286

Prevalence of potentially inappropriate prescribing in older adults in Central and Eastern Europe: a systematic review and synthesis without meta-analysis

We aimed to systematically review the prevalence of potentially inappropriate prescribing (PIP) in older adults in Central and Eastern Europe (CEE) in all care settings. We searched Embase and MEDLINE (up to June 2019) and checked the reference lists of the included studies and relevant reviews. Eligible studies used validated explicit or implicit tools to assess the PIP prevalence in older adults in CEE. All study designs were considered, except case‒control studies and case series. We assessed the risk of bias using the Joanna Briggs Institute Prevalence Critical Appraisal Tool and the certainty of evidence using the GRADE approach. Meta-analysis was inappropriate due to heterogeneity in the outcome measurements. Therefore, we used the synthesis without meta-analysis approach—summarizing effect estimates method. This review included twenty-seven studies with 139,693 participants. Most studies were cross-sectional and conducted in high-income countries. The data synthesis across 26 studies revealed the PIP prevalence: the median was 34.6%, the interquartile range was 25.9–63.2%, and the range was 6.5–95.8%. The certainty of this evidence was very low due to the risk of bias, imprecision, and inconsistency. These findings show that PIP is a prevalent issue in the CEE region. Further well-designed studies conducted across countries are needed to strengthen the existing evidence and increase the generalizability of findings

Prevalence, country-specific prescribing patterns and determinants of benzodiazepine use in community-residing older adults in 7 European countries

Background: The use of benzodiazepines (BZDs) in older population is often accompanied by drug-related complications. Inappropriate BZD use significantly alters older adults’ clinical and functional status. This study compares the prevalence, prescribing patterns and factors associated with BZD use in community-dwelling older patients in 7 European countries. Methods: International, cross-sectional study was conducted in community-dwelling older adults (65 +) in the Czech Republic, Serbia, Estonia, Bulgaria, Croatia, Turkey, and Spain between Feb2019 and Mar2020. Structured and standardized questionnaire based on interRAI assessment scales was applied. Logistic regression was used to evaluate factors associated with BZD use. Results: Out of 2,865 older patients (mean age 73.2 years ± 6.8, 61.2% women) 14.9% were BZD users. The highest prevalence of BZD use was identified in Croatia (35.5%), Spain (33.5%) and Serbia (31.3%). The most frequently prescribed BZDs were diazepam (27.9% of 426 BZD users), alprazolam (23.7%), bromazepam (22.8%) and lorazepam (16.7%). Independent factors associated with BZD use were female gender (OR 1.58, 95%CI 1.19–2.10), hyperpolypharmacy (OR 1.97, 95%CI 1.22–3.16), anxiety (OR 4.26, 95%CI 2.86–6.38), sleeping problems (OR 4.47, 95%CI 3.38–5.92), depression (OR 1.95, 95%CI 1.29–2.95), repetitive anxious complaints (OR 1.77, 95%CI 1.29–2.42), problems with syncope (OR 1.78, 95%CI 1.03–3.06), and loss of appetite (OR 0.60, 95%CI 0.38–0.94). In comparison to Croatia, residing in other countries was associated with lower odds of BZD use (ORs varied from 0.49 (95%CI 0.32–0.75) in Spain to 0.01 (95%CI 0.00–0.03) in Turkey), excluding Serbia (OR 1.11, 95%CI 0.79–1.56). Conclusions: Despite well-known negative effects, BZDs are still frequently prescribed in older outpatient population in European countries. Principles of safer geriatric prescribing and effective deprescribing strategies should be individually applied in older BZD users

Targeted delivery of a vaccine protein to Langerhans cells in the human skin via the C-type lectin receptor Langerin

Human skin is a preferred vaccination site as it harbors multiple dendritic cell (DC) subsets, which display distinct C-type lectin receptors (CLR) that recognize pathogens. Antigens can be delivered to CLR by antibodies or ligands to boost antigen-specific immune responses. This concept has been established in mouse models but detailed insights into the functional consequences of antigen delivery to human skin DC in situ are sparse. In this study, we cloned and produced an anti-human Langerin antibody conjugated to the EBV nuclear antigen 1 (EBNA1). We confirmed specific binding of anti-Langerin-EBNA1 to Langerhans cells (LC). This novel LC-based vaccine was then compared to an existing anti-DEC-205-EBNA1 fusion protein by loading LC in epidermal cell suspensions before coculturing them with autologous T cells. After restimulation with EBNA1-peptides, we detected elevated levels of IFN-γ- and TNF-α-positive CD4+ T cells with both vaccines. When we injected the fusion proteins intradermally into human skin explants, emigrated skin DC targeted via DEC-205-induced cytokine production by T cells, whereas the Langerin-based vaccine failed to do so. In summary, we demonstrate that antibody-targeting approaches via the skin are promising vaccination strategies, however, further optimizations of vaccines are required to induce potent immune responses

Analysis and recommendations on Design for All related higher education and research policies in EU member countries

The report includes recommendations for further development of DfA related strategies and policies in Europe, based on the analysis of the state of the art in Design for All education and research strategies and policies in EU member countries, complemented with considerations on respective strategies in the USA

Teaching DfA core knowledge and skill sets; experience in including inclusive design

The purpose of this document is twofold. Firstly it is to present the teaching pilots that were undertaken by members of the network, and describes the pilot setting and the material taught, as related to the taxonomy of Design for All knowledge and skill sets developed in previous deliverables. Each pilot indicates topics taught and to which categories of the taxonomy they belong. Furthermore, student expectations and reactions to the DfA teaching pilots are described by means of the information gained from questionnaires. In this way the taxonomy is evaluated by the teaching pilot experiences for robustness in completeness and usefulness. The second purpose of this exercise is to highlight best practices in, and possible obstacles and other challenges to implementing and maintaining of Design for All courses and modules in a range of higher education schemes, so that education policies and strategies may be informed accordingly. Both of these objectives help to further the work on recommendations for curriculum work on Design for All, in terms of content and in terms of sustainability

Impaired gp100-Specific CD8(+) T-Cell Responses in the Presence of Myeloid-Derived Suppressor Cells in a Spontaneous Mouse Melanoma Model.

Murine tumor models that closely reflect human diseases are important tools to investigate carcinogenesis and tumor immunity. The transgenic (tg) mouse strain tg(Grm1)EPv develops spontaneous melanoma due to ectopic overexpression of the metabotropic glutamate receptor 1 (Grm1) in melanocytes. In the present study, we characterized the immune status and functional properties of immune cells in tumor-bearing mice. Melanoma development was accompanied by a reduction in the percentages of CD4(+) T cells including regulatory T cells (Tregs) in CD45(+) leukocytes present in tumor tissue and draining lymph nodes (LNs). In contrast, the percentages of CD8(+) T cells were unchanged, and these cells showed an activated phenotype in tumor mice. Endogenous melanoma-associated antigen glycoprotein 100 (gp100)-specific CD8(+) T cells were not deleted during tumor development, as revealed by pentamer staining in the skin and draining LNs. They, however, were unresponsive to ex vivo gp100-peptide stimulation in late-stage tumor mice. Interestingly, immunosuppressive myeloid-derived suppressor cells (MDSCs) were recruited to tumor tissue with a preferential accumulation of granulocytic MDSC (grMDSCs) over monocytic MDSC (moMDSCs). Both subsets produced Arginase-1, inducible nitric oxide synthase (iNOS), and transforming growth factor-β and suppressed T-cell proliferation in vitro. In this work, we describe the immune status of a spontaneous melanoma mouse model that provides an interesting tool to develop future immunotherapeutical strategies.journal articleresearch support, n.i.h., extramuralresearch support, non-u.s. gov't2015 Nov2015 06 29importe