A5045947279- Pharmaceutical Practices and Patient Outcomes
- Health Systems, Economic Evaluations, Quality of Life
- Medication Adherence and Compliance
- Atrial Fibrillation Management and Outcomes
- Pharmaceutical studies and practices
- Chronic Disease Management Strategies
- Pharmacogenetics and Drug Metabolism
- Heart Failure Treatment and Management
- Healthcare cost, quality, practices
- Cardiac electrophysiology and arrhythmias
- Blood Pressure and Hypertension Studies
- Electronic Health Records Systems
- Drug Transport and Resistance Mechanisms
- Antiplatelet Therapy and Cardiovascular Diseases
- Computational Drug Discovery Methods
- Emergency and Acute Care Studies
- Histone Deacetylase Inhibitors Research
- Cardiac, Anesthesia and Surgical Outcomes
- Healthcare Policy and Management
- Machine Learning in Healthcare
- Statistical Methods in Clinical Trials
- Venous Thromboembolism Diagnosis and Management
- Antibiotics Pharmacokinetics and Efficacy
- Advanced Causal Inference Techniques
- Biopolymer Synthesis and Applications
University Hospital Heidelberg
2015-2025
Heidelberg University
2016-2025
German Center for Infection Research
2023
Objectives To investigate the relationship between polypharmacy and frailty. Design Longitudinal, observational cohort study. Setting Saarland, Germany. Participants 3,058 community‐dwelling adults aged 57 84 years. Measurements Frailty was assessed according to frailty phenotype, described by Fried et al. Polypharmacy hyperpolypharmacy were defined as concomitant use of five or more 10 drugs, respectively. We associations prevalent incident within 3 years follow‐up logistic regression...
Background: Whether arrhythmia risks will increase if drugs with electrocardiographic (ECG) QT-prolonging properties are combined is generally supposed but not well studied. Based on available evidence, the Arizona Center for Education and Research Therapeutics (AZCERT) classification defines risk of QT prolongation exposure to single drugs. We aimed investigate how combining AZCERT drug categories impacts duration relative affects extent pharmacodynamic drug–drug interactions. Methods: In a...
BackgroundThe implementation of new technology can interrupt established workflows in health care settings. The Quality Maternal Care (QUALMAT) project has introduced an electronic clinical decision support system (eCDSS) for antenatal (ANC) and delivery rural primary facilities Africa.ObjectiveThis study was carried out to investigate the influence QUALMAT eCDSS on workflow workers Ghana Tanzania.DesignA direct observation, time-and-motion ANC processes conducted using a structured data...
Plasma concentrations of direct oral anticoagulants (DOACs) vary largely between individuals, and they correlate well with desired adverse outcomes. Although regular concentration monitoring DOACs is not recommended, information on DOAC exposure could be useful in situations when multiple DOAC-clearance pathways are impaired or nonadherence suspected. Self-sampling techniques, like the use dried-blood spots (DBSs), would particularly because enable collection ambulatory patients at relevant...
Treatment complexity rises in line with the number of drugs, single doses, and administration methods, thereby threatening patient adherence. Patients multimorbidity often need flexible, individualised treatment regimens, but alterations during course may further increase complexity. The objective our study was to explore medication changes older patients polypharmacy general practice.We retrospectively analysed data from cluster-randomised PRIMUM trial (PRIoritisation MUltimedication...
Background Cardiovascular disease is a leading cause of death in older people, and the impact being exposed or not to preventive cardiovascular medicines accordingly high. Underutilization beneficial drugs common, but prevalence estimates differ across settings, knowledge on predictors limited, clinical consequences are rarely investigated. Methods Using data from prospective population-based cohort study, we assessed prevalence, determinants, outcomes medication underuse based criteria...
Until today, adult and pediatric clinical trials investigating single-agent or combinatorial HDAC inhibitors including vorinostat in solid tumors have largely failed to demonstrate efficacy. These results may part be explained by data from preclinical models showing significant activity only at higher concentrations compared those achieved with current dosing regimens. In the trial, we applied an intra-patient dose escalation design. The purpose of this trial was determine a safe...
Objectives Depression is common among elderly people. However, diagnosis and adequate treatment frequently difficult. Research on underuse overuse of antidepressants in persons scarce. This study investigates the utilization appropriateness pharmacological psychological depression a large cohort community‐dwelling adults. Methods A subsample 3117 participants (aged 55‐85 y) third follow‐up (2008‐2010) population‐based German ESTHER was included. assessed using eight‐item Patient Health...
Objective Hip fractures are among the most frequently occurring fragility in older adults, associated with a loss of quality life, high mortality, and use healthcare resources. The aim was to apply superlearner method predict osteoporotic hip using administrative claims data compare its performance established methods. Methods We devided 288,086 individuals aged 65 years without care level into training (80%) validation set (20%). Subsequently, we trained algorithm that considered both...
Purpose Using clinical administrative data (CAD) of inpatients, we aimed to identify ICD-10 codes coding for potentially preventable inhospital adverse drug events (ADE) that affect the length hospital stay (LOS) and thus patient well-being cost. Methods We retrospectively assessed CAD all inpatient stays in 2012 a German university hospital. Predefined indicating ADE (ADE codes) were further specified based on expert ratings mechanism preventability routine particularly ADE. In...
Lipid-based drug delivery systems can be surface-modified by lipid conjugates of the substance in question. The most important modifications include arginine-rich cell-penetrating peptides (CPP). A toxicokinetic evaluation these is im-portant during preclinical and clinical development formulations. Due to their amphiphilic properties high number basic amino acid residues, CPP exhibit difficult characteristics regard plasma bioanalysis with LC-MS/MS instruments. These especially challenging...
Purpose Pregabalin, gabapentin, and carbamazepine, a potent inducer of cytochrome P450 (CYP) 3A4 P-glycoprotein, are frequently used antiepileptic drugs that often administered together with factor Xa inhibitors (FXaI). We aimed to investigate whether potentially clinically relevant drug-drug interactions occur these combinations. Methods In an open-label fixed-sequence trial in 36 healthy volunteers, we evaluated the pharmacokinetics 60 mg edoxaban microdosed FXaI cocktail (25 µg apixaban,...
Background In the growing population of elderly, drug-related problems are considered an important health care safety issue. One aspect this is prescription potentially inappropriate medication (PIM) which to increase costs. Objective Using data from Health Economics Potentially Inappropriate Medication (HEPIME) study, we aimed analyze how number prescribed substances moderates association PIM use as defined by German PRISCUS list and costs applying a longitudinal perspective. Methods An...
Endothelin receptor antagonists (ERA) and phosphodiesterase 5 inhibitors (PDE5I) are long-term therapeutics for the treatment of pulmonary arterial hypertension (PAH). Their interindividual pharmacokinetic variability is remarkably large, despite seriousness disease, nonadherence occurring. Therefore, methods to monitor sufficient circulating drug levels essential. The objectives this study were develop validate dried blood spot (DBS) assays quantification ambrisentan, bosentan, sildenafil,...
The solute carrier organic anion transporter family member 1B1 (SLCO1B1) gene encodes for a membrane-bound protein involved in active cellular influx of many endogenous compounds and xenobiotics. SLCO1B1 genetic variation is associated, example, with highly variable rifampicin exposure, thus influencing the cornerstone antituberculosis therapy, especially sub-Saharan Africa where it key therapeutic modality. Yet, there no SLCO1B1-guided pharmacogenetic dosing recommendation to reduce risk...
In acute stroke patients, plasma concentrations of direct oral anticoagulants (DOAC) at hospital admission only poorly mirror DOAC exposure or the coagulation status time event. Here, we evaluated whether and concentration transient ischemic attacks (TIA) strokes correlate with their likelihood occurrence.Prospectively, consecutive patients TIA were included. Admission measured by ultraperformance liquid chromatography- tandem mass spectrometry. Individual (area under curve) event onset...
Abstract Purpose We assessed the differential effect of clarithromycin, a strong inhibitor cytochrome P450 (CYP) 3A4 and P-glycoprotein, on pharmacokinetics regular dose edoxaban microdose cocktail factor Xa inhibitors (FXaI). Concurrently, CYP3A activity was determined with midazolam microdose. Methods In an open-label fixed-sequence trial in 12 healthy volunteers, microdosed FXaI (μ-FXaI; 25 μg apixaban, 50 edoxaban, rivaroxaban) 60 mg before during clarithromycin (2 x 500 mg/d) dosed to...
Background Hospital readmissions place a major burden on patients and health care systems worldwide, but little is known about patterns timing of in Germany. Methods We used German insurance claims (AOK, 2011–2016) ≥ 65 years hospitalized for acute myocardial infarction (AMI), heart failure (HF), composite stroke, transient ischemic attack, or atrial fibrillation (S/AF), chronic obstructive pulmonary disease (COPD), type 2 diabetes mellitus, osteoporosis to identify hospital within 30 90...
Measures for improving medication safety in outpatient care are often complex and involve reviews. Over the period 2016-2022 (with a preceeding one-year pilot phase), an interprofessional management program- Medicines Initiative Saxony-Thuringia (Arzneimittelinitiative Sachsen-Thüringen, ARMIN)-was implemented two German federal states. More than 5000 patients received review by end of 2019 team composed physicians pharmacists were provided with joint, continuous thereafter.In framework...
Aims We assessed the potential mutual interaction of oral macitentan (cytochrome P450 (CYP) 3A4 substrate) at steady‐state with single‐dose rivaroxaban (CYP3A4 and P‐glycoprotein evaluated effect CYP3A inducer St John's wort (SJW) on pharmacokinetics these drugs in healthy volunteers. Methods Twelve volunteers completed this open‐label, monocentre, two‐period, one‐sequence phase I clinical trial. The (10 mg) was study days 3 (single dose), 15 (steady‐state), 16 (impact rivaroxaban) 29 (after...