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Wiedemann A, Stein J, Manseck A, Kirschner-Hermanns R, Bannowsky A, Wirz S, Kuru TH, Salem J. [Polypharmacy and medication review in the context of prehabilitation]. UROLOGIE (HEIDELBERG, GERMANY) 2023; 62:1025-1033. [PMID: 37682348 DOI: 10.1007/s00120-023-02174-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 09/09/2023]
Abstract
Against the background of typical geriatric multimorbidity and with the particular vulnerability of geriatric patients, polypharmacy deserves special attention. In accordance with the guidelines, medication should not only be reviewed regularly, but also on an ad hoc basis and with each hospital stay-and also in the context of prehabilitation. Thus, not only substances that interfere with the currently planned intervention, anesthesia, or risk of bleeding should be considered, but any medication that increases common risks for geriatric patients. These include drugs that cause or increase a tendency to fall, induce delirium, or alter the comedication through potential drug-drug interactions. Measures to minimize the risk include the following: exact documentation of medications, structured and complete transfer of information, patient and family training about any side effects that may occur, a recall system for possible laboratory checks, and compliance with the instructions for taking the medication.
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Affiliation(s)
- A Wiedemann
- Urologische Abteilung, Evangelisches Krankenhaus Witten gGmbH, Pferdebachstr. 27, 58455, Witten, Deutschland.
- Lehrstuhl für Geriatrie, Universität Witten/Herdecke, Witten, Deutschland.
| | - J Stein
- Urologische Abteilung, Klinikum Großburgwedel, Großburgwedel, Deutschland
| | - A Manseck
- Urologische Abteilung, Klinikum Ingolstadt GmbH, Ingolstadt, Deutschland
| | - R Kirschner-Hermanns
- Neuro-Urologie/Klinik für Urologie und Kinderurologie, Universitätsklinikum Bonn, Bonn, Deutschland
- Neuro-Urologie, Johanniter Neurologisches Rehabilitationszentrum Bonn-Godeshöhe, Bonn-Godeshöhe, Deutschland
| | - A Bannowsky
- Klinik für Urologie, Imland-Klinik Rendsburg, Rendsburg, Deutschland
| | - S Wirz
- Abteilung für Anästhesiologie, Intensivmedizin, Schmerz und Palliativmedizin, Zentrum für Schmerzmedizin, Weaningzentrum, GFO-Kliniken Bonn/Cura Bad Honnef, Bonn, Deutschland
| | - T H Kuru
- Curos urologisches Zentrum, Köln, Abteilung für Urologie, Klinik Links vom Rhein, Köln, Deutschland
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Brandenburg a.d. Havel, MHB Brandenburg Theodor Fontane, Brandenburg a.d. Havel, Deutschland
| | - J Salem
- Curos urologisches Zentrum, Köln, Abteilung für Urologie, Klinik Links vom Rhein, Köln, Deutschland
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Brandenburg a.d. Havel, MHB Brandenburg Theodor Fontane, Brandenburg a.d. Havel, Deutschland
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Manseck A, Piotrowski A, Butea MC, Foller S, Gleissner J, Kahlmeyer A, Karstedt H, Kirschner-Hermanns R, Liebald T, Linné C, Moll V, Otto U, Schorn A, Stein J, Wagner A, Wiedemann A. [Guidelines for consultations regarding incontinence care products]. Urologe A 2022; 61:3-12. [PMID: 35006283 DOI: 10.1007/s00120-021-01721-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2021] [Indexed: 10/19/2022]
Abstract
An investigation of the German consumer organisation "Stiftung Warentest" in 2017 confirmed significant deficiencies in the information, advice and supply of incontinence care products received by urinary incontinence patients. The German Society of Urology (DGU) thereupon drafted and later published guidelines concerning the consultation of patients in the context of incontinence care. Important aspects of the consultation process include the determination of the type of incontinence as well as its severity, clinical examination, and advice regarding possible curative treatments. However, the advice appointment takes centre stage and should ideally be conducted by a qualified person in a separate room granting sufficient privacy and time. Furthermore, repeated supply of a selection of samples for differing degrees and types of incontinence, accommodating the patient's individual preferences and anatomical features, is crucial in order to ensure optimal incontinence care. In the case of commercial health care service providers, transparency relating to the financial implications of e.g. expensive products is key, which is what has been intended by German health insurance providers. The new guidelines concerning urinary incontinence care consultation constitute a step towards the improvement and structuring of processes in the consultation regarding, and the supply of, incontinence care products.
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Affiliation(s)
- Andreas Manseck
- Urologischen Klinik, Klinikum Ingolstadt, Krumenauerstr. 25, 85049, Ingolstadt, Deutschland.
| | - A Piotrowski
- Urologische Klinik, Pyhrn-Eisenwurzen Klinikum Steyr, Steyr, Österreich
| | - M C Butea
- Urologisches Kompetenzzentrum für die Rehabilitation - UKR, Kliniken Hartenstein, Bad Wildungen, Deutschland
| | - S Foller
- Klinik und Poliklinik für Urologie, Universitätsklinikum Jena, Jena, Deutschland
| | - J Gleissner
- Urologische Praxis, Uro-Gyn-Zentrum, Wuppertal, Deutschland
| | - A Kahlmeyer
- Urologische Praxis, Urologie am Weinberg Kassel, Kassel, Deutschland
| | - H Karstedt
- Praxis für Urologie, Gelsenkirchen, Deutschland
| | - R Kirschner-Hermanns
- Neuro-Urologie, Universitätsklinikum Bonn, Bonn, Deutschland.,Neuro-Urologie, Neurologisches Rehabilitationszentrum Bonn-Godeshöhe, Bonn, Deutschland
| | - T Liebald
- Urologische Praxis, Dresden, Deutschland
| | - C Linné
- Urologische Praxis, Dresden, Deutschland
| | - V Moll
- Praxis für Urologie, Augsburg, Deutschland
| | - U Otto
- Urologisches Kompetenzzentrum für die Rehabilitation - UKR, Kliniken Hartenstein, Bad Wildungen, Deutschland
| | - A Schorn
- Praxis für Urologie, Saarburg, Deutschland
| | - J Stein
- Urologische Abteilung, Klinikum Großburgwedel, Großburgwedel, Deutschland
| | - A Wagner
- Praxis für Urologie, Limburgerhof, Deutschland
| | - A Wiedemann
- Urologische Abteilung, Evangelisches Krankenhaus Witten gGmbH, Lehrstuhl für Geriatrie, Universität Witten/Herdecke, Witten, Deutschland
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