TY  - JOUR
AU  - Bužančić, Iva
AU  - Belec, Dora
AU  - Držaić, Margita
AU  - Kummer, Ingrid
AU  - Brkić, Jovana
AU  - Fialová, Daniela
AU  - Ortner Hadžiabdić, Maja
PY  - 2024
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/5344
AB  - Aims: The aim of this study was to compare the clinical decision-making for benzodiazepine deprescribing between a healthcare provider (HCP) and an artificial intelligence (AI) chatbot GPT4 (ChatGPT-4). Methods: We analysed real-world data from a Croatian cohort of community-dwelling benzodiazepine patients (n = 154) within the EuroAgeism H2020 ESR 7 project. HCPs evaluated the data using pre-established deprescribing criteria to assess benzodiazepine discontinuation potential. The research team devised and tested AI prompts to ensure consistency with HCP judgements. An independent researcher employed ChatGPT-4 with predetermined prompts to simulate clinical decisions for each patient case. Data derived from human-HCP and ChatGPT-4 decisions were compared for agreement rates and Cohen's kappa. 
Results : Both HPC and ChatGPT identified patients for benzodiazepine deprescribing (96.1% and 89.6%, respectively), showing an agreement rate of 95% (κ=.200,P=.012). Agreement on four deprescribing criteria ranged from 74.7% to 91.3%(lack of indicationκ=.352,P< .001; prolonged useκ=.088,P=.280; safety concernsκ=.123,P=.006; incorrect dosageκ=.264,P=.001). Important limitationsof GPT-4 responses were identified, including 22.1% ambiguous outputs, genericanswers and inaccuracies, posing inappropriate decision-making risks.Conclusions : While AI-HCP agreement is substantial, sole AI reliance poses a risk forunsuitable clinical decision-making. This study's findings reveal both strengths andareas for enhancement of ChatGPT-4 in the deprescribing recommendations within areal-world sample. Our study underscores the need for additional research on chatbot functionality in patient therapy decision-making, further fostering the advance-ment of AI for optimal performance.
PB  - John Wiley and Sons Inc
T2  - British Journal of Clinical Pharmacology
T1  - Clinical decision-making in benzodiazepine deprescribing by healthcare providers vs. AI-assisted approach
VL  - 90
IS  - 3
SP  - 662
EP  - 674
DO  - 10.1111/bcp.15963
ER  - 

@article{
author = "Bužančić, Iva and Belec, Dora and Držaić, Margita and Kummer, Ingrid and Brkić, Jovana and Fialová, Daniela and Ortner Hadžiabdić, Maja",
year = "2024",
abstract = "Aims: The aim of this study was to compare the clinical decision-making for benzodiazepine deprescribing between a healthcare provider (HCP) and an artificial intelligence (AI) chatbot GPT4 (ChatGPT-4). Methods: We analysed real-world data from a Croatian cohort of community-dwelling benzodiazepine patients (n = 154) within the EuroAgeism H2020 ESR 7 project. HCPs evaluated the data using pre-established deprescribing criteria to assess benzodiazepine discontinuation potential. The research team devised and tested AI prompts to ensure consistency with HCP judgements. An independent researcher employed ChatGPT-4 with predetermined prompts to simulate clinical decisions for each patient case. Data derived from human-HCP and ChatGPT-4 decisions were compared for agreement rates and Cohen's kappa. 
Results : Both HPC and ChatGPT identified patients for benzodiazepine deprescribing (96.1% and 89.6%, respectively), showing an agreement rate of 95% (κ=.200,P=.012). Agreement on four deprescribing criteria ranged from 74.7% to 91.3%(lack of indicationκ=.352,P< .001; prolonged useκ=.088,P=.280; safety concernsκ=.123,P=.006; incorrect dosageκ=.264,P=.001). Important limitationsof GPT-4 responses were identified, including 22.1% ambiguous outputs, genericanswers and inaccuracies, posing inappropriate decision-making risks.Conclusions : While AI-HCP agreement is substantial, sole AI reliance poses a risk forunsuitable clinical decision-making. This study's findings reveal both strengths andareas for enhancement of ChatGPT-4 in the deprescribing recommendations within areal-world sample. Our study underscores the need for additional research on chatbot functionality in patient therapy decision-making, further fostering the advance-ment of AI for optimal performance.",
publisher = "John Wiley and Sons Inc",
journal = "British Journal of Clinical Pharmacology",
title = "Clinical decision-making in benzodiazepine deprescribing by healthcare providers vs. AI-assisted approach",
volume = "90",
number = "3",
pages = "662-674",
doi = "10.1111/bcp.15963"
}

Bužančić, I., Belec, D., Držaić, M., Kummer, I., Brkić, J., Fialová, D.,& Ortner Hadžiabdić, M.. (2024). Clinical decision-making in benzodiazepine deprescribing by healthcare providers vs. AI-assisted approach. in British Journal of Clinical Pharmacology
John Wiley and Sons Inc., 90(3), 662-674.
https://doi.org/10.1111/bcp.15963

Bužančić I, Belec D, Držaić M, Kummer I, Brkić J, Fialová D, Ortner Hadžiabdić M. Clinical decision-making in benzodiazepine deprescribing by healthcare providers vs. AI-assisted approach. in British Journal of Clinical Pharmacology. 2024;90(3):662-674.
doi:10.1111/bcp.15963 .

Bužančić, Iva, Belec, Dora, Držaić, Margita, Kummer, Ingrid, Brkić, Jovana, Fialová, Daniela, Ortner Hadžiabdić, Maja, "Clinical decision-making in benzodiazepine deprescribing by healthcare providers vs. AI-assisted approach" in British Journal of Clinical Pharmacology, 90, no. 3 (2024):662-674,
https://doi.org/10.1111/bcp.15963 . .

TY  - JOUR
AU  - Bužančić, Iva
AU  - Držaić, Margita
AU  - Kummer, Ingrid
AU  - Ortner Hadžiabdić, Maja
AU  - Brkić, Jovana
AU  - Fialová, Daniela
PY  - 2024
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/5571
AB  - 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.
PB  - Nature Research
T2  - Scientific Reports
T1  - Deprescribing potential of commonly used medications among community-dwelling older adults: insights from a pharmacist’s geriatric assessment
VL  - 14
IS  - 1
SP  - 6235
DO  - 10.1038/s41598-024-56780-1
ER  - 

@article{
author = "Bužančić, Iva and Držaić, Margita and Kummer, Ingrid and Ortner Hadžiabdić, Maja and Brkić, Jovana and Fialová, Daniela",
year = "2024",
abstract = "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.",
publisher = "Nature Research",
journal = "Scientific Reports",
title = "Deprescribing potential of commonly used medications among community-dwelling older adults: insights from a pharmacist’s geriatric assessment",
volume = "14",
number = "1",
pages = "6235",
doi = "10.1038/s41598-024-56780-1"
}

Bužančić, I., Držaić, M., Kummer, I., Ortner Hadžiabdić, M., Brkić, J.,& Fialová, D.. (2024). Deprescribing potential of commonly used medications among community-dwelling older adults: insights from a pharmacist’s geriatric assessment. in Scientific Reports
Nature Research., 14(1), 6235.
https://doi.org/10.1038/s41598-024-56780-1

Bužančić I, Držaić M, Kummer I, Ortner Hadžiabdić M, Brkić J, Fialová D. Deprescribing potential of commonly used medications among community-dwelling older adults: insights from a pharmacist’s geriatric assessment. in Scientific Reports. 2024;14(1):6235.
doi:10.1038/s41598-024-56780-1 .

Bužančić, Iva, Držaić, Margita, Kummer, Ingrid, Ortner Hadžiabdić, Maja, Brkić, Jovana, Fialová, Daniela, "Deprescribing potential of commonly used medications among community-dwelling older adults: insights from a pharmacist’s geriatric assessment" in Scientific Reports, 14, no. 1 (2024):6235,
https://doi.org/10.1038/s41598-024-56780-1 . .

TY  - JOUR
AU  - Lukačišinová, Anna
AU  - Reissigová, Jindra
AU  - Ortner-Hadžiabdić, Maja
AU  - Brkić, Jovana
AU  - Okuyan, Betul
AU  - Volmer, Daisy
AU  - Tadić, Ivana
AU  - Modamio, Pilar
AU  - Mariño, Eduardo
AU  - Tachkov, Konstantine
AU  - Liperotti, Rosa
AU  - Onder, Graziano
AU  - Finne-Soveri, Harriet
AU  - van Hout, Hein
AU  - Howard, Elizabeth P.
AU  - Fialová, Daniela
PY  - 2024
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/5563
AB  - 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.
PB  - BioMed Central Ltd
T2  - BMC Geriatrics
T1  - Prevalence, country-specific prescribing patterns and determinants of benzodiazepine use in community-residing older adults in 7 European countries
VL  - 24
IS  - 1
DO  - 10.1186/s12877-024-04742-7
ER  - 

@article{
author = "Lukačišinová, Anna and Reissigová, Jindra and Ortner-Hadžiabdić, Maja and Brkić, Jovana and Okuyan, Betul and Volmer, Daisy and Tadić, Ivana and Modamio, Pilar and Mariño, Eduardo and Tachkov, Konstantine and Liperotti, Rosa and Onder, Graziano and Finne-Soveri, Harriet and van Hout, Hein and Howard, Elizabeth P. and Fialová, Daniela",
year = "2024",
abstract = "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.",
publisher = "BioMed Central Ltd",
journal = "BMC Geriatrics",
title = "Prevalence, country-specific prescribing patterns and determinants of benzodiazepine use in community-residing older adults in 7 European countries",
volume = "24",
number = "1",
doi = "10.1186/s12877-024-04742-7"
}

Lukačišinová, A., Reissigová, J., Ortner-Hadžiabdić, M., Brkić, J., Okuyan, B., Volmer, D., Tadić, I., Modamio, P., Mariño, E., Tachkov, K., Liperotti, R., Onder, G., Finne-Soveri, H., van Hout, H., Howard, E. P.,& Fialová, D.. (2024). Prevalence, country-specific prescribing patterns and determinants of benzodiazepine use in community-residing older adults in 7 European countries. in BMC Geriatrics
BioMed Central Ltd., 24(1).
https://doi.org/10.1186/s12877-024-04742-7

Lukačišinová A, Reissigová J, Ortner-Hadžiabdić M, Brkić J, Okuyan B, Volmer D, Tadić I, Modamio P, Mariño E, Tachkov K, Liperotti R, Onder G, Finne-Soveri H, van Hout H, Howard EP, Fialová D. Prevalence, country-specific prescribing patterns and determinants of benzodiazepine use in community-residing older adults in 7 European countries. in BMC Geriatrics. 2024;24(1).
doi:10.1186/s12877-024-04742-7 .

Lukačišinová, Anna, Reissigová, Jindra, Ortner-Hadžiabdić, Maja, Brkić, Jovana, Okuyan, Betul, Volmer, Daisy, Tadić, Ivana, Modamio, Pilar, Mariño, Eduardo, Tachkov, Konstantine, Liperotti, Rosa, Onder, Graziano, Finne-Soveri, Harriet, van Hout, Hein, Howard, Elizabeth P., Fialová, Daniela, "Prevalence, country-specific prescribing patterns and determinants of benzodiazepine use in community-residing older adults in 7 European countries" in BMC Geriatrics, 24, no. 1 (2024),
https://doi.org/10.1186/s12877-024-04742-7 . .