MediNews, the newsletter of the Department of Medicine at the University of Toronto, featured #GeriMedJC in this month's issue here. Inspired by our Respirology colleagues (check out #rsjc), we hope that other subspecialty divisions will follow suit.
Saturday, 27 September 2014
Sunday, 21 September 2014
@GeriMedJC has an international following
As of this week, the Twitter moderator account for #GeriMedJC, @GeriMedJC, has 116 followers. Here's a look at the geographical distribution:
This is nice to see especially since the live version of the journal club is based in Toronto, Canada.
Friday, 19 September 2014
#GeriMedJC: September 19, 2014
The two articles critically appraised during today's #GeriMedJC were:
Long article (45 minutes is dedicated to discussion in the live version of the journal club):
Atypical Antipsychotic Drugs and the Risk for Acute Kidney Injury and Other Adverse Outcomes in Older Adults. Ann Intern Med. 2014;161:242-248.
Short article (15 minutes is dedicated to discussion in the live version of the journal club):
The efficacy and tolerability of the b3-adrenoceptor agonist Mirabegron for the treatment of symptoms of overactive bladder in older patients. Age and Ageing 2014;43:666–675.
More than double the impressions and more than double the tweets compared to the first #GeriMedJC! This is what Symplur analytics had to say about today's tweet chat:
Missed the discussion? You can get the transcript of the #GeriMedJC tweet chat here.
And special thanks to all those who participated in the Tweet chat:
For all those still lurking, you'll have your chance to engage on October 31, 2014 at the next #GeriMedJC. Follow @GeriMedJC on Twitter for the announcement on the articles for the next #GeriMedJC!
Long article (45 minutes is dedicated to discussion in the live version of the journal club):
Atypical Antipsychotic Drugs and the Risk for Acute Kidney Injury and Other Adverse Outcomes in Older Adults. Ann Intern Med. 2014;161:242-248.
The efficacy and tolerability of the b3-adrenoceptor agonist Mirabegron for the treatment of symptoms of overactive bladder in older patients. Age and Ageing 2014;43:666–675.
Missed the discussion? You can get the transcript of the #GeriMedJC tweet chat here.
And special thanks to all those who participated in the Tweet chat:
For all those still lurking, you'll have your chance to engage on October 31, 2014 at the next #GeriMedJC. Follow @GeriMedJC on Twitter for the announcement on the articles for the next #GeriMedJC!
Thursday, 11 September 2014
Short article chosen for the September 2014 #GeriMedJC.
What does a short article mean? In the live version of the Geriatric Medicine Journal Club held at the University of Toronto, 15 minutes is devoted to the presentation and discussion of the article.
The efficacy and tolerability of the b3-adrenoceptor agonist Mirabegron for the treatment of symptoms of overactive bladder in older patients. Age and Ageing 2014;43:666–675.
Overactive bladder symptoms are common in the elderly and adversely affect quality of life. The side effect profile of existing pharmacotherapy limits use. This study of a newer medication may be of interest. Note that #GeriMedJC has no financial conflicts of interest and articles are chosen for critical appraisal based on interest and potential impact.
The full text of the article can be found here and the abstract is posted below.
Engage in the discussion September 19, 2014 at 08:00 EDT / noon GMT and don't forget to use the hashtag #GeriMedJC.
BACKGROUND: Mirabegron is a β3-adrenoceptor agonist developed for the treatment of symptoms of overactive bladder (OAB). As the prevalence of OAB increases with age, a prospective subanalysis of individual and pooled efficacy and tolerability data from three 12-week, randomised, Phase III trials, and of tolerability data from a 1-year safety trial were conducted in order to evaluate the efficacy and tolerability of mirabegron in subgroups of patients aged ≥65 and ≥75 years.
METHODS: Primary efficacy outcomes were change from baseline to final visit in the mean number of incontinence episodes/24 h and the mean number of micturitions/24 h. Tolerability was assessed by the incidence of treatment-emergent adverse events (TEAEs).
RESULTS: Over 12 weeks mirabegron 25 mg and 50 mg once-daily reduced the mean numbers of incontinence episodes and micturitions/24 h from baseline to final visit in patients aged ≥65 and ≥75 years. Mirabegron was well tolerated: in both age groups, hypertension and urinary tract infection were among the most common TEAEs over 12 weeks and 1 year. The incidence of dry mouth, a typical anticholinergic TEAE, was up to sixfold higher among the older patients randomised to tolterodine than any dose of mirabegron.
CONCLUSIONS: These analyses have demonstrated the efficacy of mirabegron over 12 weeks and the tolerability of mirabegron over 12 weeks and 1 year in OAB patients aged ≥65 and ≥75 years, supporting mirabegron as a therapeutic option in older patients with OAB.
Long article chosen for the September 2014 #GeriMedJC.
What does a long article mean? In the live version of the Geriatric Medicine Journal Club held at the University of Toronto, 45 minutes is devoted to the presentation and discussion of the article.
Atypical Antipsychotic Drugs and the Risk for Acute Kidney Injury and Other Adverse Outcomes in Older Adults. Ann Intern Med. 2014;161:242-248.
The long article chosen is an Ontario based study conducted at the Institute for Clinical Evaluative Sciences (ICES). It is sure to be of interest! Atypical antipsychotics are getting a lot of bad press and here is just some fuel to the fire. Perhaps the participants from the Nephrology Journal Club (#NephJC) would be interested in this critical appraisal of this article too.
The article can be found here: and the abstract is posted below.
Engage in the discussion September 19, 2014 at 08:00 EDT / noon GMT and don't forget to use the hashtag #GeriMedJC.
BACKGROUND: Several adverse outcomes attributed to atypical antipsychotic drugs, specifically quetiapine, risperidone, and olanzapine, are known to cause acute kidney injury (AKI). Such outcomes include hypotension, acute urinary retention, and the neuroleptic malignant syndrome or rhabdomyolysis.
OBJECTIVE: To investigate the risk for AKI and other adverse outcomes associated with use of atypical antipsychotic drugs versus nonuse.
DESIGN: Population-based cohort study.
SETTING: Ontario, Canada, from 2003 to 2012.
PATIENTS: Adults aged 65 years or older who received a new outpatient prescription for an oral atypical antipsychotic drug (n = 97 777) matched 1:1 with those who did not receive such a prescription.
MEASUREMENTS: The primary outcome was hospitalization with AKI (assessed by using a hospital diagnosis code and, in a subpopulation, serum creatinine levels) within 90 days of prescription for atypical antipsychotic drugs.
RESULTS: Atypical antipsychotic drug use versus nonuse was associated with a higher risk for hospitalization with AKI (relative risk [RR], 1.73 [95% CI, 1.55 to 1.92]). This association was consistent when AKI was assessed in a subpopulation for which information on serum creatinine levels was available (5.46% vs. 3.34%; RR, 1.70 [CI, 1.22 to 2.38]; absolute risk increase, 2.12% [CI, 0.80% to 3.43%]). Drug use was also associated with hypotension (RR, 1.91 [CI, 1.60 to 2.28]), acute urinary retention (RR, 1.98 [CI, 1.63 to 2.40]), and all-cause mortality (RR, 2.39 [CI, 2.28 to 2.50]).
LIMITATION: Only older adults were included in the study.
CONCLUSION: Atypical antipsychotic drug use is associated with an increased risk for AKI and other adverse outcomes that may explain the observed association with AKI. The findings support current safety concerns about the use of these drugs in older adults.
Atypical Antipsychotic Drugs and the Risk for Acute Kidney Injury and Other Adverse Outcomes in Older Adults. Ann Intern Med. 2014;161:242-248.
The long article chosen is an Ontario based study conducted at the Institute for Clinical Evaluative Sciences (ICES). It is sure to be of interest! Atypical antipsychotics are getting a lot of bad press and here is just some fuel to the fire. Perhaps the participants from the Nephrology Journal Club (#NephJC) would be interested in this critical appraisal of this article too.
The article can be found here: and the abstract is posted below.
Engage in the discussion September 19, 2014 at 08:00 EDT / noon GMT and don't forget to use the hashtag #GeriMedJC.
BACKGROUND: Several adverse outcomes attributed to atypical antipsychotic drugs, specifically quetiapine, risperidone, and olanzapine, are known to cause acute kidney injury (AKI). Such outcomes include hypotension, acute urinary retention, and the neuroleptic malignant syndrome or rhabdomyolysis.
OBJECTIVE: To investigate the risk for AKI and other adverse outcomes associated with use of atypical antipsychotic drugs versus nonuse.
DESIGN: Population-based cohort study.
SETTING: Ontario, Canada, from 2003 to 2012.
PATIENTS: Adults aged 65 years or older who received a new outpatient prescription for an oral atypical antipsychotic drug (n = 97 777) matched 1:1 with those who did not receive such a prescription.
MEASUREMENTS: The primary outcome was hospitalization with AKI (assessed by using a hospital diagnosis code and, in a subpopulation, serum creatinine levels) within 90 days of prescription for atypical antipsychotic drugs.
RESULTS: Atypical antipsychotic drug use versus nonuse was associated with a higher risk for hospitalization with AKI (relative risk [RR], 1.73 [95% CI, 1.55 to 1.92]). This association was consistent when AKI was assessed in a subpopulation for which information on serum creatinine levels was available (5.46% vs. 3.34%; RR, 1.70 [CI, 1.22 to 2.38]; absolute risk increase, 2.12% [CI, 0.80% to 3.43%]). Drug use was also associated with hypotension (RR, 1.91 [CI, 1.60 to 2.28]), acute urinary retention (RR, 1.98 [CI, 1.63 to 2.40]), and all-cause mortality (RR, 2.39 [CI, 2.28 to 2.50]).
LIMITATION: Only older adults were included in the study.
CONCLUSION: Atypical antipsychotic drug use is associated with an increased risk for AKI and other adverse outcomes that may explain the observed association with AKI. The findings support current safety concerns about the use of these drugs in older adults.
Sunday, 7 September 2014
Thanks for the support! @GeriMedJC at over 100 followers!
Just over a month since inception, the moderator account for the Geriatric Medicine Journal Club, @GeriMedJC, has just over 100 followers on Twitter.
Discussions are only as rich as the engagement, so spread the word!
The next #GeriMedJC will be on September 19, 2014 at 08:00 EDT / noon GMT. Articles TBA.
Discussions are only as rich as the engagement, so spread the word!
The next #GeriMedJC will be on September 19, 2014 at 08:00 EDT / noon GMT. Articles TBA.
Saturday, 6 September 2014
Date and time for next Geriatric Medicine Journal Club tweet chat (#GeriMedJC)
September 19, 2014 at 08:00 EDT / 12:00 noon GMT.
Articles to be announced.
Follow us on Twitter @GeriMedJC! Remember to use the hashtag #GeriMedJC.
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