Access of medication review for people living with dementia : An analysis of inequality using Swedish register data
Saha, Sanjib LU
; Persson, Sofie
LU
; Jarl, Johan
LU
; Trepel, Dominic
; Lenander, Cecilia
LU
; Londos, Elisabet
LU
; Midlöv, Patrik
LU
; Lawlor, Brian
; Toresson, Håkan
LU
and Gerdtham, Ulf-Göran
LU
(2025)
In Alzheimer's & dementia : the journal of the Alzheimer's Association
21(11).
- Abstract
- INTRODUCTION
This study examines medication reviews (MRs) among people living with dementia (PWD) in Sweden, focusing on frequency and factors influencing access.
METHODS
Using nationwide register data, all diagnosed PWD from 2010 to 2016 were assessed for MR receipt in 2015 and/or 2016. The analysis guided by the Andersen healthcare utilization framework, considered predisposing, enabling, and need-based factors through multiple logistic regression.
RESULTS
The MR rate was 16% in 2015, 21% in 2016, and 30% across both years. Increased MR likelihood was linked to higher comorbidity (adjusted odds ratio [aOR] = 1.45, p = 0.00), polypharmacy (aOR = 1.55, p = 0.00), and residential care (aOR = 3.92, p = 0.00),... (More) - INTRODUCTION
This study examines medication reviews (MRs) among people living with dementia (PWD) in Sweden, focusing on frequency and factors influencing access.
METHODS
Using nationwide register data, all diagnosed PWD from 2010 to 2016 were assessed for MR receipt in 2015 and/or 2016. The analysis guided by the Andersen healthcare utilization framework, considered predisposing, enabling, and need-based factors through multiple logistic regression.
RESULTS
The MR rate was 16% in 2015, 21% in 2016, and 30% across both years. Increased MR likelihood was linked to higher comorbidity (adjusted odds ratio [aOR] = 1.45, p = 0.00), polypharmacy (aOR = 1.55, p = 0.00), and residential care (aOR = 3.92, p = 0.00), while being married or cohabiting reduced (aOR = 0.80, p = 0.00) MR receipt.
DISCUSSION
Despite national guidelines recommending annual MRs since 2012, rates remain low, especially outside residential care. The findings highlight the need for more equitable MR access for all PWD, particularly those not in residential care.
Highlights
Only 16%–21% of people with dementia received a medication review in 2015–2016 in Sweden.
Higher comorbidity, polypharmacy, and residential care increased likelihood of receiving a medication review.
Being married or cohabiting lowered the chance of receiving a medication review.
Education level and gender did not affect access to medication reviews. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1c3154db-3417-4ee7-9945-4c9fa6a4d58d
- author
- Saha, Sanjib
LU
; Persson, Sofie
LU
; Jarl, Johan
LU
; Trepel, Dominic
; Lenander, Cecilia
LU
; Londos, Elisabet
LU
; Midlöv, Patrik
LU
; Lawlor, Brian
; Toresson, Håkan
LU
and Gerdtham, Ulf-Göran
LU
- organization
- publishing date
- 2025-11
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- medication management, medication review, pharmaceutical review, registry data
- in
- Alzheimer's & dementia : the journal of the Alzheimer's Association
- volume
- 21
- issue
- 11
- article number
- e70909
- publisher
- Wiley
- external identifiers
-
- pmid:41231424
- scopus:105021853652
- ISSN
- 1552-5279
- DOI
- 10.1002/alz.70909
- language
- English
- LU publication?
- yes
- id
- 1c3154db-3417-4ee7-9945-4c9fa6a4d58d
- date added to LUP
- 2025-11-14 07:50:53
- date last changed
- 2025-12-02 15:50:51
@article{1c3154db-3417-4ee7-9945-4c9fa6a4d58d,
abstract = {{INTRODUCTION<br/>This study examines medication reviews (MRs) among people living with dementia (PWD) in Sweden, focusing on frequency and factors influencing access.<br/><br/>METHODS<br/>Using nationwide register data, all diagnosed PWD from 2010 to 2016 were assessed for MR receipt in 2015 and/or 2016. The analysis guided by the Andersen healthcare utilization framework, considered predisposing, enabling, and need-based factors through multiple logistic regression.<br/><br/>RESULTS<br/>The MR rate was 16% in 2015, 21% in 2016, and 30% across both years. Increased MR likelihood was linked to higher comorbidity (adjusted odds ratio [aOR] = 1.45, p = 0.00), polypharmacy (aOR = 1.55, p = 0.00), and residential care (aOR = 3.92, p = 0.00), while being married or cohabiting reduced (aOR = 0.80, p = 0.00) MR receipt.<br/><br/>DISCUSSION<br/>Despite national guidelines recommending annual MRs since 2012, rates remain low, especially outside residential care. The findings highlight the need for more equitable MR access for all PWD, particularly those not in residential care.<br/><br/>Highlights<br/>Only 16%–21% of people with dementia received a medication review in 2015–2016 in Sweden.<br/>Higher comorbidity, polypharmacy, and residential care increased likelihood of receiving a medication review.<br/>Being married or cohabiting lowered the chance of receiving a medication review.<br/>Education level and gender did not affect access to medication reviews.}},
author = {{Saha, Sanjib and Persson, Sofie and Jarl, Johan and Trepel, Dominic and Lenander, Cecilia and Londos, Elisabet and Midlöv, Patrik and Lawlor, Brian and Toresson, Håkan and Gerdtham, Ulf-Göran}},
issn = {{1552-5279}},
keywords = {{medication management; medication review; pharmaceutical review; registry data}},
language = {{eng}},
number = {{11}},
publisher = {{Wiley}},
series = {{Alzheimer's & dementia : the journal of the Alzheimer's Association}},
title = {{Access of medication review for people living with dementia : An analysis of inequality using Swedish register data}},
url = {{http://dx.doi.org/10.1002/alz.70909}},
doi = {{10.1002/alz.70909}},
volume = {{21}},
year = {{2025}},
}