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Potentially inappropriate medication among people with dementia in eight European countries

Renom-Guiteras, Anna; Thürmann, Petra A.; Miralles, Ramón; Klaaßen-Mielke, Renate; Thiem, Ulrich; Stephan, Astrid; Bleijlevens, Michel H.C.; Jolley, David; Leino-Kilpi, Helena and Hallberg, Ingalill Rahm LU , et al. (2018) In Age and Ageing 47(1). p.68-74
Abstract

Objectives: to evaluate the frequency of potentially inappropriate medication (PIM) prescription among older people with dementia (PwD) from eight countries participating in the European study 'RightTimePlaceCare', and to evaluate factors and adverse outcomes associated with PIM prescription.Methods: survey of 2,004 PwD including a baseline assessment and follow-up after 3 months. Interviewers gathered data on age, sex, prescription of medication, cognitive status, functional status, comorbidity, setting and admission to hospital, fall-related injuries and mortality in the time between baseline and follow-up. The European Union(7)-PIM list was used to evaluate PIM prescription. Multivariate regression analysis was used to investigate... (More)

Objectives: to evaluate the frequency of potentially inappropriate medication (PIM) prescription among older people with dementia (PwD) from eight countries participating in the European study 'RightTimePlaceCare', and to evaluate factors and adverse outcomes associated with PIM prescription.Methods: survey of 2,004 PwD including a baseline assessment and follow-up after 3 months. Interviewers gathered data on age, sex, prescription of medication, cognitive status, functional status, comorbidity, setting and admission to hospital, fall-related injuries and mortality in the time between baseline and follow-up. The European Union(7)-PIM list was used to evaluate PIM prescription. Multivariate regression analysis was used to investigate factors and adverse outcomes associated with PIM prescription.Results: overall, 60% of the participants had at least one PIM prescription and 26.4% at least two. The PIM therapeutic subgroups most frequently prescribed were psycholeptics (26% of all PIM prescriptions) and 'drugs for acid-related disorders' (21%). PwD who were 80 years and older, lived in institutional long-term care settings, had higher comorbidity and were more functionally impaired were at higher risk of being prescribed two PIM or more. The prescription of two or more PIM was associated with higher chance of suffering from at least one fall-related injury and at least one episode of hospitalisation in the time between baseline and follow-up.Conclusions: PIM use among PwD is frequent and is associated with institutional long-term care, age, advanced morbidity and functional impairment. It also appears to be associated with adverse outcomes. Special attention should be paid to psycholeptics and drugs for acid-related disorders.

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published
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keywords
Aged, Inappropriate prescribing, Older people, Potentially inappropriate medication list, Proton-pump inhibitors, Psychotropic drugs
in
Age and Ageing
volume
47
issue
1
pages
7 pages
publisher
Oxford University Press
external identifiers
  • scopus:85040556691
  • pmid:28985257
ISSN
0002-0729
DOI
10.1093/ageing/afx147
language
English
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yes
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b65742d5-4434-41e3-9b4b-e8df394c1915
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2018-02-06 09:40:12
date last changed
2018-02-07 03:00:02
@article{b65742d5-4434-41e3-9b4b-e8df394c1915,
  abstract     = {<p>Objectives: to evaluate the frequency of potentially inappropriate medication (PIM) prescription among older people with dementia (PwD) from eight countries participating in the European study 'RightTimePlaceCare', and to evaluate factors and adverse outcomes associated with PIM prescription.Methods: survey of 2,004 PwD including a baseline assessment and follow-up after 3 months. Interviewers gathered data on age, sex, prescription of medication, cognitive status, functional status, comorbidity, setting and admission to hospital, fall-related injuries and mortality in the time between baseline and follow-up. The European Union(7)-PIM list was used to evaluate PIM prescription. Multivariate regression analysis was used to investigate factors and adverse outcomes associated with PIM prescription.Results: overall, 60% of the participants had at least one PIM prescription and 26.4% at least two. The PIM therapeutic subgroups most frequently prescribed were psycholeptics (26% of all PIM prescriptions) and 'drugs for acid-related disorders' (21%). PwD who were 80 years and older, lived in institutional long-term care settings, had higher comorbidity and were more functionally impaired were at higher risk of being prescribed two PIM or more. The prescription of two or more PIM was associated with higher chance of suffering from at least one fall-related injury and at least one episode of hospitalisation in the time between baseline and follow-up.Conclusions: PIM use among PwD is frequent and is associated with institutional long-term care, age, advanced morbidity and functional impairment. It also appears to be associated with adverse outcomes. Special attention should be paid to psycholeptics and drugs for acid-related disorders.</p>},
  author       = {Renom-Guiteras, Anna and Thürmann, Petra A. and Miralles, Ramón and Klaaßen-Mielke, Renate and Thiem, Ulrich and Stephan, Astrid and Bleijlevens, Michel H.C. and Jolley, David and Leino-Kilpi, Helena and Hallberg, Ingalill Rahm and Saks, Kai and Soto-Martin, Maria and Zabalegui, Adelaida and Meyer, Gabriele and Sauerland, Dirk and Wuebker, Ansgar and Bremer, Patrick and Afram, Basema and Beerens, Hanneke C. and Verbeek, Hilde and Zwakhalen, Sandra M.G. and Ruwaard, Dirk and Ambergen, Ton and Emilsson, Ulla Melin and Karlsson, Staffan and Bokberg, Christina and Lethin, Connie and Challis, David and Sutcliffe, Caroline and Tucker, Sue and Bowns, Ian and Roe, Brenda and Burns, Alistair and Koskenniemi, Jaana and Suhonen, Riitta and Viitanen, Matti and Arve, Seija and Stolt, Minna and Hupli, Maija and Tiit, Ene Margit and Leibur, Jelena and Raamat, Katrin and Armolik, Angelika and Toivari, Teija Tuula Marjatta and Navarro, Montserrat and Cabrera, Esther and Risco, Ester and Alvira, Carme and Farré, Marta and Miguel, Susana and Soto, Maria and Milhet, Agathe and Sourdet, Sandrine and Gillette, Sophie and Vellas, Bruno and , },
  issn         = {0002-0729},
  keyword      = {Aged,Inappropriate prescribing,Older people,Potentially inappropriate medication list,Proton-pump inhibitors,Psychotropic drugs},
  language     = {eng},
  month        = {01},
  number       = {1},
  pages        = {68--74},
  publisher    = {Oxford University Press},
  series       = {Age and Ageing},
  title        = {Potentially inappropriate medication among people with dementia in eight European countries},
  url          = {http://dx.doi.org/10.1093/ageing/afx147},
  volume       = {47},
  year         = {2018},
}