Advanced

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 Saks, Kai, 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.

(Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
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
LU publication?
yes
id
b65742d5-4434-41e3-9b4b-e8df394c1915
date added to LUP
2018-02-06 09:40:12
date last changed
2019-05-21 03:59:19
@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 Saks, Kai and Soto-Martin, Maria and Zabalegui, Adelaida and Meyer, Gabriele 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},
}