Potentially inappropriate medication among people with dementia in eight European countries

Author:

Renom-Guiteras Anna123,Thürmann Petra A45,Miralles Ramón23,Klaaßen-Mielke Renate6,Thiem Ulrich67,Stephan Astrid18,Bleijlevens Michel H C9,Jolley David10,Leino-Kilpi Helena11,Rahm Hallberg Ingalill12,Saks Kai13,Soto-Martin Maria14,Zabalegui Adelaida1516,Meyer Gabriele18,

Affiliation:

1. School of Nursing Science, University of Witten/Herdecke, Witten, Germany

2. Geriatrics Department, University Hospital Parc de Salut Mar, Barcelona, Spain

3. Universitat Autònoma de Barcelona, Barcelona, Spain

4. Chair of Clinical Pharmacology, University of Witten/Herdecke, Witten, Germany

5. Philipp Klee-Institute of Clinical Pharmacology, HELIOS University Clinic Wuppertal, Wuppertal, Germany

6. Department of Medical Informatics, Biometry and Epidemiology, Ruhr University, Bochum, Germany

7. Department of Geriatrics, Elisabeth Krankenhaus Essen, Essen, Germany

8. Institute of Health and Nursing Science, Medical Faculty, Martin Luther UniversityHalle-Wittenberg, Halle (Saale), Germany

9. Care and Public Health Research Institute (Caphri), Department of Health Services Research, Maastricht University, Maastricht, The Netherlands

10. Honorary Reader in Old Age Psychiatry, Personal Social Services Unit, University of Manchester, Manchester, UK

11. Department of Nursing Science and Nurse Director, University of Turku, Turku University Hospital, Turku, Finland

12. The Pufendorf Institute of Advanced Studies, Lund University, Lund, Sweden

13. Department of Internal Medicine, University of Tartu, Tartu, Estonia

14. Department of Geriatric Medicine, Gerontopole, Alzheimer Disease Research Center, Inserm UMR 1027, University Hospital of Toulouse, France

15. Hospital Clinic de Barcelona, Barcelona, Spain

16. School of Medicine, Universitat de Barcelona, Barcelona, Spain

Abstract

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 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.

Funder

European Commission

Publisher

Oxford University Press (OUP)

Subject

Geriatrics and Gerontology,Ageing,General Medicine

Reference30 articles.

1. Comorbidity and polypharmacy in people with dementia: insights from a large, population-based cross-sectional analysis of primary care data;Clague;Age Ageing,2017

2. Inappropriate dug use in people with cognitive impairment and dementia: a systematic review;Johnell;Curr Clin Pharmacol,2015

3. Potentially inappropriate medications in the elderly: a French consensus panel list;Laroche;Eur J Clin Pharmacol,2007

4. STOPP (Screening Tool of Older Person’s Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation;Gallagher;Int J Clin Pharmacol Ther,2008

5. A European study investigating patterns of transition from home care towards institutional dementia care: the protocol of a RightTimePlaceCare study;Verbeek;BMC Public Health,2012

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