TY - JOUR
T1 - Potentially inappropriate medication among people with dementia in eight European countries
AU - Renom-Guiteras, Anna
AU - Thurmann, Petra A.
AU - Miralles, Ramon
AU - Klaassen-Mielke, Renate
AU - Thiem, Ulrich
AU - Stephan, Astrid
AU - Bleijlevens, Michel H. C.
AU - Jolley, David
AU - Leino-Kilpi, Helena
AU - Hallberg, Ingalill Rahm
AU - Saks, Kai
AU - Soto-Martin, Maria
AU - Zabalegui, Adelaida
AU - Meyer, Gabriele
AU - RightTimePlaceCare Consortium
PY - 2018/1/1
Y1 - 2018/1/1
N2 - 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.
AB - 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.
KW - inappropriate prescribing
KW - aged
KW - potentially inappropriate medication list
KW - psychotropic drugs
KW - proton-pump inhibitors
KW - older people
KW - PROTON PUMP INHIBITORS
KW - MINI-MENTAL-STATE
KW - LONG-TERM USE
KW - OLDER PERSONS
KW - DRUG-USE
KW - ELDERLY-PATIENTS
KW - CARE
KW - VALIDATION
KW - IMPACT
KW - EVENTS
U2 - 10.1093/ageing/afx147
DO - 10.1093/ageing/afx147
M3 - Article
C2 - 28985257
SN - 0002-0729
VL - 47
SP - 68
EP - 74
JO - Age and Ageing
JF - Age and Ageing
IS - 1
ER -