Potentially inappropriate medication use among patients with Alzheimer disease in the REAL.FR cohort: be aware of atropinic and benzodiazepine drugs!

Montastruc, François; Gardette, Virginie; Cantet, Christelle; Piau, Antoine; Lapeyre‐Mestre, Maryse; Vellas, Bruno; Montastruc, Jean‐Louis; Andrieu, Sandrine

doi:10.1007/s00228-013-1506-8

Cited by 67 publications

(71 citation statements)

References 37 publications

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“…While some variability can be expected because of differences in the criteria the various tools employ-for example, in drug-disease interactions and dosing limits for certain drugs-the ability to apply criteria consistently across studies was also not possible because of the availability of certain drugs in different countries (Appendix 1). The variability in the prevalence of potentially inappropriate medications based on the tool used to detect it is illustrated dramatically in Montastruc et al 's study 27 25 this may have been driven by the use of estrogens among women. Indeed, when the authors analyzed the data based on a model in which they removed estrogen use, no significant differences were found between men and women in potentially inappropriate medication use.…”

Section: Discussionmentioning

confidence: 99%

“…This significant association remained after a multivariate analysis was conducted (OR = 3.6, 95% CI = 2.6-4.5). 27 In Pugh et al 's study, 28 the number of unique medications was identified as a risk factor for drug-disease interactions among dementia patients (OR = 1.13, 95% CI = 1.12- …”

Section: Medication Usementioning

confidence: 98%

“…23 Among patients diagnosed with mild to moderate dementia, the greatest proportion were taking benzodiazepines or benzodiazepine analogues (8.5%). 27 Koyama et al 24 reported that 15.2%…”

Section: Drugs and Pharmacological Classes Implicated In Potentially mentioning

confidence: 99%

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Use of potentially inappropriate medications among ambulatory home-dwelling elderly patients with dementia: A review of the literature

2017

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Background: Older adults with dementia are at high risk for drug-related adverse outcomes. While much is known about potentially inappropriate medication use in older adults, its prevalence and characteristics among those with dementia are not as well elucidated. We conducted a literature review to examine the prevalence of potentially inappropriate medication use among home-dwelling older adults with dementia. Our secondary aim was to determine the most frequently implicated medications and factors associated with potentially inappropriate medication use.

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Section: Discussionmentioning

confidence: 99%

Section: Medication Usementioning

confidence: 98%

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Use of potentially inappropriate medications among ambulatory home-dwelling elderly patients with dementia: A review of the literature

2017

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“…The publication of studies increased over time; there was one paper published in 2002 (earliest included paper) [18] and five in 2013 [19-23] (Tables 1 and 2 ).…”

Section: Resultsmentioning

confidence: 99%

Inappropriate Drug Use in People with Cognitive Impairment and Dementia: A Systematic Review

Johnell

2015

CCP

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The aim of this systematic review was to identify, assess and summarize studies about potentially inappropriate drug use (IDU) in cognitive impairment and dementia and to present findings about whether cognitive impairment and dementia are associated with IDU. The search was made in Medline/PubMed using free terms in the title or abstract. The inclusion criteria were: English language, published until 1 March 2014, original quantitative study and assessment of overall IDU with a consensus based summarized measure. Exclusion criteria were: focus on specific patient group (other than cognitive impairment or dementia), focus on specific drug class and failure to present a prevalence measure of IDU or an effect estimate (i.e. odds ratio). Of the initial 182 studies found in Medline, 22 articles fulfilled the criteria. Most studies used the Beers criteria for assessment of IDU. Prevalence of IDU among individuals with cognitive impairment or dementia ranged from 10.2% to 56.4% and was higher in nursing home settings than in community-dwelling samples. Most studies reported a lower likelihood of IDU in case of cognitive impairment or dementia. To conclude, IDU is highly prevalent among persons with cognitive impairment and dementia, although these conditions seem to be associated with a lower probability of IDU. This might reflect an awareness among clinicians of cautious prescribing to this vulnerable group of patients. More studies on large cohorts of persons with cognitive impairment and dementia are needed to draw conclusions about optimal drug prescribing to this frail group of older persons.

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“…[7][8][9] There is additional concern about the association between BZD use and cognitive decline in Alzheimer's disease. [10][11][12][13] Patients with stroke suffer from major comorbidities, including cardiac arrhythmias and sleep-related hypoxaemia. 14 Few studies have addressed the effect on mortality when using antidepressants in patients with post-stroke.…”

Section: Introductionmentioning

confidence: 99%

Mortality and use of psychotropic medication in patients with stroke: a population-wide, register-based study

et al. 2016

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Objectives The study sought to describe whether psychotropic medication may have long-term side effects in patients with stroke compared with controls. Setting Use of national register data from healthcare services were identified from the Danish National Patient Registry in Denmark. Information about psychotropic medication use was obtained from the Danish Register of Medicinal Product Statistics. Objectives We aimed to evaluate all-cause mortality in relation to the use of benzodiazepines, antidepressants and antipsychotics in patients with stroke and matched controls. Participants Patients with a diagnosis of stroke and either no drug use or preindex use of psychotropic medication (n=49 968) and compared with control subjects (n=86 100) matched on age, gender, marital status and community location. Primary outcome measure All-cause mortality. Results All-cause mortality was higher in patients with previous stroke compared with control subjects. Mortality HRs were increased for participants prescribed serotonergic antidepressant drugs (HR=1.699 (SD=0.030), p=0.001 in patients; HR=1.908 (0.022), p<0.001 in controls, respectively), tricyclic antidepressants (HR=1.365 (0.045), p<0.001; HR=1.733 (0.022), p<0.001), benzodiazepines (HR=1.643 (0.040), p<0.001; HR=1.776 (0.053), p<0.001), benzodiazepine-like drugs (HR=1.776 (0.021), p<0.001; HR=1.547 (0.025), p<0.001), first-generation antipsychotics (HR=2.001 (0.076), p<0.001; HR=3.361 (0.159), p<0.001) and second-generation antipsychotics (HR=1.645 (0.070), p<0.001; HR=2.555 (0.086), p<0.001), compared with no drug use. Interaction analysis suggested statistically significantly higher mortality HRs for most classes of psychotropic drugs in controls compared with patients with stroke. Conclusions All-cause mortality was higher in patients with stroke and controls treated with benzodiazepines, antidepressants and antipsychotics than in their untreated counterparts. Our findings suggest that care should be taken in the use and prescription of such drugs, and that they should be used in conjunction with adequate clinical controls.

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Potentially inappropriate medication use among patients with Alzheimer disease in the REAL.FR cohort: be aware of atropinic and benzodiazepine drugs!

Cited by 67 publications

References 37 publications

Use of potentially inappropriate medications among ambulatory home-dwelling elderly patients with dementia: A review of the literature

Use of potentially inappropriate medications among ambulatory home-dwelling elderly patients with dementia: A review of the literature

Inappropriate Drug Use in People with Cognitive Impairment and Dementia: A Systematic Review

Mortality and use of psychotropic medication in patients with stroke: a population-wide, register-based study

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