Drug related problems in older adults living with dementia

Abstract

Background Compared with those without dementia, older patients with dementia admitted to acute care settings are at higher risk for triad combination of polypharmacy (PP), potentially inappropriate medication (PIM), and drug-drug interaction (DDI), which may consequently result in detrimental health. The aims of this research were to assess risk factors associated with triad combination of PP, PIM and DDI among hospitalized older patients with dementia, and to assess prevalence and characteristics of PP, PIM and DDI in this population. Methods In this retrospective cross-sectional study, 416 older inpatients diagnosed with dementia and referred for specialist geriatric consultation at a tertiary hospital in Brisbane, Australia during 2006-2016 were enrolled. Patients were categorized into two groups according to their exposure to the combination of PP, PIM and DDI: 'triad combination' and 'non-triad combination'. Data were collected using the interRAI Acute Care (AC) assessment instrument. Independent risk factors of exposure to the triad combination were evaluated using bivariate and multivariate logistic regression analyses. Results Overall, 181 (43.5%) were classified as triad combination group. The majority of the population took at least 1 PIM (56%) or experienced at least one potential DDI (76%). Over 75% of the participants were exposed to polypharmacy. The most common prescribed PIMs were antipsychotics, followed by benzodiazepines. The independent risk factors of the triad combination were the presence of atrial fibrillation diagnosis and higher medications use in cardiac therapy, psycholeptics and psychoanaleptics. Conclusions The exposure to triad combination of PP, PIM and DDI are common among people with dementia as a result of their vulnerable conditions and the greater risks of adverse events

Clinical Pharmacist Intervention on Drug-Related Problems among Elderly Patients Admitted to Medical Wards of Northwest Ethiopia Comprehensive Specialized Hospitals: A Multicenter Prospective, Observational Study

“…Patients with one or more medical conditions increased their risk of developing DRPs by 1.48 times when compared to those who did not have any comorbid conditions; this conclusion is consistent with research from the Netherlands [38], India [39], and Norway [40], but differs from a study 8 BioMed Research International conducted in Gondar hospital [41] and a multicenter study in southwestern Ethiopian hospitals [42], which is not statistically different. In fact, as comorbidities and the number of medications rise, patients are at a higher risk of getting DRPs.…”

Clinical significance of potential drug–drug interactions in older adults with psychiatric disorders: a retrospective study

“…Ocana-Zurita [22] performed a retrospective and cross-sectional study and found that 68.25% of schizophrenic patients were at risk of pDDIs. Ruangritchankul [23] found that 76% of older adults diagnosed with dementia experienced at least 1 pDDI. Independent factors of ADRs vary in studies.…”

Can clinician champions reduce potentially inappropriate medications in people living with dementia? Study protocol for a cluster randomized trial

“…For people living with dementia (PLWD), the overuse of potentially inappropriate medications (PIMs), those for which the potential for harm outweighs benefit, remains a persistent problem despite evidence-based guidelines supporting their de-adoption [1][2][3]. These harms can include falls, cognitive impairment, hospital admission, functional impairment, and death.…”