Potential high-risk drug-drug interactions among elderly outpatients with dementia: a cross-sectional stud

Ferreira, Felipe; Diniz, Julia Silva Valério; Souza, Patrícia Medeiros de; Freitas, Marco Polo Dias; Camargos, Einstein Francisco; Kusano, Liana Tieko Evangelista; Santos-Neto, Leopoldo Luiz dos

doi:10.5327/z2447-2115201500010005

Cited by 2 publications

(2 citation statements)

References 22 publications

(24 reference statements)

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“…With regard to factors associated with polypharmacy, a higher number of prescribed medication in cardiac therapy, psycholeptics and psychoanaleptics were revealed. The findings from previous studies contribute to a growing body of evidence which demonstrates the presence of drug interactions associated with a higher risk of polypharmacy [101][102][103]. According to Park H-Y el al's study [104] polypharmacy is associated with the increase of comorbidities, which was not seen in our study.…”

Section: Plos Onecontrasting

confidence: 50%

Drug related problems in older adults living with dementia

et al. 2020

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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

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Section: Plos Onecontrasting

confidence: 50%

Drug related problems in older adults living with dementia

et al. 2020

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“…Impaired cognition, along with advancing age, may lead to increased consumption of medicines; thus, special attention is warranted for potential drug interactions among people with cognitive impairment or dementia. 72 The ADEs related to ChEIs also showed an association with mortality in this review. Rivastigmine had the highest odds of risk of mortality, followed by donepezil.…”

Section: Discussionmentioning

confidence: 59%

Outcomes of Medication Misadventure Among People With Cognitive Impairment or Dementia: A Systematic Review and Meta-analysis

et al. 2020

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Objective: To investigate mortality and hospitalization outcomes associated with medication misadventure (including medication errors [MEs], such as the use of potentially inappropriate medications [PIMs], and adverse drug events [ADEs]) among people with cognitive impairment or dementia. Data Sources: Ovid MEDLINE, Ovid EMBASE, Ovid International Pharmaceutical Abstracts, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Central Register of Controlled Trials were searched from inception to December 2019. Study Selection and Data Extraction: Relevant studies using any study design were included. Reviewers independently performed critical appraisal and extracted relevant data. Data Synthesis: The systematic review included 10 studies that reported the outcomes of mortality or hospitalization associated with medication misadventure, including PIMs (n=5), ADEs (n=2), a combination of MEs and ADEs (n=2), and drug interactions (n=1). Five studies examining the association between PIMs and mortality/hospitalization were included in the meta-analyses. Exposure to PIMs was not associated with either mortality (odds ratio [OR]=1.36; 95%CI=0.79-2.35) or hospitalization (OR=1.02; 95%CI=0.83-1.26). In contrast, single studies indicated that ADEs with cholinesterase inhibitors were associated with mortality and hospitalization. Relevance to Patient Care and Clinical Practice: Individuals with cognitive impairment or dementia are at increased risk of medication misadventure; based on relatively limited published data, this does not necessarily translate to increased mortality and hospitalization. Conclusions: Overall, medication misadventure was not associated with mortality or hospitalization in people with cognitive impairment or dementia, noting the limited number of studies, difficulty in controlling potential confounding variables, and that most studies focus on PIMs.

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Potential high-risk drug-drug interactions among elderly outpatients with dementia: a cross-sectional stud

Cited by 2 publications

References 22 publications

Drug related problems in older adults living with dementia

Drug related problems in older adults living with dementia

Outcomes of Medication Misadventure Among People With Cognitive Impairment or Dementia: A Systematic Review and Meta-analysis

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