Potentially inappropriate medication among people with dementia in eight European countries

Anna Renom-Guiteras, Petra A. Thürmann, Ramón Miralles, Renate Klaaßen-Mielke, Ulrich Thiem, Astrid Stephan, Michel H.C. Bleijlevens, David Jolley, Helena Leino-Kilpi, Ingalill Rahm Hallberg, Kai Saks, Maria Soto-Martin, Adelaida Zabalegui, Gabriele Meyer, Dirk Sauerland, Ansgar Wuebker, Patrick Bremer, Jan P.H. Hamersb, Basema Afram, Hanneke C. BeerensHilde Verbeek, Sandra M.G. Zwakhalen, Dirk Ruwaard, Ton Ambergen, Ulla Melin Emilsson, Staffan Karlsson, Christina Bokberg, Connie Lethin, David Challis, Caroline Sutcliffe, Sue Tucker, Ian Bowns, Brenda Roe, Alistair Burns, Jaana Koskenniemi, Riitta Suhonen, Matti Viitanen, Seija Arve, Minna Stolt, Maija Hupli, Ene Margit Tiit, Jelena Leibur, Katrin Raamat, Angelika Armolik, Teija Tuula Marjatta Toivari, Montserrat Navarro, Esther Cabrera, Ester Risco, Carme Alvira, Marta Farré, Susana Miguel, Maria Soto, Agathe Milhet, Sandrine Sourdet, Sophie Gillette, Bruno Vellas

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25 Citations (Scopus)

Abstract

© The Author 2017. 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.
Original languageEnglish
Pages (from-to)68-74
JournalAge and Ageing
Volume47
Issue number1
DOIs
Publication statusPublished - 1 Jan 2018

Keywords

  • Aged
  • Inappropriate prescribing
  • Older people
  • Potentially inappropriate medication list
  • Proton-pump inhibitors
  • Psychotropic drugs

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