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. Beerens; Hilde 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

doi:10.1093/ageing/afx147

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

Department of Medicine

Research output: Contribution to journal › Article › Research › peer-review

51 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 language	English
Pages (from-to)	68-74
Journal	Age and Ageing
Volume	47
Issue number	1
DOIs	https://doi.org/10.1093/ageing/afx147
Publication status	Published - 1 Jan 2018

Keywords

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

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10.1093/ageing/afx147

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Renom-Guiteras, A., Thürmann, P. A., Miralles, R., Klaaßen-Mielke, R., Thiem, U., Stephan, A., Bleijlevens, M. H. C., Jolley, D., Leino-Kilpi, H., Hallberg, I. R., Saks, K., Soto-Martin, M., Zabalegui, A., Meyer, G., Sauerland, D., Wuebker, A., Bremer, P., Hamersb, J. P. H., Afram, B., ... Vellas, B. (2018). Potentially inappropriate medication among people with dementia in eight European countries. Age and Ageing, 47(1), 68-74. https://doi.org/10.1093/ageing/afx147

@article{268af5deafa14c08b35a651268dd2dc8,

title = "Potentially inappropriate medication among people with dementia in eight European countries",

abstract = "{\textcopyright} 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.",

keywords = "Aged, Inappropriate prescribing, Older people, Potentially inappropriate medication list, Proton-pump inhibitors, Psychotropic drugs",

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

year = "2018",

month = jan,

day = "1",

doi = "10.1093/ageing/afx147",

language = "English",

volume = "47",

pages = "68--74",

journal = "Age and Ageing",

issn = "0002-0729",

number = "1",

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Renom-Guiteras, A, Thürmann, PA, Miralles, R, Klaaßen-Mielke, R, Thiem, U, Stephan, A, Bleijlevens, MHC, Jolley, D, Leino-Kilpi, H, Hallberg, IR, Saks, K, Soto-Martin, M, Zabalegui, A, Meyer, G, Sauerland, D, Wuebker, A, Bremer, P, Hamersb, JPH, Afram, B, Beerens, HC, Verbeek, H, Zwakhalen, SMG, Ruwaard, D, Ambergen, T, Emilsson, UM, Karlsson, S, Bokberg, C, Lethin, C, Challis, D, Sutcliffe, C, Tucker, S, Bowns, I, Roe, B, Burns, A, Koskenniemi, J, Suhonen, R, Viitanen, M, Arve, S, Stolt, M, Hupli, M, Tiit, EM, Leibur, J, Raamat, K, Armolik, A, Toivari, TTM, Navarro, M, Cabrera, E, Risco, E, Alvira, C, Farré, M, Miguel, S, Soto, M, Milhet, A, Sourdet, S, Gillette, S & Vellas, B 2018, 'Potentially inappropriate medication among people with dementia in eight European countries', Age and Ageing, vol. 47, no. 1, pp. 68-74. https://doi.org/10.1093/ageing/afx147

TY - JOUR

T1 - Potentially inappropriate medication among people with dementia in eight European countries

AU - Renom-Guiteras, Anna

AU - Thürmann, Petra A.

AU - Miralles, Ramón

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 - Sauerland, Dirk

AU - Wuebker, Ansgar

AU - Bremer, Patrick

AU - Hamersb, Jan P.H.

AU - Afram, Basema

AU - Beerens, Hanneke C.

AU - Verbeek, Hilde

AU - Zwakhalen, Sandra M.G.

AU - Ruwaard, Dirk

AU - Ambergen, Ton

AU - Emilsson, Ulla Melin

AU - Karlsson, Staffan

AU - Bokberg, Christina

AU - Lethin, Connie

AU - Challis, David

AU - Sutcliffe, Caroline

AU - Tucker, Sue

AU - Bowns, Ian

AU - Roe, Brenda

AU - Burns, Alistair

AU - Koskenniemi, Jaana

AU - Suhonen, Riitta

AU - Viitanen, Matti

AU - Arve, Seija

AU - Stolt, Minna

AU - Hupli, Maija

AU - Tiit, Ene Margit

AU - Leibur, Jelena

AU - Raamat, Katrin

AU - Armolik, Angelika

AU - Toivari, Teija Tuula Marjatta

AU - Navarro, Montserrat

AU - Cabrera, Esther

AU - Risco, Ester

AU - Alvira, Carme

AU - Farré, Marta

AU - Miguel, Susana

AU - Soto, Maria

AU - Milhet, Agathe

AU - Sourdet, Sandrine

AU - Gillette, Sophie

AU - Vellas, Bruno

PY - 2018/1/1

Y1 - 2018/1/1

N2 - © 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.

AB - © 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.

KW - Aged

KW - Inappropriate prescribing

KW - Older people

KW - Potentially inappropriate medication list

KW - Proton-pump inhibitors

KW - Psychotropic drugs

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 -

Potentially inappropriate medication among people with dementia in eight European countries

Abstract

Keywords

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