Prevalence of Potentially Inappropriate Medication Use in Older Inpatients with and without Cognitive Impairment: A Systematic Review

2018 ◽  
Vol 61 (4) ◽  
pp. 1639-1652 ◽  
Author(s):  
Mitchell R. Redston ◽  
Sarah N. Hilmer ◽  
Andrew J. McLachlan ◽  
Alexander J. Clough ◽  
Danijela Gnjidic
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Inappropriate Medication ◽  
Medication Use ◽  
Potentially Inappropriate Medication ◽  
Inappropriate Medication Use ◽  
Older Inpatients

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

2017 ◽  
Vol 150 (3) ◽  
pp. 169-183 ◽  
Author(s):  
Tejal Patel ◽  
Karen Slonim ◽  
Linda Lee
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Adverse Events ◽  
Inappropriate Medication ◽  
Medication Use ◽  
Adverse Outcomes ◽  
Potentially Inappropriate Medication ◽  
Potentially Inappropriate Medications ◽  
Inappropriate Medication Use ◽  
Inappropriate Medications

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. Methods: MEDLINE, EMBASE, CINAHL, and International Pharmaceutical Abstracts were searched between 1946 and 2014 for articles that referenced potentially inappropriate medication use and types of dementia. One reviewer screened all titles and abstracts from the initial search and full-text articles after the initial screen for eligibility, then 2 reviewers independently abstracted data from included studies. Results: Searches yielded 81 articles, of which 7 met inclusion criteria. Prevalence of potentially inappropriate medication use varied from 15% to 46.8%. No single drug or drug class was reported consistently across all studies as the most frequent potentially inappropriate medication, but anticholinergics and benzodiazepines, drugs that affect cognition, were among the most common medications or pharmacological classes listed. Discussion: Older adults with dementia may be particularly vulnerable to potentially inappropriate medications because of cognitive impairment from their condition and the greater likelihood of experiencing adverse events from medications. Given this population’s greater susceptibility to adverse events, more intense medication and patient monitoring may be warranted, especially among those taking anticholinergics and benzodiazepines, as these drugs can contribute to cognitive impairment.

Polypharmacy and Potentially Inappropriate Medication Use in Older Blacks with Diabetes Mellitus Presenting to the Emergency Department

2021 ◽  
pp. 089826432110455
Author(s):  
Ginah Nightingale ◽  
Emily M. Scopelliti ◽  
Robin Casten ◽  
Monica Woloshin ◽  
Shu Xiao ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Emergency Department ◽  
Controlled Trial ◽  
Inappropriate Medication ◽  
Medication Use ◽  
Potentially Inappropriate Medication ◽  
Cross Sectional ◽  
Randomized Controlled ◽  
Inappropriate Medication Use ◽  
Sectional Analysis

Background: Medication-related problems in older Blacks with diabetes mellitus (DM) are not well established. Objectives: To describe the frequency of medication-related problems in older Blacks with DM presenting to the emergency department (ED). Methods: The study was a cross-sectional analysis of baseline data from a randomized controlled trial evaluating Blacks aged ≥60 years of age presenting to the ED. Polypharmacy, potentially inappropriate medication (PIM) use, and anticholinergic score were evaluated. Results: Of 168 patients (median age = 68, range 60–92), most ( n = 164, 98%) were taking ≥5 medications, and 67 (39.9%) were taking a PIM. A majority ( n = 124, 74%) were taking a medication with an anticholinergic score ≥1. Number of medications was correlated with number of PIMs ( r = .22, p = .004) and anticholinergic score ( r = .50, p < .001). Conclusion: Polypharmacy and PIM use was common in older Blacks with DM.

scholarly journals An Ecological Approach to Reducing Potentially Inappropriate Medication Use: Canadian Deprescribing Network

2017 ◽  
Vol 36 (1) ◽  
pp. 97-107 ◽  
Author(s):  
Cara Tannenbaum ◽  
Barbara Farrell ◽  
James Shaw ◽  
Steve Morgan ◽  
Johanna Trimble ◽  
...  
Keyword(s):  
Inappropriate Medication ◽  
Medication Use ◽  
Personnes Âgées ◽  
Potentially Inappropriate Medication ◽  
Ecological Approach ◽  
Effets Indésirables ◽  
Système De Santé ◽  
Inappropriate Medication Use ◽  
Soins De Santé ◽  
Professionnels De La Santé

RÉSUMÉLa polypharmacie est en croissance au Canada, ainsi que les effets indésirables des médicaments et les coûts associés à la drogue. Une partie de la solution peut être la déprescription—le processus planifié et contrôlé de la réduction des doses ou la cessation des médicaments qui peuvent nutrient ou qui n’offrent plus d’avantage. La déprescription peut être un processus complexe impliquant des patients, les professionnels de la santé et des facteurs de politique et d’organisation qui peuvent servir comme facilitateurs ou obstacles. Cet article décrit la justification, le fondement théorique et le processus de développement d’un Réseau canadien de dépréscription (ReCaD), un réseau d’individus, d’organisations et de décideurs engagés à promouvoir l’utilisation appropriée des médicaments et des approches non pharmacologiques aux soins parmi les personnes âgées au Canada. ReCaD déploiera plusieurs niveaux d’action à travers des groupes de parties prenantes multiples simultanément dans une approche écologique à l’évolution du système de santé. ReCaD propose un modèle unique qui pourrait être appliqué à la fois dans les contextes nationaux et aux différents défis de transformation dans les soins de santé.

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