Potentially Inappropriate Medication in Older Persons With Dementia: Does a Migration Background Matter?

Autor:	Strooij BT; Amsterdam UMC, Location Vrije Universiteit Amsterdam, Department of General Practice, Amsterdam, The Netherlands; Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands; Amsterdam Public Health, Aging & Later Life, Amsterdam, The Netherlands. Electronic address: b.strooij@amsterdamumc.nl., Blom MT; Amsterdam UMC, Location Vrije Universiteit Amsterdam, Department of General Practice, Amsterdam, The Netherlands; Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands., van Hout HPJ; Amsterdam UMC, Location Vrije Universiteit Amsterdam, Department of General Practice, Amsterdam, The Netherlands., Maarsingh OR; Amsterdam UMC, Location Vrije Universiteit Amsterdam, Department of General Practice, Amsterdam, The Netherlands; Amsterdam Public Health, Aging & Later Life, Amsterdam, The Netherlands., Elders PJM; Amsterdam UMC, Location Vrije Universiteit Amsterdam, Department of General Practice, Amsterdam, The Netherlands; Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands., van Campen JPCM; Department of Geriatrics, OLVG Hospital, Amsterdam, The Netherlands., van der Heide I; Nivel, Netherlands Institute for Health Services Research, Utrecht, The Netherlands., Verheij RA; Nivel, Netherlands Institute for Health Services Research, Utrecht, The Netherlands; Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands., Joling KJ; Amsterdam Public Health, Aging & Later Life, Amsterdam, The Netherlands; Amsterdam UMC, Location Vrije Universiteit Amsterdam, Department of Medicine for Older People, Amsterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	Journal of the American Medical Directors Association [J Am Med Dir Assoc] 2024 Sep; Vol. 25 (9), pp. 105150. Date of Electronic Publication: 2024 Jul 14.
DOI:	10.1016/j.jamda.2024.105150
Abstrakt:	Objectives: Previous research in the general population shows more potentially inappropriate medications (PIMs) among persons with a migration background compared with persons without a migration background. This study investigated the association between non-Western (nw) migration background (MB) and dementia-specific PIMs in older adults with dementia in the Netherlands. Design: Cohort study using routinely recorded electronic health records and administrative data. Setting and Participants: Electronic health record data of general practitioners from the NIVEL-Primary Care Database, were linked to registries managed by Statistics Netherlands (2013-2014). A total of 9055 community-dwelling older adults with dementia were included, among whom 294 persons had an nw-MB from Africa, South America, or Asia, based on their country of birth. Methods: We determined the presence of dementia-specific PIM prescriptions and compared this between persons with an nw-MB and without an MB, using logistic regression analysis adjusted for follow-up time, age, registered sex, and total number of prescriptions. Interaction effects of potentially relevant covariates were tested. The 3 largest nw-MB groups in the Netherlands were analyzed separately. Results: Dementia-specific PIMs were less frequently prescribed to persons with an nw-MB compared to persons without an MB with a dementia diagnosis [30.6% vs 34.4%, odds ratio (OR) 0.71, 95% CI 0.54-0.92], with especially less often a benzodiazepine prescription in the group with an nw-MB, compared to persons without an MB (15.0% vs 19.3%, OR 0.61, 95% CI 0.43-0.84). Dementia duration, living alone, household income, and degree of urbanization did not influence the associations. Conclusions and Implications: Among older adults with dementia in the Netherlands, persons with an nw-MB had less often a dementia-specific PIM prescription compared to persons without an MB. Whether this difference is a reflection of better quality of care, higher professional uncertainty, or less recognition of (mental) health problems in persons with an nw-MB and dementia, needs further investigation. Competing Interests: Disclosures The authors declare no conflicts of interest. (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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