Prevalence of potentially inappropriate prescription in community-dwelling patients with advanced dementia and palliative care needs
| Autor: | Olga Tornero-Torres, Raquel Fuentes-Irigoyen, Isabel Lozano-Montoya, Francisco J. Gómez-Pavón, Javier Jaramillo-Hidalgo, Pilar Tejada-González |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Drug Aging medicine.medical_specialty Palliative care media_common.quotation_subject Population Medicine (miscellaneous) Inappropriate Prescribing 03 medical and health sciences 0302 clinical medicine Pharmacotherapy Internal medicine Prevalence medicine Humans 030212 general & internal medicine Medical prescription education Potentially Inappropriate Medication List Retrospective Studies media_common Aged 80 and over Polypharmacy education.field_of_study business.industry Palliative Care Severe dementia Advanced dementia Dementia Female Independent Living Geriatrics and Gerontology business 030217 neurology & neurosurgery |
| Zdroj: | Revista Española de Geriatría y Gerontología. 56:203-207 |
| ISSN: | 0211-139X |
| Popis: | Objective To establish the prevalence of potentially inappropriate prescription (PIP) in older people with advanced dementia, monitored by a Geriatric Home Care Unit (GHC), as well as the associated risk factors and costs. Methods Community-dwelling patients ≥65 years with an advanced dementia diagnosis (GDS-FAST ≥ 7a) and poor 1-year vital prognosis (Frail-VIG ≥ 0.6) were included. Pharmacotherapy history was reviewed retrospectively, collecting functional and cognitive status, on the first GHC visit, of patients assessed January 2016–January 2019. Potentially inappropriate medication was defined following STOPP-Frail criteria. Results 100 patients included (76% women, 89.15 ± 5.8 years). Total medications prescribed 760 (7.63 ± 3.4 drugs per patient). 85% patients were given at least one drug considered to be PIP. 26% (196) of the total drugs registered were PIPs. Patients who were prescribed an inappropriate drug showed a higher number of total prescribed drugs (7.92 ± 3.42 vs 6.00 ± 2.24; p 0.04) and a higher frequency of polypharmacy (84.7% vs 60%; p 0.025). Risk of receiving inappropriate medication increased by 24% for each additional drug prescribed (OR 1.24; 95% CI 1.01–1.52; p 0.04). The costs associated with PIP were 113.99 euros per 100 patients/day; 41,606.35 euros per 100 patients/year. Conclusions Prescription of PIP to community-dwelling patients with severe dementia and poor vital prognosis is common and is associated with high economic impact in this population group. |
| Databáze: | OpenAIRE |
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