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. 2020 Dec;86(12):2414-2423.
doi: 10.1111/bcp.14345. Epub 2020 Jun 1.

Potentially inappropriate medication use and related hospital admissions in aged care residents: The impact of dementia

Tesfahun C Eshetie  1 , Greg Roberts  2 , Tuan A Nguyen  1 , Marianne H Gillam  1 , Dorsa Maher  2   3 , Lisa M Kalisch Ellett  1
Affiliations

Potentially inappropriate medication use and related hospital admissions in aged care residents: The impact of dementia

Tesfahun C Eshetie et al. Br J Clin Pharmacol. 2020 Dec.

Abstract

Aims: To determine the prevalence of potentially inappropriate medication (PIM) use at hospital admission and discharge, and the contribution to hospital admission among residential aged care facility residents with and without dementia.

Methods: We conducted a secondary analysis using data from a multihospital prospective cohort study involving consecutively admitted older adults, aged 75 years or older, who were taking 5 or more medications prior to hospital admission and discharged to a residential aged care facility in South Australia. PIM use was identified using the 2015 Screening Tool for Older Persons' Prescription and 2019 Beers criteria. An expert panel of clinicians with geriatric medicine expertise evaluated the contribution of PIM to hospital admission.

Results: In total, 181 participants were included, the median age was 87.5 years and 54.7% were female. Ninety-one (50.3%) had a diagnosis of dementia. Participants with dementia had fewer PIMs, according to at least 1 of the 2 screening criteria, than those without dementia, at admission (dementia: 76 [83.5%] vs no dementia: 84 [93.3%], P = .04) and discharge (78 [85.7%] vs 83 [92.2%], P = .16). PIM use was causal or contributory to the admission in 28.1% of study participants (n = 45) who were taking at least 1 PIM at admission.

Conclusions: Over 80% of acutely admitted older adults took PIMs at hospital admission and discharge and for over a quarter of these people the admissions were attributable to PIM use. Hospitalisation presents an opportunity for comprehensive medication reviews, and targeted interventions that enhance such a process could reduce PIM use and related harm.

Keywords: Beers criteria; STOPP criteria; dementia; long term care; medication-related hospitalisation; potentially inappropriate medication; residential aged care facility.

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Conflict of interest statement

There are no competing interest to declare.

Figures

FIGURE 1
FIGURE 1
Study flow chart
FIGURE 2
FIGURE 2
Percentage and types of potentially inappropriate medication (PIM)‐related events causal or contributory to the admission in the study cohort
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