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Effects of a Medication Review on Delirium in Older Hospitalised Patients: A Comparative Retrospective Cohort Study

BACKGROUND: Delirium in older hospitalised patients is a common and serious disorder. Polypharmacy and certain medications are risk factors for developing delirium. A medication review could benefit older hospitalised patients with delirium. OBJECTIVES: (1) Evaluate the effects of medication review...

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Autores principales: van Velthuijsen, Eveline L., Zwakhalen, Sandra M. G., Pijpers, Evelien, van de Ven, Liesbeth I., Ambergen, Ton, Mulder, Wubbo J., Verhey, Frans R. J., Kempen, Gertrudis I. J. M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5847150/
https://www.ncbi.nlm.nih.gov/pubmed/29396715
http://dx.doi.org/10.1007/s40266-018-0523-9
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author van Velthuijsen, Eveline L.
Zwakhalen, Sandra M. G.
Pijpers, Evelien
van de Ven, Liesbeth I.
Ambergen, Ton
Mulder, Wubbo J.
Verhey, Frans R. J.
Kempen, Gertrudis I. J. M.
author_facet van Velthuijsen, Eveline L.
Zwakhalen, Sandra M. G.
Pijpers, Evelien
van de Ven, Liesbeth I.
Ambergen, Ton
Mulder, Wubbo J.
Verhey, Frans R. J.
Kempen, Gertrudis I. J. M.
author_sort van Velthuijsen, Eveline L.
collection PubMed
description BACKGROUND: Delirium in older hospitalised patients is a common and serious disorder. Polypharmacy and certain medications are risk factors for developing delirium. A medication review could benefit older hospitalised patients with delirium. OBJECTIVES: (1) Evaluate the effects of medication review on length of delirium, length of hospital stay, mortality, and discharge destination; and (2) describe and analyse the proposed changes to medication and its implementation by the treating physician. SETTING: The study was conducted at Maastricht University Medical Centre+. METHODS: We compared two cohorts of older patients with delirium: the first cohort from before introducing the medication review, and a second cohort 5 months after introduction of the medication review. Data were extracted from the patients’ digital medical records. RESULTS: A significant interaction effect of cohort and number of medications taken by the patient was found for duration of delirium: patients from the second cohort taking between zero and six medications had significantly shorter delirious episodes than patients in the first cohort. This effect bordered on significance for patients taking between seven and 11 medications, but disappeared for patients taking 12 or more medications. No other statistically significant differences were found between the cohorts. The proposed changes in medication were implemented for 71% of the patients. CONCLUSION: A medication review seems to significantly decrease the length of an older patient’s delirious episode. Given the clinical relevance of these findings, we advise medication reviews for all older patients who are delirious or are at risk of developing delirium. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40266-018-0523-9) contains supplementary material, which is available to authorized users.
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spelling pubmed-58471502018-03-20 Effects of a Medication Review on Delirium in Older Hospitalised Patients: A Comparative Retrospective Cohort Study van Velthuijsen, Eveline L. Zwakhalen, Sandra M. G. Pijpers, Evelien van de Ven, Liesbeth I. Ambergen, Ton Mulder, Wubbo J. Verhey, Frans R. J. Kempen, Gertrudis I. J. M. Drugs Aging Original Research Article BACKGROUND: Delirium in older hospitalised patients is a common and serious disorder. Polypharmacy and certain medications are risk factors for developing delirium. A medication review could benefit older hospitalised patients with delirium. OBJECTIVES: (1) Evaluate the effects of medication review on length of delirium, length of hospital stay, mortality, and discharge destination; and (2) describe and analyse the proposed changes to medication and its implementation by the treating physician. SETTING: The study was conducted at Maastricht University Medical Centre+. METHODS: We compared two cohorts of older patients with delirium: the first cohort from before introducing the medication review, and a second cohort 5 months after introduction of the medication review. Data were extracted from the patients’ digital medical records. RESULTS: A significant interaction effect of cohort and number of medications taken by the patient was found for duration of delirium: patients from the second cohort taking between zero and six medications had significantly shorter delirious episodes than patients in the first cohort. This effect bordered on significance for patients taking between seven and 11 medications, but disappeared for patients taking 12 or more medications. No other statistically significant differences were found between the cohorts. The proposed changes in medication were implemented for 71% of the patients. CONCLUSION: A medication review seems to significantly decrease the length of an older patient’s delirious episode. Given the clinical relevance of these findings, we advise medication reviews for all older patients who are delirious or are at risk of developing delirium. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40266-018-0523-9) contains supplementary material, which is available to authorized users. Springer International Publishing 2018-02-02 2018 /pmc/articles/PMC5847150/ /pubmed/29396715 http://dx.doi.org/10.1007/s40266-018-0523-9 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Research Article
van Velthuijsen, Eveline L.
Zwakhalen, Sandra M. G.
Pijpers, Evelien
van de Ven, Liesbeth I.
Ambergen, Ton
Mulder, Wubbo J.
Verhey, Frans R. J.
Kempen, Gertrudis I. J. M.
Effects of a Medication Review on Delirium in Older Hospitalised Patients: A Comparative Retrospective Cohort Study
title Effects of a Medication Review on Delirium in Older Hospitalised Patients: A Comparative Retrospective Cohort Study
title_full Effects of a Medication Review on Delirium in Older Hospitalised Patients: A Comparative Retrospective Cohort Study
title_fullStr Effects of a Medication Review on Delirium in Older Hospitalised Patients: A Comparative Retrospective Cohort Study
title_full_unstemmed Effects of a Medication Review on Delirium in Older Hospitalised Patients: A Comparative Retrospective Cohort Study
title_short Effects of a Medication Review on Delirium in Older Hospitalised Patients: A Comparative Retrospective Cohort Study
title_sort effects of a medication review on delirium in older hospitalised patients: a comparative retrospective cohort study
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5847150/
https://www.ncbi.nlm.nih.gov/pubmed/29396715
http://dx.doi.org/10.1007/s40266-018-0523-9
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