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Effects of Pharmacists’ Interventions on Inappropriate Drug Use and Drug-Related Readmissions in People with Dementia—A Secondary Analysis of a Randomized Controlled Trial

Age-associated physiological changes and extensive drug treatment including use of potentially inappropriate medications (PIMs) pose a significant risk of drug–drug interactions and adverse drug events among elderly people with dementia. This study aimed at analysing the effects of clinical pharmaci...

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Autores principales: Gustafsson, Maria, Sjölander, Maria, Pfister, Bettina, Schneede, Jörn, Lövheim, Hugo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874546/
https://www.ncbi.nlm.nih.gov/pubmed/29337859
http://dx.doi.org/10.3390/pharmacy6010007
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author Gustafsson, Maria
Sjölander, Maria
Pfister, Bettina
Schneede, Jörn
Lövheim, Hugo
author_facet Gustafsson, Maria
Sjölander, Maria
Pfister, Bettina
Schneede, Jörn
Lövheim, Hugo
author_sort Gustafsson, Maria
collection PubMed
description Age-associated physiological changes and extensive drug treatment including use of potentially inappropriate medications (PIMs) pose a significant risk of drug–drug interactions and adverse drug events among elderly people with dementia. This study aimed at analysing the effects of clinical pharmacists’ interventions on use of PIMs, risk of emergency department visits, and time to institutionalization. Furthermore, a descriptive analysis was conducted of circumstances associated with drug-related readmissions. This is a secondary analysis of data from a randomized controlled intervention study conducted in two hospitals in Northern Sweden. The study included patients (n = 460) 65 years or older with dementia or cognitive impairment. The intervention consisted of comprehensive medication reviews conducted by clinical pharmacists as part of a healthcare team. There was a larger decrease in PIMs in the intervention group compared with the control group (p = 0.011). No significant difference was found in time to first all-cause emergency department visits (HR = 0.994, 95% CI = 0.755–1.307 p = 0.963, simple Cox regression) or time to institutionalization (HR = 0.761, 95% CI = 0.409–1.416 p = 0.389, simple Cox regression) within 180 days. Common reasons for drug-related readmissions were negative effects of sedatives, opioids, antidepressants, and anticholinergic agents, resulting in confusion, falling, and sedation. Drug-related readmissions were associated with living at home, heart failure, and diabetes. Pharmacist-provided interventions were able to reduce PIMs among elderly people with dementia and cognitive impairment.
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spelling pubmed-58745462018-04-02 Effects of Pharmacists’ Interventions on Inappropriate Drug Use and Drug-Related Readmissions in People with Dementia—A Secondary Analysis of a Randomized Controlled Trial Gustafsson, Maria Sjölander, Maria Pfister, Bettina Schneede, Jörn Lövheim, Hugo Pharmacy (Basel) Article Age-associated physiological changes and extensive drug treatment including use of potentially inappropriate medications (PIMs) pose a significant risk of drug–drug interactions and adverse drug events among elderly people with dementia. This study aimed at analysing the effects of clinical pharmacists’ interventions on use of PIMs, risk of emergency department visits, and time to institutionalization. Furthermore, a descriptive analysis was conducted of circumstances associated with drug-related readmissions. This is a secondary analysis of data from a randomized controlled intervention study conducted in two hospitals in Northern Sweden. The study included patients (n = 460) 65 years or older with dementia or cognitive impairment. The intervention consisted of comprehensive medication reviews conducted by clinical pharmacists as part of a healthcare team. There was a larger decrease in PIMs in the intervention group compared with the control group (p = 0.011). No significant difference was found in time to first all-cause emergency department visits (HR = 0.994, 95% CI = 0.755–1.307 p = 0.963, simple Cox regression) or time to institutionalization (HR = 0.761, 95% CI = 0.409–1.416 p = 0.389, simple Cox regression) within 180 days. Common reasons for drug-related readmissions were negative effects of sedatives, opioids, antidepressants, and anticholinergic agents, resulting in confusion, falling, and sedation. Drug-related readmissions were associated with living at home, heart failure, and diabetes. Pharmacist-provided interventions were able to reduce PIMs among elderly people with dementia and cognitive impairment. MDPI 2018-01-16 /pmc/articles/PMC5874546/ /pubmed/29337859 http://dx.doi.org/10.3390/pharmacy6010007 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gustafsson, Maria
Sjölander, Maria
Pfister, Bettina
Schneede, Jörn
Lövheim, Hugo
Effects of Pharmacists’ Interventions on Inappropriate Drug Use and Drug-Related Readmissions in People with Dementia—A Secondary Analysis of a Randomized Controlled Trial
title Effects of Pharmacists’ Interventions on Inappropriate Drug Use and Drug-Related Readmissions in People with Dementia—A Secondary Analysis of a Randomized Controlled Trial
title_full Effects of Pharmacists’ Interventions on Inappropriate Drug Use and Drug-Related Readmissions in People with Dementia—A Secondary Analysis of a Randomized Controlled Trial
title_fullStr Effects of Pharmacists’ Interventions on Inappropriate Drug Use and Drug-Related Readmissions in People with Dementia—A Secondary Analysis of a Randomized Controlled Trial
title_full_unstemmed Effects of Pharmacists’ Interventions on Inappropriate Drug Use and Drug-Related Readmissions in People with Dementia—A Secondary Analysis of a Randomized Controlled Trial
title_short Effects of Pharmacists’ Interventions on Inappropriate Drug Use and Drug-Related Readmissions in People with Dementia—A Secondary Analysis of a Randomized Controlled Trial
title_sort effects of pharmacists’ interventions on inappropriate drug use and drug-related readmissions in people with dementia—a secondary analysis of a randomized controlled trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874546/
https://www.ncbi.nlm.nih.gov/pubmed/29337859
http://dx.doi.org/10.3390/pharmacy6010007
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