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Drug-related hospital admissions among old people with dementia.

https://arctichealth.org/en/permalink/ahliterature280643
Source
Eur J Clin Pharmacol. 2016 Sep;72(9):1143-53
Publication Type
Article
Date
Sep-2016
Author
Maria Gustafsson
Maria Sjölander
Bettina Pfister
Jeanette Jonsson
Jörn Schneede
Hugo Lövheim
Source
Eur J Clin Pharmacol. 2016 Sep;72(9):1143-53
Date
Sep-2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cognition Disorders - epidemiology
Dementia - epidemiology
Drug-Related Side Effects and Adverse Reactions - classification - epidemiology
Female
Hospitalization - statistics & numerical data
Hospitals, County - statistics & numerical data
Hospitals, University - statistics & numerical data
Humans
Male
Sweden - epidemiology
Abstract
Drug treatment associated problems are common and are the cause of a large proportion of hospitalizations in old people. People with dementia are especially at risk of drug-related problems. The objectives of this study were to assess the occurrence and character of drug-related problems that lead to acute hospital admissions among old people (=65 years) with dementia or cognitive impairment.
This study was conducted in orthopedic and internal medicine wards in two hospitals in Northern Sweden. Information about acute admissions was collected from the medical records. A total of 458 people aged 65 years or older with dementia or cognitive impairment were included in the study. The contribution of drug-related problems to each hospitalization was assessed.
Of 458 acute hospital admissions, 189 (41.3 %) were determined to be drug-related. The most common drug-related problem (86/189; 45.5 %) was an adverse drug reaction. In total, 264 drugs were judged to be involved in 189 drug-related admissions, of which cardiovascular (29.5 %) and psychotropic (26.9 %) drugs were the most commonly involved drug classes. The relationship between the drug-related problem and the admission was judged certain in 25 cases, probable in 78 cases, and possible in 86 cases. Drug-related admissions were more common among people taking more drugs (p = 0.035) and among younger patients (p = 0.031).
Drug-related problems appear to be responsible for a major proportion of hospitalizations among old people with dementia or cognitive impairment. Targeted interventions such as education and medication reviews may be warranted to reduce drug-related problems.
PubMed ID
27377393 View in PubMed
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Drug-related problems and medication reviews among old people with dementia.

https://arctichealth.org/en/permalink/ahliterature290985
Source
BMC Pharmacol Toxicol. 2017 Jun 27; 18(1):52
Publication Type
Journal Article
Randomized Controlled Trial
Date
Jun-27-2017
Author
Bettina Pfister
Jeanette Jonsson
Maria Gustafsson
Author Affiliation
Department of Pharmacology and Clinical Neuroscience, Umeå University, SE-90187, Umeå, Sweden.
Source
BMC Pharmacol Toxicol. 2017 Jun 27; 18(1):52
Date
Jun-27-2017
Language
English
Publication Type
Journal Article
Randomized Controlled Trial
Keywords
Aged
Aged, 80 and over
Cognitive Dysfunction
Dementia
Drug-Related Side Effects and Adverse Reactions - prevention & control
Female
Humans
Male
Medication Errors - prevention & control - statistics & numerical data
Medication Reconciliation
Patient care team
Pharmacists
Sweden
Abstract
Drug-related problems, including medication errors and adverse drug events, are common among old people. Due to, for example, greater susceptibility to side effects, people with dementia are even more at risk of drug-related problems. The objectives of this study were to assess the occurrence and character of drug-related problems found among old people with dementia or cognitive impairment.
Data from a randomized controlled clinical trial exploring the effects of a pharmacist intervention as part of a hospital ward team in patients 65 years and older with dementia or cognitive impairment were used. The study was conducted between 2012 and 2014 in the orthopedic and medicine wards in two hospitals located in Northern Sweden. Drug-related problems identified in this patient group were classified and described, and associations with different factors were investigated.
Clinical pharmacists identified at least one DRP in 66% (140/212) of participants in the intervention group, for a total of 310 DRPs. Ineffective drug/inappropriate drug and unnecessary drug therapy were the most common drug-related problems. Discontinuation of drug therapy was the most common action carried out. Drug-related problems were more common among people prescribed a larger number of drugs and among people with an earlier stroke.
Drug-related problems are common among people with dementia and cognitive impairment. Comprehensive medication reviews conducted by clinical pharmacists as part of a health care team might be important to prevent, identify and solve these problems.
Notes
Cites: Pharm World Sci. 2006 Jun;28(3):152-8 PMID 17004023
Cites: Drug Saf. 2012 Jan;35 Suppl 1:29-45 PMID 23446784
Cites: J Eval Clin Pract. 2007 Oct;13(5):781-8 PMID 17824872
Cites: JAMA. 2003 Apr 2;289(13):1652-8 PMID 12672733
Cites: Br J Clin Pharmacol. 1991 Mar;31(3):257-61 PMID 2054264
Cites: Drugs Aging. 1999 Jul;15(1):15-28 PMID 10459729
Cites: Br J Clin Pharmacol. 2004 Jan;57(1):6-14 PMID 14678335
Cites: Drugs Aging. 2015 May;32(5):391-400 PMID 25925940
Cites: Exp Gerontol. 2004 Nov-Dec;39(11-12):1731-8 PMID 15582289
Cites: Drugs. 2003;63(6):525-34 PMID 12656651
Cites: Arch Intern Med. 2009 May 11;169(9):894-900 PMID 19433702
Cites: J Bone Miner Metab. 2004;22(2):120-6 PMID 14999522
Cites: J Aging Health. 2009 Jun;21(4):567-80 PMID 19339680
Cites: Am J Health Syst Pharm. 2015 Sep 1;72(17 Suppl 2):S120-6 PMID 26272892
Cites: Med Care. 2010 Oct;48(10):923-33 PMID 20720510
Cites: Lancet. 1994 Apr 30;343(8905):1075-8 PMID 7909103
Cites: Neuropsychopharmacology. 2002 Oct;27(4):646-54 PMID 12377401
Cites: Drugs Aging. 2016 Dec;33(12 ):889-899 PMID 27734278
Cites: Eur J Clin Pharmacol. 2016 Sep;72 (9):1143-53 PMID 27377393
Cites: Gerontology. 2014;60(2):114-22 PMID 24246485
Cites: Ann Intern Med. 1992 Dec 15;117(12):1010-3 PMID 1443969
Cites: Eur J Clin Pharmacol. 2017 Jul;73(7):827-835 PMID 28391409
Cites: Basic Clin Pharmacol Toxicol. 2013 Jun;112(6):359-73 PMID 23506448
Cites: Pharm Res. 2015 Mar;32(3):819-39 PMID 25319097
Cites: PLoS One. 2014 Nov 03;9(11):e111797 PMID 25364817
Cites: Int Psychogeriatr. 2013 Sep;25(9):1415-23 PMID 23782794
Cites: Intern Med J. 2001 May-Jun;31(4):199-205 PMID 11456032
PubMed ID
28655357 View in PubMed
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Impact of clinical pharmacist engagement in ward teams on the number of drug-related readmissions among older patients with dementia or cognitive impairment: An economic evaluation.

https://arctichealth.org/en/permalink/ahliterature299173
Source
Res Social Adm Pharm. 2019 03; 15(3):287-291
Publication Type
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Date
03-2019
Author
Maria Sjölander
Lars Lindholm
Bettina Pfister
Jeanette Jonsson
Jörn Schneede
Hugo Lövheim
Maria Gustafsson
Author Affiliation
Department of Pharmacology and Clinical Neuroscience, Clinical Pharmacology, Umeå University, Umeå, Sweden.
Source
Res Social Adm Pharm. 2019 03; 15(3):287-291
Date
03-2019
Language
English
Publication Type
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Cognitive Dysfunction - drug therapy - economics
Dementia - drug therapy - economics
Drug-Related Side Effects and Adverse Reactions - economics
Female
Humans
Male
Medication Reconciliation
Patient Care Team - economics
Patient Readmission - economics
Pharmacists - economics
Pharmacy Service, Hospital - economics
Sweden
Abstract
Clinical pharmacists play an increasing role in the pharmacological treatment of hospital-admitted older patients with dementia or cognitive impairment. In an earlier randomised controlled trial, clinical pharmacist involvement in the ward team could significantly reduce drug-related readmissions in patient subgroups. However, the economic impact of the intervention has not been addressed so far.
To evaluate the economic impact of clinical pharmacist engagement in hospital ward teams for medication therapy management in older patients with dementia or cognitive impairments.
Economic evaluation of a randomised controlled trial conducted in two hospitals in Northern Sweden between January 2012 and December 2014. Participants included 460 hospital-admitted older patients with dementia or cognitive impairments. Patients were randomly assigned to usual care, or usual care with pharmacist intervention; the intervention consisted of medication reconciliation, medication review, and participation in ward rounds. The outcomes were measured as drug-related readmissions to hospital as assessed by a group of external experts, 180 and 30 days after discharge. Costs included pharmacists' direct labour costs for the interventions, average costs for drug-related readmissions, and from this the total cost per person was calculated.
The effect of the intervention on drug-related readmissions within 180 days was significant in patients without heart failure (subgroup analysis), and the intervention resulted in cost savings of €950 per person in this subgroup. Drug-related readmissions within 30 days were reduced in the total sample (post-hoc analysis), and the cost-savings in this intervention group were €460 per person.
Post-hoc and subgroup analyses indicate that engagement of pharmacists in hospital ward teams reduced the number of drug-related readmissions, and that the cost per person was lower in the intervention group compared to the control group. Including clinical pharmacists created savings in the subgroups of older patients with dementia or cognitive impairments.
PubMed ID
29778344 View in PubMed
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