Drug-related hospital admissions among old people with dementia
- 730 Downloads
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.
KeywordsOld people Dementia Drug-related problems Drug-related hospitalizations
This study was supported financially by grants from the Swedish Dementia Association, the County Council of Västerbotten, Janne Elgqvists foundation, the Swedish Society of Medicine and the foundation for Medical Research in Skellefteå.
Compliance with ethical standards
M. Gustafsson, B. Pfister, J. Jonsson, and H. Lövheim analyzed and interpreted the data and prepared the manuscript. M. Gustafsson, M. Sjölander, B. Pfister, J. Jonsson, J. Schneede, and H. Lövheim were responsible for the study concept and design. All authors carried out a critical revision of the manuscript, contributed with comments, and approved the final version.
Conflict of interest
The authors declare that they have no conflicts of interest.
- 14.Lauque S, Arnaud-battandier F, Gillette S, Jm P, Andrieu S, Cantet C, Vellas B (2004) Improvement of weight and fat-free mass with oral nutritional supplementation in patients with Alzheimer’s disease at risk of malnutrition: a prospective randomized study. J Am Geriatr Soc 52(10):1702–1707CrossRefPubMedGoogle Scholar
- 16.Krista LL, Nathan H, Goran E, Robert Van R, Kenton R, Claudio AN (2002) Central serotonergic activity is related to the aggressive behaviors of Alzheimer’s disease. Neuropsychopharmacology 27(4):646Google Scholar
- 21.Cipolle R, Strand L, Morely P (1998) Pharmaceutical care practice. The McGraw-Hill Companies inc, New YorkGoogle Scholar
- 22.The National Board of Health and Welfare (2010). Indikatorer för god läkemedelsterapi hos äldre. [Eng. Indicators for evaluating the quality of older people's drug therapy]. Available from http://www.socialstyrelsen.se/publikationer2010/2010-6-29. Accessed 23 Nov 2015.
- 23.Taffet G, Donohue J, Altman P (2014) Considerations for managing chronic obstructive pulmonary disease in the elderly. Clin Interv Aging:23–30Google Scholar
- 28.Gillespie U, Alassaad A, Henrohn D, Garmo H, Hammarlund-Udenaes M, Toss H, Kettis-Lindblad A, Melhus H, Morlin C (2009) A comprehensive pharmacist intervention to reduce morbidity in patients 80 years or older: a randomized controlled trial. Arch Intern Med 169(9):894–900CrossRefPubMedGoogle Scholar