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Drug-related hospital admissions among old people with dementia

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusion

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.

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Acknowledgments

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.

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Authors and Affiliations

  1. Department of Pharmacology and Clinical Neuroscience, Division of Clinical Pharmacology, Umeå University, Umeå, Sweden

    Maria Gustafsson, Maria Sjölander, Bettina Pfister, Jeanette Jonsson & Jörn Schneede

  2. Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden

    Maria Gustafsson & Hugo Lövheim

Authors
  1. Maria Gustafsson
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  2. Maria Sjölander
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  3. Bettina Pfister
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  4. Jeanette Jonsson
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  5. Jörn Schneede
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  6. Hugo Lövheim
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Corresponding author

Correspondence to Maria Gustafsson.

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Author’s contributions

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.

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Gustafsson, M., Sjölander, M., Pfister, B. et al. Drug-related hospital admissions among old people with dementia. Eur J Clin Pharmacol 72, 1143–1153 (2016). https://doi.org/10.1007/s00228-016-2084-3

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  • DOI: https://doi.org/10.1007/s00228-016-2084-3

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