Drug-related hospital admissions among old people with dementia

Eur J Clin Pharmacol. 2016 Sep;72(9):1143-53. doi: 10.1007/s00228-016-2084-3. Epub 2016 Jul 5.

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.

Keywords: Dementia; Drug-related hospitalizations; Drug-related problems; Old people.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognition Disorders / epidemiology*
  • Dementia / epidemiology*
  • Drug-Related Side Effects and Adverse Reactions / classification
  • Drug-Related Side Effects and Adverse Reactions / epidemiology*
  • Female
  • Hospitalization / statistics & numerical data*
  • Hospitals, County / statistics & numerical data
  • Hospitals, University / statistics & numerical data
  • Humans
  • Male
  • Sweden / epidemiology