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Comparison of Potentially Inappropriate Medications for People with Dementia at Admission and Discharge during An Unplanned Admission to Hospital: Results from the SMS Dementia Study

1
Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
2
Hunter New England Local Health District, New Lambton Heights, NSW 2305, Australia
3
Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
*
Author to whom correspondence should be addressed.
SMS stands for Safe Medication Strategy Dementia study.
Healthcare 2019, 7(1), 8; https://doi.org/10.3390/healthcare7010008
Received: 13 December 2018 / Revised: 4 January 2019 / Accepted: 7 January 2019 / Published: 9 January 2019
(This article belongs to the Special Issue Care of People Living with Dementia)
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Abstract

People with dementia (PWD) and cognitive impairment are particularly vulnerable to medication problems, and unplanned admission to hospital presents an opportunity to address polypharmacy, potentially inappropriate medications (PIMs) and anticholinergic burden. This study aimed to compare PIMS and other medication data for PWD to determine whether these changed during hospitalization. Medications documented in patient’s records at admission and discharge were evaluated for PWD recruited to phase one of a prospective quasi-experimental pre/post-controlled trial that was conducted at two regional hospitals in NSW, Australia. The study sample included PWD or cognitive impairment having an unplanned admission to hospital. Data were collected using a purpose developed audit tool for medications and PIMs, and a Modified Anticholinergic Burden Scale. Total participants were 277, and results determined that the cognitive status of PWD is not always detected during an unplanned admission. This may make them more vulnerable to medication problems and poor outcomes. Polypharmacy and PIMS for PWD were high at admission and significantly reduced at discharge. However, PWD should be routinely identified as high risk at admission; and there is potential to further reduce polypharmacy and PIMs during admission to hospital, particularly psychotropic medications at discharge. Future studies should focus on evaluating targeted interventions designed to increase medication safety for PWD. View Full-Text
Keywords: polypharmacy; potentially inappropriate medications; people with dementia; anticholinergic burden; unplanned admission polypharmacy; potentially inappropriate medications; people with dementia; anticholinergic burden; unplanned admission
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Kable, A.; Fullerton, A.; Fraser, S.; Palazzi, K.; Hullick, C.; Oldmeadow, C.; Pond, D.; Searles, A.; Edmunds, K.; Attia, J.; On behalf of SMS Dementia Study investigators. Comparison of Potentially Inappropriate Medications for People with Dementia at Admission and Discharge during An Unplanned Admission to Hospital: Results from the SMS Dementia Study. Healthcare 2019, 7, 8.

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