Tags

Type your tag names separated by a space and hit enter

Investigating polypharmacy and drug burden index in hospitalised older people.
Intern Med J 2013; 43(8):912-8IM

Abstract

AIMS

To investigate the changes in polypharmacy and the drug burden index (DBI) occurring during hospitalisation for older people. The secondary aim was to examine the associations of these two measures with the length of hospital stay and admission for falls or delirium.

METHODS

A retrospective analysis of patients' medical records was undertaken at a large university teaching hospital (Sydney, Australia) for patients with the age of ≥ 65 years and admitted under the care of the geriatric medicine or rehabilitation teams. Polypharmacy was defined as the use of more than five regular medications. The DBI measures exposure to drugs with anticholinergic and sedative effects. Logistic regression analysis was conducted to investigate the associations between polypharmacy and DBI with outcome measures. Data are presented using odds ratios with 95% confidence intervals.

RESULTS

A total of 329 patients was included in this study. The mean (± standard deviation) age of the population was 84.6 ± 7.0 years, 62% were female and 40% were admitted from residential aged-care facilities. On admission, polypharmacy was observed in 60% of the cohort and DBI exposure for 50%. DBI and polypharmacy exposure decreased during hospitalisation, but only the number of medications taken decreased by a statistically significant margin (P = 0.02). Patients with a high DBI (≥ 1) were approximately three times more likely to be admitted for delirium than those with no DBI exposure (odds ratio, 2.95; 95% confidence interval, 1.34-6.51).

CONCLUSIONS

In the present study, DBI was associated with an increased risk of hospital admission for delirium only. Polypharmacy was not associated with any of the clinical measures.

Authors+Show Affiliations

Faculty of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23734965

Citation

Best, O, et al. "Investigating Polypharmacy and Drug Burden Index in Hospitalised Older People." Internal Medicine Journal, vol. 43, no. 8, 2013, pp. 912-8.
Best O, Gnjidic D, Hilmer SN, et al. Investigating polypharmacy and drug burden index in hospitalised older people. Intern Med J. 2013;43(8):912-8.
Best, O., Gnjidic, D., Hilmer, S. N., Naganathan, V., & McLachlan, A. J. (2013). Investigating polypharmacy and drug burden index in hospitalised older people. Internal Medicine Journal, 43(8), pp. 912-8. doi:10.1111/imj.12203.
Best O, et al. Investigating Polypharmacy and Drug Burden Index in Hospitalised Older People. Intern Med J. 2013;43(8):912-8. PubMed PMID: 23734965.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Investigating polypharmacy and drug burden index in hospitalised older people. AU - Best,O, AU - Gnjidic,D, AU - Hilmer,S N, AU - Naganathan,V, AU - McLachlan,A J, PY - 2013/04/16/received PY - 2013/05/20/accepted PY - 2013/6/6/entrez PY - 2013/6/6/pubmed PY - 2014/3/25/medline KW - adverse drug reaction KW - aged KW - delirium KW - drug burden index KW - fall KW - polypharmacy SP - 912 EP - 8 JF - Internal medicine journal JO - Intern Med J VL - 43 IS - 8 N2 - AIMS: To investigate the changes in polypharmacy and the drug burden index (DBI) occurring during hospitalisation for older people. The secondary aim was to examine the associations of these two measures with the length of hospital stay and admission for falls or delirium. METHODS: A retrospective analysis of patients' medical records was undertaken at a large university teaching hospital (Sydney, Australia) for patients with the age of ≥ 65 years and admitted under the care of the geriatric medicine or rehabilitation teams. Polypharmacy was defined as the use of more than five regular medications. The DBI measures exposure to drugs with anticholinergic and sedative effects. Logistic regression analysis was conducted to investigate the associations between polypharmacy and DBI with outcome measures. Data are presented using odds ratios with 95% confidence intervals. RESULTS: A total of 329 patients was included in this study. The mean (± standard deviation) age of the population was 84.6 ± 7.0 years, 62% were female and 40% were admitted from residential aged-care facilities. On admission, polypharmacy was observed in 60% of the cohort and DBI exposure for 50%. DBI and polypharmacy exposure decreased during hospitalisation, but only the number of medications taken decreased by a statistically significant margin (P = 0.02). Patients with a high DBI (≥ 1) were approximately three times more likely to be admitted for delirium than those with no DBI exposure (odds ratio, 2.95; 95% confidence interval, 1.34-6.51). CONCLUSIONS: In the present study, DBI was associated with an increased risk of hospital admission for delirium only. Polypharmacy was not associated with any of the clinical measures. SN - 1445-5994 UR - https://www.unboundmedicine.com/medline/citation/23734965/Investigating_polypharmacy_and_drug_burden_index_in_hospitalised_older_people_ L2 - https://doi.org/10.1111/imj.12203 DB - PRIME DP - Unbound Medicine ER -