Use of Potentially Harmful Medications and Health-Related Quality of Life among People with Dementia Living in Residential Aged Care Facilities
Open Access
- 7 September 2012
- journal article
- research article
- Published by S. Karger AG in Dementia and Geriatric Cognitive Disorders Extra
- Vol. 2 (1), 361-371
- https://doi.org/10.1159/000342172
Abstract
Background: Use of potentially harmful medications (PHMs) is common in people with dementia living in Residential Aged Care Facilities (RACFs) and increases the risk of adverse health outcomes. Debate persists as to how PHM use and its association with quality of life should be measured. We designed this study to determine the association of exposure to PHM, operationalized by three different measures, with self-reported Health-Related Quality of Life among people with dementia residing in RACFs. Methods: Cross-sectional study of 351 people aged >65 years diagnosed with dementia residing in RACFs and with MMSE ≤24. The primary outcome measure was the self-rated Quality of Life – Alzheimer’s disease questionnaire (QoL-AD). We collected data on patients’ medications, age, gender, MMSE total score, Neuropsychiatric Inventory total score, and comorbidities. Using regression analyses, we calculated crude and adjusted mean differences between groups exposed and not exposed to PHM according to potentially inappropriate medications (PIMs; identified by Modified Beers criteria), Drug Burden Index (DBI) >0 and polypharmacy (i.e. ≥5 medications). Results: Of 226 participants able to rate their QoL-AD, 56.41% were exposed to at least one PIM, 82.05% to medication contributing to DBI >0, and 91.74% to polypharmacy. Exposure to PIMs was not associated with self-reported QoL-AD ratings, while exposure to DBI >0 and polypharmacy were (also after adjustment); exposure to DBI >0 tripled the odds of lower QoL-AD ratings. Conclusion: Exposure to PHM, as identified by DBI >0 and by polypharmacy (i.e. ≥5 medications), but not by PIMs (Modified Beers criteria), is inversely associated with self-reported health-related quality of life for people with dementia living in RACFs.This publication has 39 references indexed in Scilit:
- Medication quality and quality of life in the elderly, a cohort studyHealth and Quality of Life Outcomes, 2011
- Quality use of medicines and health outcomes among a cohort of community dwelling older men: an observational studyBritish Journal of Clinical Pharmacology, 2010
- Dementia in residential care: education intervention trial (DIRECT); protocol for a randomised controlled trialTrials, 2010
- Drug Burden Index Score and Functional Decline in Older PeopleThe American Journal of Medicine, 2009
- Drug Burden Index and physical function in older Australian menBritish Journal of Clinical Pharmacology, 2009
- Inappropriate prescribing and adverse drug events in older peopleBMC Geriatrics, 2009
- Inappropriate Medication Use and Prescribing Indicators in Elderly AustraliansDrugs & Aging, 2008
- Hospitalization and Death Associated With Potentially Inappropriate Medication Prescriptions Among Elderly Nursing Home ResidentsArchives of Internal Medicine, 2005
- The Association of Inappropriate Drug Use with Hospitalisation and MortalityDrugs & Aging, 2005
- Association between falls in elderly women and chronic diseases and drug use: cross sectional studyBMJ, 2003