Potentially inappropriate prescribing in people with dementia: An Australian population‐based study
Objective To investigate the prevalence of potentially inappropriate prescribing (PIP) using the Screening Tool of Older Person's Prescriptions (STOPP) criteria in people with dementia compared with people without dementia. Methods A retrospective cohort study was conducted using the Pharmaceut...
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| Veröffentlicht in: | International journal of geriatric psychiatry 2019-10, Vol.34 (10), p.1498-1505 |
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| container_title | International journal of geriatric psychiatry |
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| creator | Eshetie, Tesfahun C. Nguyen, Tuan A. Gillam, Marianne H. Kalisch Ellett, Lisa M. |
| description | Objective
To investigate the prevalence of potentially inappropriate prescribing (PIP) using the Screening Tool of Older Person's Prescriptions (STOPP) criteria in people with dementia compared with people without dementia.
Methods
A retrospective cohort study was conducted using the Pharmaceutical Benefits Scheme 10% sample of pharmacy claims. People with dementia were defined as those dispensed a medicine for dementia (cholinesterase inhibitors, memantine, or risperidone for behavioural and psychological symptoms of dementia) between 1 January 2005 and 31 December 2015, aged 65 years or older at 1 January 2016 and alive at the end of 2016. An age‐ and gender‐matched comparison cohort of people not dispensed medicines for dementia was identified. PIP prevalence was determined between 1 January 2016 and 31 December 2016.
Results
In total, 8280 people dispensed medicines for dementia and 41 400 comparisons not dispensed medicines for dementia were included: 63% were female and the median age was 82 years. PIP prevalence was 79% among people with dementia compared with 70% among the comparison group (P |
| doi_str_mv | 10.1002/gps.5160 |
| format | Article |
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To investigate the prevalence of potentially inappropriate prescribing (PIP) using the Screening Tool of Older Person's Prescriptions (STOPP) criteria in people with dementia compared with people without dementia.
Methods
A retrospective cohort study was conducted using the Pharmaceutical Benefits Scheme 10% sample of pharmacy claims. People with dementia were defined as those dispensed a medicine for dementia (cholinesterase inhibitors, memantine, or risperidone for behavioural and psychological symptoms of dementia) between 1 January 2005 and 31 December 2015, aged 65 years or older at 1 January 2016 and alive at the end of 2016. An age‐ and gender‐matched comparison cohort of people not dispensed medicines for dementia was identified. PIP prevalence was determined between 1 January 2016 and 31 December 2016.
Results
In total, 8280 people dispensed medicines for dementia and 41 400 comparisons not dispensed medicines for dementia were included: 63% were female and the median age was 82 years. PIP prevalence was 79% among people with dementia compared with 70% among the comparison group (P < .0001). Use of anticholinergics, long‐term use of high‐dose proton pump inhibitors, and use of benzodiazepines were the most common instances of PIP in people with dementia. After adjustments for age, gender, comorbidity, and number of prescribers, people with dementia were more likely to be exposed to PIP than comparisons (adjusted OR 1.44, 95% CI, 1.35‐1.53, P < .0001).
Conclusions
PIP was more common in people dispensed medicines for dementia than comparisons. These results highlight the need for effective interventions to optimize prescribing in people with dementia.</description><identifier>ISSN: 0885-6230</identifier><identifier>EISSN: 1099-1166</identifier><identifier>DOI: 10.1002/gps.5160</identifier><identifier>PMID: 31173395</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Aged ; Aged, 80 and over ; Anticholinergics ; Australia - epidemiology ; Benzodiazepines - therapeutic use ; Cholinergic Antagonists - therapeutic use ; Cholinesterase inhibitors ; Comorbidity ; Dementia ; Dementia - drug therapy ; Dementia disorders ; Female ; Geriatric psychiatry ; Humans ; Inappropriate Prescribing - statistics & numerical data ; Male ; Medicare ; medication‐related problems ; Memantine ; Population studies ; Population-based studies ; potentially inappropriate medications ; potentially inappropriate prescribing ; Proton pump inhibitors ; Proton Pump Inhibitors - therapeutic use ; Retrospective Studies ; Risperidone</subject><ispartof>International journal of geriatric psychiatry, 2019-10, Vol.34 (10), p.1498-1505</ispartof><rights>2019 John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3490-dccce7f9a22961004c01aec1467c313689a92a0cd1805d4c39c34a7d99ddc9a13</citedby><cites>FETCH-LOGICAL-c3490-dccce7f9a22961004c01aec1467c313689a92a0cd1805d4c39c34a7d99ddc9a13</cites><orcidid>0000-0001-5063-6128 ; 0000-0001-7253-988X ; 0000-0002-9528-9278</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fgps.5160$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fgps.5160$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31173395$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Eshetie, Tesfahun C.</creatorcontrib><creatorcontrib>Nguyen, Tuan A.</creatorcontrib><creatorcontrib>Gillam, Marianne H.</creatorcontrib><creatorcontrib>Kalisch Ellett, Lisa M.</creatorcontrib><title>Potentially inappropriate prescribing in people with dementia: An Australian population‐based study</title><title>International journal of geriatric psychiatry</title><addtitle>Int J Geriatr Psychiatry</addtitle><description>Objective
To investigate the prevalence of potentially inappropriate prescribing (PIP) using the Screening Tool of Older Person's Prescriptions (STOPP) criteria in people with dementia compared with people without dementia.
Methods
A retrospective cohort study was conducted using the Pharmaceutical Benefits Scheme 10% sample of pharmacy claims. People with dementia were defined as those dispensed a medicine for dementia (cholinesterase inhibitors, memantine, or risperidone for behavioural and psychological symptoms of dementia) between 1 January 2005 and 31 December 2015, aged 65 years or older at 1 January 2016 and alive at the end of 2016. An age‐ and gender‐matched comparison cohort of people not dispensed medicines for dementia was identified. PIP prevalence was determined between 1 January 2016 and 31 December 2016.
Results
In total, 8280 people dispensed medicines for dementia and 41 400 comparisons not dispensed medicines for dementia were included: 63% were female and the median age was 82 years. PIP prevalence was 79% among people with dementia compared with 70% among the comparison group (P < .0001). Use of anticholinergics, long‐term use of high‐dose proton pump inhibitors, and use of benzodiazepines were the most common instances of PIP in people with dementia. After adjustments for age, gender, comorbidity, and number of prescribers, people with dementia were more likely to be exposed to PIP than comparisons (adjusted OR 1.44, 95% CI, 1.35‐1.53, P < .0001).
Conclusions
PIP was more common in people dispensed medicines for dementia than comparisons. These results highlight the need for effective interventions to optimize prescribing in people with dementia.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anticholinergics</subject><subject>Australia - epidemiology</subject><subject>Benzodiazepines - therapeutic use</subject><subject>Cholinergic Antagonists - therapeutic use</subject><subject>Cholinesterase inhibitors</subject><subject>Comorbidity</subject><subject>Dementia</subject><subject>Dementia - drug therapy</subject><subject>Dementia disorders</subject><subject>Female</subject><subject>Geriatric psychiatry</subject><subject>Humans</subject><subject>Inappropriate Prescribing - statistics & numerical data</subject><subject>Male</subject><subject>Medicare</subject><subject>medication‐related problems</subject><subject>Memantine</subject><subject>Population studies</subject><subject>Population-based studies</subject><subject>potentially inappropriate medications</subject><subject>potentially inappropriate prescribing</subject><subject>Proton pump inhibitors</subject><subject>Proton Pump Inhibitors - therapeutic use</subject><subject>Retrospective Studies</subject><subject>Risperidone</subject><issn>0885-6230</issn><issn>1099-1166</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMtKAzEUQIMotlbBL5ABN26m5jGvuCtFq1CwoK6HNLmtKZmHyQxldn6C3-iXmD5UEFxlcc895B6EzgkeEozp9bJ2w5gk-AD1CeY8JCRJDlEfZ1kcJpThHjpxboWxn5HsGPUYISljPO4jmFUNlI0WxnSBLkVd26q2WjQQ1BactHquy6WfBDVUtYFgrZvXQEGxXboJRmUwal1jhdHCM1XdGtHoqvx8_5gLBypwTau6U3S0EMbB2f4doJe72-fxfTh9nDyMR9NQsojjUEkpIV1wQSlP_GGRxESAJFGSSkZYknHBqcBSkQzHKpKM-z2RKs6VklwQNkBXO6-_4q0F1-SFdhKMESVUrcsp9ZV4GnPm0cs_6Kpqbel_5ynfjXqM_gqlrZyzsMh9nELYLic436TPffp8k96jF3thOy9A_YDfrT0Q7oC1NtD9K8ons6et8AvhHY7n</recordid><startdate>201910</startdate><enddate>201910</enddate><creator>Eshetie, Tesfahun C.</creator><creator>Nguyen, Tuan A.</creator><creator>Gillam, Marianne H.</creator><creator>Kalisch Ellett, Lisa M.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5063-6128</orcidid><orcidid>https://orcid.org/0000-0001-7253-988X</orcidid><orcidid>https://orcid.org/0000-0002-9528-9278</orcidid></search><sort><creationdate>201910</creationdate><title>Potentially inappropriate prescribing in people with dementia: An Australian population‐based study</title><author>Eshetie, Tesfahun C. ; Nguyen, Tuan A. ; Gillam, Marianne H. ; Kalisch Ellett, Lisa M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3490-dccce7f9a22961004c01aec1467c313689a92a0cd1805d4c39c34a7d99ddc9a13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anticholinergics</topic><topic>Australia - epidemiology</topic><topic>Benzodiazepines - therapeutic use</topic><topic>Cholinergic Antagonists - therapeutic use</topic><topic>Cholinesterase inhibitors</topic><topic>Comorbidity</topic><topic>Dementia</topic><topic>Dementia - drug therapy</topic><topic>Dementia disorders</topic><topic>Female</topic><topic>Geriatric psychiatry</topic><topic>Humans</topic><topic>Inappropriate Prescribing - statistics & numerical data</topic><topic>Male</topic><topic>Medicare</topic><topic>medication‐related problems</topic><topic>Memantine</topic><topic>Population studies</topic><topic>Population-based studies</topic><topic>potentially inappropriate medications</topic><topic>potentially inappropriate prescribing</topic><topic>Proton pump inhibitors</topic><topic>Proton Pump Inhibitors - therapeutic use</topic><topic>Retrospective Studies</topic><topic>Risperidone</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Eshetie, Tesfahun C.</creatorcontrib><creatorcontrib>Nguyen, Tuan A.</creatorcontrib><creatorcontrib>Gillam, Marianne H.</creatorcontrib><creatorcontrib>Kalisch Ellett, Lisa M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of geriatric psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Eshetie, Tesfahun C.</au><au>Nguyen, Tuan A.</au><au>Gillam, Marianne H.</au><au>Kalisch Ellett, Lisa M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Potentially inappropriate prescribing in people with dementia: An Australian population‐based study</atitle><jtitle>International journal of geriatric psychiatry</jtitle><addtitle>Int J Geriatr Psychiatry</addtitle><date>2019-10</date><risdate>2019</risdate><volume>34</volume><issue>10</issue><spage>1498</spage><epage>1505</epage><pages>1498-1505</pages><issn>0885-6230</issn><eissn>1099-1166</eissn><abstract>Objective
To investigate the prevalence of potentially inappropriate prescribing (PIP) using the Screening Tool of Older Person's Prescriptions (STOPP) criteria in people with dementia compared with people without dementia.
Methods
A retrospective cohort study was conducted using the Pharmaceutical Benefits Scheme 10% sample of pharmacy claims. People with dementia were defined as those dispensed a medicine for dementia (cholinesterase inhibitors, memantine, or risperidone for behavioural and psychological symptoms of dementia) between 1 January 2005 and 31 December 2015, aged 65 years or older at 1 January 2016 and alive at the end of 2016. An age‐ and gender‐matched comparison cohort of people not dispensed medicines for dementia was identified. PIP prevalence was determined between 1 January 2016 and 31 December 2016.
Results
In total, 8280 people dispensed medicines for dementia and 41 400 comparisons not dispensed medicines for dementia were included: 63% were female and the median age was 82 years. PIP prevalence was 79% among people with dementia compared with 70% among the comparison group (P < .0001). Use of anticholinergics, long‐term use of high‐dose proton pump inhibitors, and use of benzodiazepines were the most common instances of PIP in people with dementia. After adjustments for age, gender, comorbidity, and number of prescribers, people with dementia were more likely to be exposed to PIP than comparisons (adjusted OR 1.44, 95% CI, 1.35‐1.53, P < .0001).
Conclusions
PIP was more common in people dispensed medicines for dementia than comparisons. These results highlight the need for effective interventions to optimize prescribing in people with dementia.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31173395</pmid><doi>10.1002/gps.5160</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-5063-6128</orcidid><orcidid>https://orcid.org/0000-0001-7253-988X</orcidid><orcidid>https://orcid.org/0000-0002-9528-9278</orcidid></addata></record> |
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| subjects | Aged Aged, 80 and over Anticholinergics Australia - epidemiology Benzodiazepines - therapeutic use Cholinergic Antagonists - therapeutic use Cholinesterase inhibitors Comorbidity Dementia Dementia - drug therapy Dementia disorders Female Geriatric psychiatry Humans Inappropriate Prescribing - statistics & numerical data Male Medicare medication‐related problems Memantine Population studies Population-based studies potentially inappropriate medications potentially inappropriate prescribing Proton pump inhibitors Proton Pump Inhibitors - therapeutic use Retrospective Studies Risperidone |
| title | Potentially inappropriate prescribing in people with dementia: An Australian population‐based study |
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