Systems to identify potentially inappropriate prescribing in people with advanced dementia: A systematic review

Disalvo, D; Luckett, T; Agar, M; Bennett, A; Davidson, PM

Systems to identify potentially inappropriate prescribing in people with advanced dementia: A systematic review

Disalvo, D Luckett, T

Agar, M

Bennett, A Davidson, PM

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Publication Type:: Journal Article
Citation:: BMC Geriatrics, 2016, 16 (1)
Issue Date:: 2016-05-31

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Field	Value	Language
dc.contributor.author	Disalvo, D	en_US
dc.contributor.author	Luckett, T https://orcid.org/0000-0001-6121-5409	en_US
dc.contributor.author	Agar, M https://orcid.org/0000-0002-6756-6119	en_US
dc.contributor.author	Bennett, A	en_US
dc.contributor.author	Davidson, PM https://orcid.org/0000-0003-2050-1534	en_US
dc.date.available	2016-05-23	en_US
dc.date.issued	2016-05-31	en_US
dc.identifier.citation	BMC Geriatrics, 2016, 16 (1)	en_US
dc.identifier.uri	http://hdl.handle.net/10453/117799
dc.description.abstract	© 2016 The Author(s). Background: Systems for identifying potentially inappropriate medications in older adults are not immediately transferrable to advanced dementia, where the management goal is palliation. The aim of the systematic review was to identify and synthesise published systems and make recommendations for identifying potentially inappropriate prescribing in advanced dementia. Methods: Studies were included if published in a peer-reviewed English language journal and concerned with identifying the appropriateness or otherwise of medications in advanced dementia or dementia and palliative care. The quality of each study was rated using the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist. Synthesis was narrative due to heterogeneity among designs and measures. Medline (OVID), CINAHL, the Cochrane Database of Systematic Reviews (2005 - August 2014) and AMED were searched in October 2014. Reference lists of relevant reviews and included articles were searched manually. Results: Eight studies were included, all of which were scored a high quality using the STROBE checklist. Five studies used the same system developed by the Palliative Excellence in Alzheimer Care Efforts (PEACE) Program. One study used number of medications as an index, and two studies surveyed health professionals' opinions on appropriateness of specific medications in different clinical scenarios. Conclusions: Future research is needed to develop and validate systems with clinical utility for improving safety and quality of prescribing in advanced dementia. Systems should account for individual clinical context and distinguish between deprescribing and initiation of medications.	en_US
dc.relation.ispartof	BMC Geriatrics	en_US
dc.relation.isbasedon	10.1186/s12877-016-0289-z	en_US
dc.subject.classification	Geriatrics	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Dementia	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Medication Therapy Management	en_US
dc.subject.mesh	Drug Prescriptions	en_US
dc.subject.mesh	Checklist	en_US
dc.subject.mesh	Inappropriate Prescribing	en_US
dc.subject.mesh	Quality Improvement	en_US
dc.subject.mesh	Potentially Inappropriate Medication List	en_US
dc.title	Systems to identify potentially inappropriate prescribing in people with advanced dementia: A systematic review	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	16	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1106 Human Movement and Sports Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Nursing
utslib.copyright.status	open_access
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	16	en_US

Abstract:

© 2016 The Author(s). Background: Systems for identifying potentially inappropriate medications in older adults are not immediately transferrable to advanced dementia, where the management goal is palliation. The aim of the systematic review was to identify and synthesise published systems and make recommendations for identifying potentially inappropriate prescribing in advanced dementia. Methods: Studies were included if published in a peer-reviewed English language journal and concerned with identifying the appropriateness or otherwise of medications in advanced dementia or dementia and palliative care. The quality of each study was rated using the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist. Synthesis was narrative due to heterogeneity among designs and measures. Medline (OVID), CINAHL, the Cochrane Database of Systematic Reviews (2005 - August 2014) and AMED were searched in October 2014. Reference lists of relevant reviews and included articles were searched manually. Results: Eight studies were included, all of which were scored a high quality using the STROBE checklist. Five studies used the same system developed by the Palliative Excellence in Alzheimer Care Efforts (PEACE) Program. One study used number of medications as an index, and two studies surveyed health professionals' opinions on appropriateness of specific medications in different clinical scenarios. Conclusions: Future research is needed to develop and validate systems with clinical utility for improving safety and quality of prescribing in advanced dementia. Systems should account for individual clinical context and distinguish between deprescribing and initiation of medications.

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http://hdl.handle.net/10453/117799