Drug burden index and potentially inappropriate medications in community-dwelling older people: The impact of home medicines review

Castelino, RL; Hilmer, SN; Bajorek, BV; Nishtala, P; Chen, TF

Drug burden index and potentially inappropriate medications in community-dwelling older people: The impact of home medicines review

Castelino, RL Hilmer, SN Bajorek, BV

Nishtala, P Chen, TF

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Publication Type:: Journal Article
Citation:: Drugs and Aging, 2010, 27 (2), pp. 135 - 148
Issue Date:: 2010-02-26

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Field	Value	Language
dc.contributor.author	Castelino, RL	en_US
dc.contributor.author	Hilmer, SN	en_US
dc.contributor.author	Bajorek, BV https://orcid.org/0000-0002-2532-7187	en_US
dc.contributor.author	Nishtala, P	en_US
dc.contributor.author	Chen, TF	en_US
dc.date.issued	2010-02-26	en_US
dc.identifier.citation	Drugs and Aging, 2010, 27 (2), pp. 135 - 148	en_US
dc.identifier.issn	1170-229X	en_US
dc.identifier.uri	http://hdl.handle.net/10453/15637
dc.description.abstract	Background: A significant problem in older people (aged ≥65 years) is the use of potentially inappropriate medications (PIMs), including those with sedative and anticholinergic properties. However, effective intervention strategies have yet to be identified. The Drug Burden Index (DBI) is an evidence-based tool that measures a persons total exposure to medications with sedative and anticholinergic properties and has been shown to be independently associated with impairment in cognitive and physical function. Objective: The main aim of the study was to investigate whether Home Medicines Review (HMR) services by pharmacists for community-dwelling older people would lead to an improvement in the use of medications, as measured by a decrease in the DBI score. The study also aimed to investigate the (i) distribution of DBI scores and PIMs among older people living in the community, and (ii) impact of pharmacists recommendations on DBI scores and PIMs. Methods: A retrospective analysis of medication reviews was performed for 372 community-dwelling older people (aged ≥65 years) who received an HMR service from the pharmacist. The main outcome measure was the total DBI score at baseline and post-HMR. The data were also examined to determine the extent of PIM use (2003 Beers criteria), and the number and nature of pharmacists recommendations. Results: Overall, medications contributing to the DBI (i.e. medications with sedative or anticholinergic properties) and PIMs were identified in 60.5% (n = 225) and 39.8% (n = 148) of the patients, respectively. Following pharmacist recommendations during the HMR service, medications contributing to the DBI were identified in 51.6% (n = 192) of the patients. A statistically © 2010 Adis Data Information BV. All rights reserved.	en_US
dc.relation.ispartof	Drugs and Aging	en_US
dc.relation.isbasedon	10.2165/11531560-000000000-00000	en_US
dc.subject.classification	Geriatrics	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Medication Errors	en_US
dc.subject.mesh	Drug Interactions	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Homes for the Aged	en_US
dc.subject.mesh	Home Care Services	en_US
dc.subject.mesh	Drug Utilization	en_US
dc.subject.mesh	Drug Prescriptions	en_US
dc.subject.mesh	Practice Patterns, Physicians'	en_US
dc.subject.mesh	Prescriptions	en_US
dc.title	Drug burden index and potentially inappropriate medications in community-dwelling older people: The impact of home medicines review	en_US
dc.type	Journal Article
utslib.citation.volume	2	en_US
utslib.citation.volume	27	en_US
utslib.for	1115 Pharmacology and Pharmaceutical Sciences	en_US
dc.location.activity	WOS:000274870400004	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
utslib.copyright.status	closed_access
pubs.issue	2	en_US
pubs.publication-status	Published	en_US
pubs.volume	27	en_US

Abstract:

Background: A significant problem in older people (aged ≥65 years) is the use of potentially inappropriate medications (PIMs), including those with sedative and anticholinergic properties. However, effective intervention strategies have yet to be identified. The Drug Burden Index (DBI) is an evidence-based tool that measures a persons total exposure to medications with sedative and anticholinergic properties and has been shown to be independently associated with impairment in cognitive and physical function. Objective: The main aim of the study was to investigate whether Home Medicines Review (HMR) services by pharmacists for community-dwelling older people would lead to an improvement in the use of medications, as measured by a decrease in the DBI score. The study also aimed to investigate the (i) distribution of DBI scores and PIMs among older people living in the community, and (ii) impact of pharmacists recommendations on DBI scores and PIMs. Methods: A retrospective analysis of medication reviews was performed for 372 community-dwelling older people (aged ≥65 years) who received an HMR service from the pharmacist. The main outcome measure was the total DBI score at baseline and post-HMR. The data were also examined to determine the extent of PIM use (2003 Beers criteria), and the number and nature of pharmacists recommendations. Results: Overall, medications contributing to the DBI (i.e. medications with sedative or anticholinergic properties) and PIMs were identified in 60.5% (n = 225) and 39.8% (n = 148) of the patients, respectively. Following pharmacist recommendations during the HMR service, medications contributing to the DBI were identified in 51.6% (n = 192) of the patients. A statistically © 2010 Adis Data Information BV. All rights reserved.

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http://hdl.handle.net/10453/15637