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Nocivelli B, Shepherd V, Hood K, Wallace C, Wood F. Identifying barriers and facilitators to the inclusion of older adults living in UK care homes in research: a scoping review. BMC Geriatr 2023; 23:446. [PMID: 37474927 PMCID: PMC10360346 DOI: 10.1186/s12877-023-04126-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/22/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND With an ageing population, older adults will have more complex health and social care needs and many of these older adults will be living in care homes. Despite the growth in care home populations, care home residents are often excluded from research that could potentially benefit their care. The purpose of this scoping review is to explore resident-related barriers and facilitators to including older people living in UK care homes in research and to identify potential approaches to modify such barriers. METHOD The 6-stage scoping review methodology framework proposed by Arksey and O'Malley guided this review. Five electronic databases (MedLine, PsychINFO, Scopus, Web of Science, CINAHL) and grey literature were searched. Identified articles went through two levels of screening, and those deemed relevant were collated, summarised and reported using a thematic analysis approach. RESULTS 90 reports were eligible for inclusion and were synthesised into 7 themes and related subthemes: (1) research design; (2) understanding and beliefs about research (resident and care home staff); (3) communication; (4) relationships; (5) eligibility criteria (resident and care home); (6) preference-based decisions; and (7) care home staff and environment. Given the complex interplay of the factors identified, both direct and indirect factors were included. CONCLUSIONS A number of recurring barriers and facilitators to the inclusion of care home residents in research are reported. However, isolating resident-related barriers was complex as both direct and indirect factors must be considered as influential. Understanding the barriers and facilitators to inclusion will enable these factors to be addressed and increase the evidence-base for care provided to older people living in care homes.
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Affiliation(s)
- Brittany Nocivelli
- Division of Population Medicine, PRIME Centre Wales, School of Medicine, Cardiff University, Cardiff, Wales.
| | - Victoria Shepherd
- Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, Wales
| | - Kerenza Hood
- Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, Wales
| | - Carolyn Wallace
- School of Care Sciences, University of South Wales, Newport, Wales
| | - Fiona Wood
- Division of Population Medicine, PRIME Centre Wales, School of Medicine, Cardiff University, Cardiff, Wales
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Navia RO, Constantine LA. Palliative care for patients with advanced dementia. Nursing 2022; 52:19-26. [PMID: 35196277 DOI: 10.1097/01.nurse.0000820024.83629.ee] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Dementia is currently the seventh leading cause of death and one of the major causes of disability and dependency among older adults globally. Its final stages are complicated by a multitude of problems that can cause immense suffering. This article explores the interconnection between advanced dementia and palliative care and the role of nurses in providing end-of-life care for these patients.
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Affiliation(s)
- R Osvaldo Navia
- R. Osvaldo Navia is the chief of Geriatrics, Palliative Medicine and Hospice; the Grace Kinney Mead Chair of Geriatrics; an attending at the Rockefeller Neuroscience Institute; and an assistant professor at West Virginia University School of Medicine
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Sawan MJ, Moga DC, Ma MJ, Ng JC, Johnell K, Gnjidic D. The value of deprescribing in older adults with dementia: a narrative review. Expert Rev Clin Pharmacol 2021; 14:1367-1382. [PMID: 34311630 DOI: 10.1080/17512433.2021.1961576] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Introduction:Mitigating the burden of unnecessary polypharmacy or multiple medication use in people living with dementia has been recognized as a key priority internationally. One approach to reducing inappropriate polypharmacy is through medication withdrawal or deprescribing.Area covered:Non-systematic searches of key databases including PubMed, Embase, and Google Scholar were conducted from inception to 28 February 2021 for articles that assessed the safety and/or efficacy of deprescribing in older adults living with dementia. Personal reference libraries were also utilized. Information on current clinical trials was found in clinicaltrial.gov.Expert Opinion: There is limited direct evidence to inform deprescribing in older adults with dementia specifically. This review identified nineteen studies that have assessed the impact of deprescribing interventions to reduce inappropriate polypharmacy or direct deprescribing of specific medications. However, the current evidence is limited in scope as most studies focused on medication-related outcomes (e.g. discontinuation of high-risk medications) rather than patient-centered outcomes in individuals living with dementia. Furthermore, most studies focused on addressing inappropriate polypharmacy in older adults with dementia living in long-term care facilities, and interventions did not involve the person and their carer. Further evidence on the impact of deprescribing in this population across clinical settings is needed.
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Affiliation(s)
- Mouna J Sawan
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.,Centre for Medicine Use and Safety, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Daniela C Moga
- College of Pharmacy, University of Kentucky, Lexington, Kentucky, USA.,Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, Kentucky, USA.,Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky, USA
| | - Megan J Ma
- College of Pharmacy, University of Kentucky, Lexington, Kentucky, USA
| | - Joanna C Ng
- College of Pharmacy, University of Kentucky, Lexington, Kentucky, USA
| | - Kristina Johnell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Danijela Gnjidic
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.,Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
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Anticholinergic Use Among the Elderly With Alzheimer Disease in South Korea: A Population-based Study. Alzheimer Dis Assoc Disord 2021; 34:238-243. [PMID: 31913963 DOI: 10.1097/wad.0000000000000370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To investigate the characteristics of anticholinergic use in the elderly with Alzheimer disease (AD) compared with those in the non-AD elderly. METHODS Using the Korean National Health Insurance Service Elderly cohort database, 388,629 adults aged 70 years and older in 2012 were included. The use of strong anticholinergic agents (ACs) in 2012 was quantified by standardized prescribed doses. Univariate and multivariate logistic regression models were applied to examine the level of their heavy use (≥90 doses of the prescribed amount in 2012) in patients with AD and potential explanations of the heavy use. RESULTS Antihistamines and antidepressants were the most prescribed strong ACs among non-AD and AD elderly, respectively. The heavy use of strong ACs was more prevalent in patients with AD than in non-AD elderly [odds ratio (95% confidence interval)=1.48 (1.41-1.56)]. When the morbidities associated with AD were adjusted for, odds ratio were reduced [0.91 (0.85-0.96)]. CONCLUSIONS Heavy use of strong ACs was more prevalent in patients with AD than in non-AD elderly. Multiple ACs for treating multimorbidities in AD were mainly attributable to their heavy use. In patients with AD, the integrated management of medications for reducing the preventable heavy use of these drugs should be reinforced.
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Jennings AA, Guerin N, Foley T. Development of a tool for monitoring the prescribing of antipsychotic medications to people with dementia in general practice: a modified eDelphi consensus study. Clin Interv Aging 2018; 13:2107-2117. [PMID: 30425465 PMCID: PMC6203170 DOI: 10.2147/cia.s178216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Despite their adverse effects, antipsychotics are frequently used to manage behavioral and psychological symptoms of dementia. Regular monitoring of antipsychotic prescribing has been shown to improve the appropriateness of prescribing. However, there is currently no consensus on what the components of such a monitoring tool would be. Aim The aim of this study was to use an expert consensus process to identify the key components of an antipsychotic repeat prescribing tool for use with people with dementia in a general practice setting. Methods A modified eDelphi technique was employed. We invited multidisciplinary experts in antipsychotic prescribing to people with dementia to participate. These experts included general practitioners (GPs), geriatricians and old age psychiatrists. The list of statements for round 1 was developed through a review of existing monitoring tools and international best practice guidelines. In the second round of the Delphi, any statement that had not reached consensus in the first round was presented for re-rating, with personalized feedback on the group and the individual’s response to the specific statement. The final round consisted of a face-to-face expert meeting to resolve any uncertainties from round 2. Results A total of 23 items were rated over two eDelphi rounds and one face-to-face consensus meeting to yield a total of 18 endorsed items and five rejected items. The endorsed statements informed the development of a structured, repeat prescribing tool for monitoring antipsychotics in people with dementia in primary care. Conclusion The development of repeat prescribing tool provides GPs with practical advice that is lacking in current guidelines and will help to support GPs by providing a structured format to use when reviewing antipsychotic prescriptions for people with dementia, ultimately improving patient care. The feasibility and acceptability of the tool now need to be evaluated in clinical practice.
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Affiliation(s)
| | - Naoihse Guerin
- Department of General Practice, University College Cork, Cork, Ireland,
| | - Tony Foley
- Department of General Practice, University College Cork, Cork, Ireland,
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Disalvo D, Luckett T, Luscombe G, Bennett A, Davidson P, Chenoweth L, Mitchell G, Pond D, Phillips J, Beattie E, Goodall S, Agar M. Potentially Inappropriate Prescribing in Australian Nursing Home Residents with Advanced Dementia: A Substudy of the IDEAL Study. J Palliat Med 2018; 21:1472-1479. [PMID: 30106321 DOI: 10.1089/jpm.2018.0070] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Prescribing medications for nursing home residents with advanced dementia should focus on optimizing function and comfort, reducing unnecessary harms and aligning care goals with a palliative approach. OBJECTIVE The aim of the study was to estimate the proportion of Australian nursing home residents with advanced dementia receiving potentially inappropriate medications, and identify those most commonly prescribed and factors associated with their use. DESIGN Data were collected through retrospective audit of medication charts. SETTING/SUBJECTS Two hundred eighteen nursing home residents with advanced dementia from 20 nursing homes participated in a cluster-randomized controlled trial of case conferencing (the IDEAL Study) from June 2013 to December 2014. MEASUREMENTS Inappropriate drug use was defined as medications classified as "never appropriate" by the Palliative Excellence in Alzheimer Care Efforts (PEACE) program criteria. Generalized linear mixed models were used to identify variables predicting use of "never" appropriate medications. RESULTS Over a quarter (n = 65, 30%) of residents received at least one medication classed as "never" appropriate, the most common being lipid-lowering agents (n = 38, 17.4%), antiplatelet agents (n = 18, 8.3%), and acetylcholinesterase inhibitors (n = 16, 7.3%). Residents who had been at the nursing home for ≤10 months (odds ratio [OR] 5.60, 95% confidence interval [CI] 1.74-18.06) and 11-21 months (OR 5.41, 95% CI 1.67-17.75) had significantly greater odds of receiving a never appropriate medication compared with residents who had been at the nursing home for >5 years. CONCLUSIONS Use of potentially inappropriate medications in Australian nursing home residents with advanced dementia is common. A greater understanding of the rationale that underpins prescribing of medications is required.
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Affiliation(s)
- Domenica Disalvo
- 1 Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney , Ultimo, New South Wales, Australia
| | - Tim Luckett
- 1 Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney , Ultimo, New South Wales, Australia
| | - Georgina Luscombe
- 2 Sydney Medical School, The University of Sydney , Ultimo, New South Wales, Australia
| | - Alexandra Bennett
- 3 NSW Therapeutic Advisory Group , Sydney, New South Wales, Australia
| | | | - Lynnette Chenoweth
- 5 Centre for Healthy Brain Ageing, University of New South Wales , Sydney, New South Wales, Australia
| | - Geoffrey Mitchell
- 6 Faculty of Medicine, The University of Queensland , St. Lucia, Queensland, Australia
| | - Dimity Pond
- 7 School of Medicine and Public Health, The University of Newcastle , Newcastle, New South Wales, Australia
| | - Jane Phillips
- 1 Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney , Ultimo, New South Wales, Australia
| | - Elizabeth Beattie
- 8 School of Nursing, Queensland University of Technology , Herston, Queensland, Australia
| | - Stephen Goodall
- 9 Centre for Health Research and Evaluation (CHERE), Faculty of Business, University of Technology , Haymarket, New South Wales, Australia
| | - Meera Agar
- 1 Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney , Ultimo, New South Wales, Australia .,10 South Western Sydney Clinical School, University of New South Wales , Sydney, New South Wales, Australia .,11 Ingham Institute of Applied Medical Research , Liverpool, New South Wales, Australia
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McCloskey B, Hughes C, Parsons C. A qualitative exploration of proxy decision makers' expectations of prescribed medications for people with advanced dementia. Palliat Med 2018; 32:1114-1123. [PMID: 29485337 DOI: 10.1177/0269216318757163] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Background: Proxy decision makers often have to make decisions for people with advanced dementia. Their expectations regarding prescribed medications have the potential to influence prescription or withdrawal of medications. However, few studies to date have explored this. Aim: To explore proxy decision makers’ expectations of prescribed medications for people with advanced dementia and to consider how these change with changing goals of care and dementia progression. Design: This is a qualitative semi-structured interview study. Setting/participants: In total, 15 proxy decision makers of people with advanced dementia were recruited via general practitioners ( n = 9), Join Dementia Research ( n = 3) and the Alzheimer’s Society Northern Ireland ( n = 3). Results: Five key themes emerged: the role as advocate, attitudes to medicines and medicine taking, uncertainty over the benefit of anti-dementia medications, stopping medications, and communication and decision-making. Proxy decision makers desired more information about prescribed medicines, particularly the indications, benefits and risks of treatment. Despite uncertainty about the benefits of anti-dementia medications, proxy decision makers were reluctant for these medications to be withdrawn. Reluctance to stop other prescribed medicines was also expressed but reduced with changing goals of care and dementia progression. Although some proxy decision makers expected to be involved in medication-related decisions, the majority preferred to delegate these decisions to healthcare professionals. However, they expected to be informed of any medication-related decisions made. Conclusion: Proxy decision makers vary in terms of their desire for active involvement in the medication decision-making process. Healthcare professionals should facilitate proxy decision maker involvement if desired. Further research is required to consider the impact of proxy decision maker involvement in decision-making.
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Affiliation(s)
| | - Carmel Hughes
- 2 School of Pharmacy, Queen's University Belfast, Belfast, UK
| | - Carole Parsons
- 2 School of Pharmacy, Queen's University Belfast, Belfast, UK
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Malek Makan A, van Hout H, Onder G, Finne-Soveri H, van der Roest H, van Marum R. Prevalence of Preventive Cardiovascular Medication Use In Nursing Home Residents. Room for Deprescribing? The SHELTER Study. J Am Med Dir Assoc 2017; 18:1037-1042. [DOI: 10.1016/j.jamda.2017.06.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 06/23/2017] [Accepted: 06/23/2017] [Indexed: 11/17/2022]
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Page AT, Clifford RM, Potter K, Seubert L, McLachlan AJ, Hill X, King S, Clark V, Ryan C, Parekh N, Etherton-Beer CD. Exploring the enablers and barriers to implementing the Medication Appropriateness Tool for Comorbid Health conditions during Dementia (MATCH-D) criteria in Australia: a qualitative study. BMJ Open 2017; 7:e017906. [PMID: 28838905 PMCID: PMC5724063 DOI: 10.1136/bmjopen-2017-017906] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The Medication Appropriateness Tool for Comorbid Health conditions in Dementia (MATCH-D) criteria provide expert consensus guidance about medication use for people with dementia. This study aimed to identify enablers and barriers to implementing the criteria in practice. SETTING Participants came from both rural and metropolitan communities in two Australian states. PARTICIPANTS Focus groups were held with consumers, general practitioners, nurses and pharmacists. OUTCOMES data were analysed thematically. RESULTS Nine focus groups were conducted. Fifty-five participants validated the content of MATCH-D, appraising them as providing patient-centred principles of care. Participants identified potential applications (including the use of MATCH-D as a discussion aid or educational tool for consumers about medicines) and suggested supporting resources. CONCLUSION Participants provided insights into applying MATCH-D in practice and suggested resources to be included in an accompanying toolkit. These data provide external validation of MATCH-D and an empiric basis for their translation to practice. Following resource development, we plan to evaluate the feasibility and efficacy of implementation in practice.
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Affiliation(s)
- Amy Theresa Page
- Western Australian Centre for Health and Ageing, School of Medicine, University of Western Australia, Perth, Australia
- School of Allied Health, University of Western Australia, Perth, Australia
| | | | - Kathleen Potter
- Western Australian Centre for Health and Ageing, School of Medicine, University of Western Australia, Perth, Australia
| | - Liza Seubert
- School of Allied Health, University of Western Australia, Perth, Australia
| | - Andrew J McLachlan
- Faculty of Pharmacy and Centre for Education and Research on Ageing, University of Sydney, Sydney, New South Wales, Australia
- Concord Hospital, Sydney, New South Wales, Australia
| | - Xaysja Hill
- School of Allied Health, University of Western Australia, Perth, Australia
| | - Stephanie King
- School of Allied Health, University of Western Australia, Perth, Australia
| | - Vaughan Clark
- School of Allied Health, University of Western Australia, Perth, Australia
| | - Cristin Ryan
- School of Pharmacy, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Christopher D Etherton-Beer
- Western Australian Centre for Health and Ageing, School of Medicine, University of Western Australia, Perth, Australia
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Parsons C. Polypharmacy and inappropriate medication use in patients with dementia: an underresearched problem. Ther Adv Drug Saf 2017; 8:31-46. [PMID: 28203365 PMCID: PMC5298466 DOI: 10.1177/2042098616670798] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Multimorbidity and polypharmacy are increasingly prevalent across healthcare systems and settings as global demographic trends shift towards increased proportions of older people in populations. Numerous studies have demonstrated an association between polypharmacy and potentially inappropriate prescribing (PIP), and have reported high prevalence of PIP across settings of care in Europe and North America and, as a consequence, increased risk of adverse drug reactions, healthcare utilization, morbidity and mortality. These studies have not focused specifically on people with dementia, despite the high risk of adverse drug reactions and PIP in this patient cohort. This narrative review considers the evidence currently available in the area, including studies examining prevalence of PIP in older people with dementia, how appropriateness of prescribing is assessed, the medications most commonly implicated, the clinical consequences, and research priorities to optimize prescribing for this vulnerable patient group. Although there has been a considerable research effort to develop criteria to assess medication appropriateness in older people in recent years, the majority of tools do not focus on people with dementia. Of the limited number of tools available, most focus on the advanced stages of dementia in which life expectancy is limited. The development of tools to assess medication appropriateness in people with mild to moderate dementia or across the full spectrum of disease severity represents an important gap in the research literature and is beginning to attract research interest, with recent studies considering the medication regimen as a whole, or misprescribing, overprescribing or underprescribing of certain medications/medication classes, including anticholinergics, psychotropics, antibiotics and analgesics. Further work is required in development and validation of criteria to assess prescribing appropriateness in this vulnerable patient population, to determine prevalence of PIP in large cohorts of people with the full spectrum of dementia variants and severities, and to examine the impact of PIP on health outcomes.
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Affiliation(s)
- Carole Parsons
- Queen’s University Belfast, 97 Lisburn Road, Belfast, Northern Ireland BT9 7BL, UK
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Abstract
BACKGROUND There are approximately 24 million people worldwide with dementia; this is likely to increase to 81 million by 2040. Dementia is a progressive condition, and usually leads to death eight to ten years after first symptoms. End-of-life care should emphasise treatments that optimise quality of life and physicians should minimise unnecessary or non-beneficial interventions. Statins are 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors; they have become the cornerstone of pharmacotherapy for the management of hypercholesterolaemia but their ability to provide benefit is unclear in the last weeks or months of life. Withdrawal of statins may improve quality of life in people with advanced dementia, as they will not be subjected to unnecessary polypharmacy or side effects. However, they may help to prevent further vascular events in people of advanced age who are at high risk of such events. OBJECTIVES To evaluate the effects of withdrawal or continuation of statins in people with dementia on: cognitive outcomes, adverse events, behavioural and functional outcomes, mortality, quality of life, vascular morbidity, and healthcare costs. SEARCH METHODS We searched ALOIS (medicine.ox.ac.uk/alois/), the Cochrane Dementia and Cognitive Improvement Group Specialised Register on 11 February 2016. We also ran additional searches in MEDLINE, EMBASE, PsycINFO, CINAHL, Clinical.Trials.gov and the WHO Portal/ICTRP on 11 February 2016, to ensure that the searches were as comprehensive and as up-to-date as possible. SELECTION CRITERIA We included all randomised, controlled clinical trials with either a placebo or 'no treatment' control group. We applied no language restrictions. DATA COLLECTION AND ANALYSIS Two review authors independently assessed whether potentially relevant studies met the inclusion criteria, using standard methodological procedures expected by Cochrane. We found no studies suitable for inclusion therefore analysed no data. MAIN RESULTS The search strategy identified 28 unique references, all of which were excluded. AUTHORS' CONCLUSIONS We found no evidence to enable us to make an informed decision about statin withdrawal in dementia. Randomised controlled studies need to be conducted to assess cognitive and other effects of statins in participants with dementia, especially when the disease is advanced.
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Affiliation(s)
- Bernadette McGuinness
- Queen's University BelfastCentre for Public HealthInstitute of Clinical Sciences, Block BGrosvenor RoadBelfastCo AntrimUKBT12 6BA
| | - Chris R Cardwell
- Queen's University BelfastCentre for Public HealthInstitute of Clinical Sciences, Block BGrosvenor RoadBelfastCo AntrimUKBT12 6BA
| | - Peter Passmore
- Queen's University BelfastCentre for Public HealthInstitute of Clinical Sciences, Block BGrosvenor RoadBelfastCo AntrimUKBT12 6BA
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13
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Naples JG, Hanlon JT, Schmader KE, Semla TP. Recent Literature on Medication Errors and Adverse Drug Events in Older Adults. J Am Geriatr Soc 2016; 64:401-8. [PMID: 26804210 DOI: 10.1111/jgs.13922] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Medication errors and adverse drug events are common in older adults, but locating literature addressing these issues is often challenging. The objective of this article is to summarize recent studies addressing medication errors and adverse drug events in a single location to improve accessibility for individuals working with older adults. A comprehensive literature search for studies published in 2014 was conducted, and 51 potential articles were identified. After critical review, 17 studies were selected for inclusion based on innovation; rigorous observational or experimental study designs; and use of reliable, valid measures. Four articles characterizing potentially inappropriate prescribing and interventions to optimize medication regimens were annotated and critiqued in detail. The authors hope that health policy-makers and clinicians find this information helpful in improving the quality of care for older adults.
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Affiliation(s)
- Jennifer G Naples
- Division of Geriatrics, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania.,Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
| | - Joseph T Hanlon
- Division of Geriatrics, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania.,Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania.,Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.,Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania.,Geriatric Research Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
| | - Kenneth E Schmader
- Division of Geriatrics, Department of Medicine, School of Medicine, Duke University Medical Center, Durham, North Carolina.,Geriatric Research, Education and Clinical Center, Durham Veterans Affairs Medical Center, Durham, North Carolina
| | - Todd P Semla
- Department of Veterans Affairs, Pharmacy Benefits Management Services, Hines, Illinois.,Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Department of Psychiatry and Behavioral Science, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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