Potentially Inappropriate Medication Use in Patients with Dementia

Kyungwon Yoon, Jung-Tae Kim, Won-Gun Kwack, Donghyun Kim, Kyung-Tae Lee, Seungwon Yang, Sangmin Lee (), Yeo-Jin Choi () and Eun-Kyoung Chung ()
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Kyungwon Yoon: Department of Pharmacy, College of Pharmacy, Kyung Hee University, Seoul 02447, Korea
Jung-Tae Kim: Department of Pharmacy, Kyung Hee University Hospital at Gangdong, Seoul 05278, Korea
Won-Gun Kwack: Division of Pulmonary, Allergy and Critical Care Medicine, Kyung Hee University Hospital, Seoul 02447, Korea
Donghyun Kim: Department of Pharmacy, College of Pharmacy, Kyung Hee University, Seoul 02447, Korea
Kyung-Tae Lee: Department of Biomedical and Pharmaceutical Sciences, Graduate School, Kyung Hee University, Seoul 02447, Korea
Seungwon Yang: Department of Pharmacy, College of Pharmacy, Kyung Hee University, Seoul 02447, Korea
Sangmin Lee: Department of Pharmacy, College of Pharmacy, Kyung Hee University, Seoul 02447, Korea
Yeo-Jin Choi: Department of Pharmacy, College of Pharmacy, Kyung Hee University, Seoul 02447, Korea
Eun-Kyoung Chung: Department of Pharmacy, College of Pharmacy, Kyung Hee University, Seoul 02447, Korea

IJERPH, 2022, vol. 19, issue 18, 1-12

Abstract: The objective of this study was to characterize the epidemiology of using potentially inappropriate medications associated with dementia exacerbation (DPIMs) in elderly outpatients with dementia. Electronic medical records were retrospectively reviewed for geriatric patients with dementia who were prescribed at least one medication in 2016 at a tertiary, university-affiliated hospital. The 2015 Beers criteria were used to define DPIMs. Logistic regression was performed to identify factors associated with prescribing DPIMs in patients with dementia. Among 2100 patients included in our study, 987 (47.0%) patients were prescribed at least one DPIM. Benzodiazepines were the most frequently prescribed DPIM followed by anticholinergics, histamine H2-receptor blockers, and zolpidem. The risk of prescribing DPIMs was significantly increased in female patients (odds ratio (OR) 1.355) with polypharmacy (OR 5.146) and multiple comorbidities (OR 1.129) ( p < 0.05 for all). Coexistence of Parkinson’s disease (OR 1.799), mood disorder (OR 1.373), or schizophrenia (OR 4.116) in patients with dementia further increased the likelihood of receiving DPIMs. In conclusion, DPIMs were commonly used in elderly patients with dementia in Korea with benzodiazepines most frequently prescribed followed by anticholinergics. Female patients using polypharmacy with multiple comorbidities should be closely monitored to minimize unnecessary DPIM use and, ultimately, DPIM-related harms.

Keywords: potentially inappropriate medication; geriatrics; dementia; Beers criteria; polypharmacy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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