Potentially Inappropriate Medication Use is Associated with Clinical Outcomes in Critically Ill Elderly Patients with Neurological Injury
详细信息 查看全文
- 作者：Catherine K. Floroff (1)
Patricia W. Slattum (1)
Spencer E. Harpe (2)
Perry Taylor (3)
Gretchen M. Brophy (1) - 关键词：Aging ; Elderly ; Older adult ; Critically ill ; Potentially inappropriate medication(s) ; Drug burden index ; Neurological injury
- 刊名：Neurocritical Care
- 出版年：2014
- 出版时间：December 2014
- 年：2014
- 卷：21
- 期：3
- 页码：526-533
- 全文大小：243 KB
- 参考文献：1. U.S. Census Bureau. United States Census. Washington DC: US Census Bureau; 2000.
2. Angus DC, Kelly MA, Schmitz RJ, White A, Popovich J Jr. Caring for the critically ill patient: current and projected workforce requirements for care of the critically ill and patients with pulmonary disease. Can we meet the requirement of an aging population? JAMA. 2000;284:2762-0. CrossRef
3. Locatelli J, Lira AR, Torraga L, Paes AT. Inappropriate medications using the Beers Criteria in Brazilian hospitalized elderly patients. Consult Pharm. 2010;25:36-0. CrossRef
4. Egger SS, Bachmann A, Hubmann N, Schlienger RG, Krahenbuhl S. Prevalence of potentially inappropriate medication use in elderly patients: comparison between general medical and geriatric wards. Drugs Aging. 2006;23:823-7. CrossRef
5. Beers MH. Explicit criteria for determining potentially inappropriate medication use by the elderly. Arch Intern Med. 1997;157:1531-. CrossRef
6. 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. Drugs Aging. 2010;27:135-8. CrossRef
7. O’Mahony D, Gallagher PF. Inappropriate prescribing in the older population: need for new criteria. Age Aging. 2008;37:138-1. CrossRef
8. Gallagher P, Ryan C, Byrne S, Kennedy J, O’Mahony D. STOPP (Screening Tool of Older Person’s Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment): consensus validation. Int J Clin Pharmacol Ther. 2008;46:72-3. CrossRef
9. Gallagher P, Baeyens JP, Topinkova E, et al. Inter-rater reliability of STOPP (Screening Tool of Older Person’s Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment) criteria amongst physicians in six European countries. Age Aging. 2009;38:603-. CrossRef
10. Hajjar ER, Hanlon JT, Sloane RJ, et al. Unnecessary drug use in frail older people at hospital discharge. J Am Geriatr Soc. 2005;53:1518-3. CrossRef
11. Onder G, Landi F, Cesari M, Gambassi G, Carbonin P, Bernabei R. Inappropriate medication use among hospitalized older adults in Italy: results from the Italian group of pharmacoepidemiology in the elderly. Eur J Clin Pharmacol. 2003;59:157-2.
12. Onder G, Landi F, Liperoti R, Fialova D, Gambassi G, Bernabei R. Impact of inappropriate drug use among hospitalized older adults. Eur J Clin Pharmacol. 2005;61:453-. CrossRef
13. Page RL, Ruscin JM. The risk of adverse drug events and hospital-related morbidity and mortality among older adults with potentially inappropriate medication use. Am J Geriatr Pharmacother. 2006;4:297-05. CrossRef
14. Laroche ML, Charmes JP, Nouaille Y, Fourrier A, Merle L. Impact of hospitalization in an acute medical geriatric unit on potentially inappropriate medication use. Drugs Aging. 2006;23:49-9. CrossRef
15. Rothberg MB, Pekow PS, Liu F, et al. Potentially inappropriate medication use in hospitalized elders. J Hosp Med. 2008;3:91-02. CrossRef
16. Corsonello A, Pedone C, Lattanzio F, et al. Potentially inappropriate medications and functional decline in elderly hospitalized patients. J Am Geriatr Soc. 2009;57:1007-4. CrossRef
17. Mattison M - 作者单位：Catherine K. Floroff (1)
Patricia W. Slattum (1)
Spencer E. Harpe (2)
Perry Taylor (3)
Gretchen M. Brophy (1)
1. School of Pharmacy, Virginia Commonwealth University, 410?N. 12th Street, Richmond, VA, 23298-0533, USA
2. Chicago College of Pharmacy, Midwestern University, 555 31st Street, Downers Grove, IL, 60515, USA
3. Virginia Commonwealth University Health System, 401?N. 12th Street, P.O. Box 980042, Richmond, VA, 23298, USA - ISSN：1556-0961
文摘
Background Limited data suggest that potentially inappropriate medications (PIMs) impact outcomes in critically ill elderly patients. No data are available on the association between PIM use as well as drug burden index (DBI), which is a measure of PIM use, and clinical outcomes in neurocritical care elderly patients. This study evaluates whether PIM use and a higher DBI are associated with poor clinical outcomes in neurocritical care elderly patients. Methods PIMs were retrospectively identified in critically ill elderly patients admitted to the neuroscience intensive care unit (NSICU) from March to July 2011. DBI was calculated based on PIM doses. Relationships with clinical outcomes were evaluated. Results PIMs were prescribed to a majority (81.3?%) of the 112 patients. Opioids were most commonly associated with a decrease in Richmond Agitation Sedation Scale (RASS) scores (56?% of PIM doses). Time to recovery was significantly longer in patients with a higher PIM burden (? PIMs: 8?h, >2 PIMs: 29?h; p?=?0.02). There was a significantly longer NSICU and hospital length of stay (9 vs 2; 15 vs 5?days; p?Glasgow Coma Scale score upon discharge (14 vs 15, p?=?0.02) in patients with a higher DBI after 72?h of hospitalization. There was no difference in mortality. Conclusions PIM use and higher DBI scores were associated with poor clinical outcomes and longer lengths of stay. Further studies are needed to determine the impact of PIMs and DBI on mortality in neurocritical care elderly patients.