PittsburghV1, Main, Exploration, bibRecord, 003009

Epidemiology of Drug-Disease Interactions in Older Veteran Nursing Home Residents

Identifieur interne : 003009 ( Main/Exploration ); précédent : 003008; suivant : 003010

Epidemiology of Drug-Disease Interactions in Older Veteran Nursing Home Residents

Auteurs : Sherrie L. Aspinall [États-Unis] ; Xinhua Zhao [États-Unis] ; Todd P. Semla [États-Unis] ; Francesca E. Cunningham [États-Unis] ; Allison M. Paquin [États-Unis] ; Mary Jo Pugh [États-Unis] ; Kenneth E. Schmader [États-Unis] ; Roslyn A. Stone [États-Unis] ; Joseph T. Hanlon [États-Unis]

Source :

Journal of the American Geriatrics Society [ 0002-8614 ] ; 2014.

RBID : PMC:4300245

Descripteurs français

KwdFr :
- Anciens combattants, Chutes accidentelles (), Défaillance cardiaque (épidémiologie), Défaillance rénale chronique (épidémiologie), Démence (épidémiologie), Femelle, Fractures de la hanche (épidémiologie), Humains, Interactions médicamenteuses, Maisons de repos, Mâle, Sujet âgé, Sujet âgé de 80 ans ou plus, Troubles de la cognition (épidémiologie), Ulcère peptique (épidémiologie), États-Unis d'Amérique (épidémiologie), Études transversales.
MESH :
- épidémiologie : Défaillance cardiaque, Défaillance rénale chronique, Démence, Fractures de la hanche, Troubles de la cognition, Ulcère peptique, États-Unis d'Amérique.
- Anciens combattants, Chutes accidentelles, Femelle, Humains, Interactions médicamenteuses, Maisons de repos, Mâle, Sujet âgé, Sujet âgé de 80 ans ou plus, Études transversales.
Wicri :
- geographic : États-Unis.

English descriptors

KwdEn :
- Accidental Falls (statistics & numerical data), Aged, Aged, 80 and over, Cognition Disorders (epidemiology), Cross-Sectional Studies, Dementia (epidemiology), Drug Interactions, Female, Heart Failure (epidemiology), Hip Fractures (epidemiology), Humans, Kidney Failure, Chronic (epidemiology), Male, Nursing Homes, Peptic Ulcer (epidemiology), United States (epidemiology), Veterans.
MESH :
- geographic , epidemiology : United States.
- epidemiology : Cognition Disorders, Dementia, Heart Failure, Hip Fractures, Kidney Failure, Chronic, Peptic Ulcer.
- statistics & numerical data : Accidental Falls.
- Aged, Aged, 80 and over, Cross-Sectional Studies, Drug Interactions, Female, Humans, Male, Nursing Homes, Veterans.

Abstract

Objectives

Few studies have examined drug-disease interactions (DDIs) in older nursing home residents. Therefore, the objective is to describe the prevalence of, and factors associated with, DDIs according to The American Geriatrics Society 2012 Beers Criteria.

Design

Cross-sectional study.

Setting

Fifteen Veterans Affairs Community Living Centers.

Participants

Patients≥65 years old with a diagnosis of dementia/cognitive impairment, history of falls/hip fractures, heart failure (HF), history of peptic ulcer disease (PUD) and/or stage IV or V chronic kidney disease (CKD).

Measurements

Prevalence of medications that could exacerbate the above conditions (i.e., DDIs).

Results

Overall, 361 of 696 (51.9%) eligible residents had ≥1 DDI. None involved those with a history of PUD; one involved a resident with CKD, and four occurred in those with HF. In residents with dementia/cognitive impairment (N=540), 50.7% took a drug that could exacerbate these conditions; the most commonly involved medications were antipsychotics (35.4%) and benzodiazepines (14.4%). In those with a history of falls/hip fractures (N=267), 67.8% received an interacting medication, with SSRIs (33.1%), antipsychotics (30.7%) and anticonvulsants (25.1%) being most commonly involved. Using separate multivariable logistic regression models, factors associated with DDIs in both dementia/cognitive impairment and falls/fractures included: age 85+ (Adjusted Odds Ratio [aOR] and 95% confidence interval [CI] of 0.38; 0.24–0.60 and aOR 0.48; 95%CI 0.24–0.96, respectively); taking 5–8 medications (aOR 2.06; 95%CI 1.02–4.16 and aOR 4.76; 95%CI 1.68–13.5, respectively) and ≥9 medications (aOR 1.99; 95%CI 1.03–3.85 and aOR 3.68; 95%CI 1.41–9.61, respectively), and being a long stay patient (aOR 1.80; 95%CI 1.04–3.12 and aOR 2.35; 95%CI 1.12–4.91, respectively).

Conclusion

Drug-disease interactions were common in older nursing home residents with dementia/cognitive impairment and/or a history of falls/fractures.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4300245

DOI: 10.1111/jgs.13197
PubMed: 25537124
PubMed Central: 4300245

Affiliations:

Le document en format XML

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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Accidental Falls (statistics & numerical data)</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Cognition Disorders (epidemiology)</term>
<term>Cross-Sectional Studies</term>
<term>Dementia (epidemiology)</term>
<term>Drug Interactions</term>
<term>Female</term>
<term>Heart Failure (epidemiology)</term>
<term>Hip Fractures (epidemiology)</term>
<term>Humans</term>
<term>Kidney Failure, Chronic (epidemiology)</term>
<term>Male</term>
<term>Nursing Homes</term>
<term>Peptic Ulcer (epidemiology)</term>
<term>United States (epidemiology)</term>
<term>Veterans</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Anciens combattants</term>
<term>Chutes accidentelles ()</term>
<term>Défaillance cardiaque (épidémiologie)</term>
<term>Défaillance rénale chronique (épidémiologie)</term>
<term>Démence (épidémiologie)</term>
<term>Femelle</term>
<term>Fractures de la hanche (épidémiologie)</term>
<term>Humains</term>
<term>Interactions médicamenteuses</term>
<term>Maisons de repos</term>
<term>Mâle</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Troubles de la cognition (épidémiologie)</term>
<term>Ulcère peptique (épidémiologie)</term>
<term>États-Unis d'Amérique (épidémiologie)</term>
<term>Études transversales</term>
</keywords>
<keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>United States</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Cognition Disorders</term>
<term>Dementia</term>
<term>Heart Failure</term>
<term>Hip Fractures</term>
<term>Kidney Failure, Chronic</term>
<term>Peptic Ulcer</term>
</keywords>
<keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Accidental Falls</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Défaillance cardiaque</term>
<term>Défaillance rénale chronique</term>
<term>Démence</term>
<term>Fractures de la hanche</term>
<term>Troubles de la cognition</term>
<term>Ulcère peptique</term>
<term>États-Unis d'Amérique</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Aged, 80 and over</term>
<term>Cross-Sectional Studies</term>
<term>Drug Interactions</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Nursing Homes</term>
<term>Veterans</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Anciens combattants</term>
<term>Chutes accidentelles</term>
<term>Femelle</term>
<term>Humains</term>
<term>Interactions médicamenteuses</term>
<term>Maisons de repos</term>
<term>Mâle</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Études transversales</term>
</keywords>
<keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>États-Unis</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objectives</title>
<p id="P2">Few studies have examined drug-disease interactions (DDIs) in older nursing home residents. Therefore, the objective is to describe the prevalence of, and factors associated with, DDIs according to The American Geriatrics Society 2012 Beers Criteria.</p>
</sec>
<sec id="S2"><title>Design</title>
<p id="P3">Cross-sectional study.</p>
</sec>
<sec id="S3"><title>Setting</title>
<p id="P4">Fifteen Veterans Affairs Community Living Centers.</p>
</sec>
<sec id="S4"><title>Participants</title>
<p id="P5">Patients≥65 years old with a diagnosis of dementia/cognitive impairment, history of falls/hip fractures, heart failure (HF), history of peptic ulcer disease (PUD) and/or stage IV or V chronic kidney disease (CKD).</p>
</sec>
<sec id="S5"><title>Measurements</title>
<p id="P6">Prevalence of medications that could exacerbate the above conditions (i.e., DDIs).</p>
</sec>
<sec id="S6"><title>Results</title>
<p id="P7">Overall, 361 of 696 (51.9%) eligible residents had ≥1 DDI. None involved those with a history of PUD; one involved a resident with CKD, and four occurred in those with HF. In residents with dementia/cognitive impairment (N=540), 50.7% took a drug that could exacerbate these conditions; the most commonly involved medications were antipsychotics (35.4%) and benzodiazepines (14.4%). In those with a history of falls/hip fractures (N=267), 67.8% received an interacting medication, with SSRIs (33.1%), antipsychotics (30.7%) and anticonvulsants (25.1%) being most commonly involved. Using separate multivariable logistic regression models, factors associated with DDIs in both dementia/cognitive impairment and falls/fractures included: age 85+ (Adjusted Odds Ratio [aOR] and 95% confidence interval [CI] of 0.38; 0.24–0.60 and aOR 0.48; 95%CI 0.24–0.96, respectively); taking 5–8 medications (aOR 2.06; 95%CI 1.02–4.16 and aOR 4.76; 95%CI 1.68–13.5, respectively) and ≥9 medications (aOR 1.99; 95%CI 1.03–3.85 and aOR 3.68; 95%CI 1.41–9.61, respectively), and being a long stay patient (aOR 1.80; 95%CI 1.04–3.12 and aOR 2.35; 95%CI 1.12–4.91, respectively).</p>
</sec>
<sec id="S7"><title>Conclusion</title>
<p id="P8">Drug-disease interactions were common in older nursing home residents with dementia/cognitive impairment and/or a history of falls/fractures.</p>
</sec>
</div>
</front>
</TEI>
<affiliations><list><country><li>États-Unis</li>
</country>
<region><li>Caroline du Nord</li>
<li>Illinois</li>
<li>Massachusetts</li>
<li>Pennsylvanie</li>
<li>Texas</li>
</region>
</list>
<tree><country name="États-Unis"><region name="Illinois"><name sortKey="Aspinall, Sherrie L" sort="Aspinall, Sherrie L" uniqKey="Aspinall S" first="Sherrie L." last="Aspinall">Sherrie L. Aspinall</name>
</region>
<name sortKey="Aspinall, Sherrie L" sort="Aspinall, Sherrie L" uniqKey="Aspinall S" first="Sherrie L." last="Aspinall">Sherrie L. Aspinall</name>
<name sortKey="Aspinall, Sherrie L" sort="Aspinall, Sherrie L" uniqKey="Aspinall S" first="Sherrie L." last="Aspinall">Sherrie L. Aspinall</name>
<name sortKey="Cunningham, Francesca E" sort="Cunningham, Francesca E" uniqKey="Cunningham F" first="Francesca E." last="Cunningham">Francesca E. Cunningham</name>
<name sortKey="Hanlon, Joseph T" sort="Hanlon, Joseph T" uniqKey="Hanlon J" first="Joseph T." last="Hanlon">Joseph T. Hanlon</name>
<name sortKey="Hanlon, Joseph T" sort="Hanlon, Joseph T" uniqKey="Hanlon J" first="Joseph T." last="Hanlon">Joseph T. Hanlon</name>
<name sortKey="Hanlon, Joseph T" sort="Hanlon, Joseph T" uniqKey="Hanlon J" first="Joseph T." last="Hanlon">Joseph T. Hanlon</name>
<name sortKey="Hanlon, Joseph T" sort="Hanlon, Joseph T" uniqKey="Hanlon J" first="Joseph T." last="Hanlon">Joseph T. Hanlon</name>
<name sortKey="Paquin, Allison M" sort="Paquin, Allison M" uniqKey="Paquin A" first="Allison M." last="Paquin">Allison M. Paquin</name>
<name sortKey="Pugh, Mary Jo" sort="Pugh, Mary Jo" uniqKey="Pugh M" first="Mary Jo" last="Pugh">Mary Jo Pugh</name>
<name sortKey="Pugh, Mary Jo" sort="Pugh, Mary Jo" uniqKey="Pugh M" first="Mary Jo" last="Pugh">Mary Jo Pugh</name>
<name sortKey="Schmader, Kenneth E" sort="Schmader, Kenneth E" uniqKey="Schmader K" first="Kenneth E." last="Schmader">Kenneth E. Schmader</name>
<name sortKey="Schmader, Kenneth E" sort="Schmader, Kenneth E" uniqKey="Schmader K" first="Kenneth E." last="Schmader">Kenneth E. Schmader</name>
<name sortKey="Semla, Todd P" sort="Semla, Todd P" uniqKey="Semla T" first="Todd P." last="Semla">Todd P. Semla</name>
<name sortKey="Semla, Todd P" sort="Semla, Todd P" uniqKey="Semla T" first="Todd P." last="Semla">Todd P. Semla</name>
<name sortKey="Stone, Roslyn A" sort="Stone, Roslyn A" uniqKey="Stone R" first="Roslyn A." last="Stone">Roslyn A. Stone</name>
<name sortKey="Stone, Roslyn A" sort="Stone, Roslyn A" uniqKey="Stone R" first="Roslyn A." last="Stone">Roslyn A. Stone</name>
<name sortKey="Zhao, Xinhua" sort="Zhao, Xinhua" uniqKey="Zhao X" first="Xinhua" last="Zhao">Xinhua Zhao</name>
</country>
</tree>
</affiliations>
</record>

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Epidemiology of Drug-Disease Interactions in Older Veteran Nursing Home Residents

Epidemiology of Drug-Disease Interactions in Older Veteran Nursing Home Residents

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