Abstract
Background: Older adults with dementia commonly receive multiple medications and have higher hospitalisation rates, elevating the risk of potentially inappropriate prescribing and in-hospital adverse drug reactions (ADR). There is limited evidence examining ADRs in older adults with dementia during hospitalisation.
Objectives: Our aim was to assess the association between dementia and incidence of
ADRs during hospitalisation and to identify prevalent types of ADRs and medications
linked to ADRs.
Design: Secondary analysis of the SENATOR trial database, which was a randomized controlled trial of an intervention to reduce ADRs in older inpatients with multimorbidity.
Setting: Six European hospitals.
Participants: 1,537 patients (47.2% females) with a mean age of 78.1 years.
Methods: Sociodemographic data, functional status, cognitive status, clinical information, and ADR-related outcomes were extracted from the SENATOR database. Inpatients with dementia were identified based on prior dementia International Classification of Diseases 10th 101 revision (ICD-10) diagnosis, receiving acetylcholinesterase inhibitors/memantine, or a Mini-Mental State Examination (MMSE) score ≤24 at admission without concurrent delirium.
Results: Among participants, 392 (25.5%) were identified as having dementia. The proportion of patients with probable/certain incident in-hospital ADRs was similar between the groups with and without dementia (22.4% vs 25.4% p>0.05). However, in-hospital rates of probable/certain ADRs from 12 common categories were less frequently identified in patients with dementia compared to those without (19.4% vs 23% p=0.025). Major constipation (6.4% vs 9.9% p=0.03) and acute dyspepsia/nausea/vomiting (2.8% vs 5% p=0.03) were less commonly observed ADRs in patients with dementia.
Conclusions and implications: We did not observe an increased risk of in-hospital ADRs among inpatients with dementia. However, ADRs related to the gastrointestinal tract and identified by subjective symptoms were less frequently identified in this group. This study lays the groundwork for developing new tools for ADR diagnosis for older patients with dementia
Objectives: Our aim was to assess the association between dementia and incidence of
ADRs during hospitalisation and to identify prevalent types of ADRs and medications
linked to ADRs.
Design: Secondary analysis of the SENATOR trial database, which was a randomized controlled trial of an intervention to reduce ADRs in older inpatients with multimorbidity.
Setting: Six European hospitals.
Participants: 1,537 patients (47.2% females) with a mean age of 78.1 years.
Methods: Sociodemographic data, functional status, cognitive status, clinical information, and ADR-related outcomes were extracted from the SENATOR database. Inpatients with dementia were identified based on prior dementia International Classification of Diseases 10th 101 revision (ICD-10) diagnosis, receiving acetylcholinesterase inhibitors/memantine, or a Mini-Mental State Examination (MMSE) score ≤24 at admission without concurrent delirium.
Results: Among participants, 392 (25.5%) were identified as having dementia. The proportion of patients with probable/certain incident in-hospital ADRs was similar between the groups with and without dementia (22.4% vs 25.4% p>0.05). However, in-hospital rates of probable/certain ADRs from 12 common categories were less frequently identified in patients with dementia compared to those without (19.4% vs 23% p=0.025). Major constipation (6.4% vs 9.9% p=0.03) and acute dyspepsia/nausea/vomiting (2.8% vs 5% p=0.03) were less commonly observed ADRs in patients with dementia.
Conclusions and implications: We did not observe an increased risk of in-hospital ADRs among inpatients with dementia. However, ADRs related to the gastrointestinal tract and identified by subjective symptoms were less frequently identified in this group. This study lays the groundwork for developing new tools for ADR diagnosis for older patients with dementia
| Original language | English |
|---|---|
| Article number | 105151 |
| Journal | Journal of the American Medical Directors Association |
| Volume | 25 |
| Issue number | 9 |
| Early online date | 27 Jul 2024 |
| DOIs | |
| Publication status | Published - Sept 2024 |
Bibliographical note
Acknowledgements This work is part of ERE thesis work at Universidad Complutense de Madrid, supervised by ACJ and CVB.Data Availability Statement
Data access is restricted to investigator teams from the included centres according to the Spanish data protection laws and European Union Laws Standards.Funding
The SENATOR trial was supported by the European Commission’s Seventh Framework Programme (FP7/2007-2013) (grant number 305930) as part of the SENATOR project
| Funders | Funder number |
|---|---|
| H2020 European Research Council | 305930 |
Keywords
- Dementia
- drugs
- adverse drug reactions
- older people
- acute care