Identifying potentially inappropriate prescribing in older people with dementia: a systematic review

被引:61
作者
Hukins, Deborah [1 ]
Macleod, Una [1 ]
Boland, Jason W. [1 ]
机构
[1] Univ Hull, Hull York Med Sch, Wolfson Ctr Palliat Care Res, Kingston Upon Hull, N Humberside, England
关键词
Potentially inappropriate prescribing; Dementia; Older people; Polypharmacy; NURSING-HOME RESIDENTS; SPECIALIST PALLIATIVE CARE; UPDATED BEERS CRITERIA; MEDICATION USE; DRUG-USE; COGNITIVE IMPAIRMENT; ANTICHOLINERGIC BURDEN; STOPP/START CRITERIA; EXPLICIT CRITERIA; CONSENSUS PANEL;
D O I
10.1007/s00228-018-02612-x
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
PurposeOlder people with dementia are at risk of adverse events associated with potentially inappropriate prescribing. Aim: to describe (1) how international tools designed to identify potentially inappropriate prescribing have been used in studies of older people with dementia, (2) the prevalence of potentially inappropriate prescribing in this cohort and (3) advantages/disadvantages of toolsMethodsSystematic literature review, designed and reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). MEDLINE, EMBASE, PsychInfo, CINAHL, the Cochrane Library, the Social Science Citation Index, OpenGrey, Base, GreyLit, Mednar and the National Database of Ageing Research were searched in April 2016 for studies describing the use of a tool or criteria to identify potentially inappropriate prescribing in older people with dementia.ResultsThree thousand three hundred twenty-six unique papers were identified; 26 were included in the review. Eight studies used more than one tool to identify potentially inappropriate prescribing. There were variations in how the tools were applied. The Beers criteria were the most commonly used tool. Thirteen of the 15 studies using the Beers criteria did not use the full tool. The prevalence of potentially inappropriate prescribing ranged from 14 to 74% in older people with dementia. Benzodiazepines, hypnotics and anticholinergics were the most common potentially inappropriately prescribed medications.ConclusionsVariations in tool application may at least in part explain variations in potentially inappropriate prescribing across studies. Recommendations include a more standardised tool usage and ensuring the tools are comprehensive enough to identify all potentially inappropriate medications and are kept up to date.
引用
收藏
页码:467 / 481
页数:15
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