Potentially inappropriate medication use in people with dementia in China and its associated factors

Abstract

AbstractBackgroundMedicine use in people with dementia is challenging. This study was conducted to examine the use of potentially inappropriate medicines that may affect cognition (PIMcog) or reduce the effectiveness of cholinesterase inhibitors (CEIs) in people with dementia.MethodA cross‐sectional study of people with dementia admitted to hospitals in Shandong, China between 31st Dec 2014 and 31st Dec 2016 was conducted. Patients’ medical records were reviewed and their medicine use assessed. Polypharmacy was defined as use of five or more medicines in the same hospital episode. Concomitant use of CEIs with anticholinergic medicines was assessed using a list of medicines with clinically relevant anticholinergic property based on a consensus combination of different anticholinergic scales. Use of PIMcog was assessed against a list of PIMcog developed based on relevant Beers 2012 and STOPP 2014 criteria. Variables associated with having a PIMcog were assessed using a multiple logistic regression.ResultOf the 453 participants with a mean age of 75.9 years, 98.7% used polypharmacy, 56.1% used a PIMcog, 30.7% used CEIs concomitantly with anticholinergics, and 32.2% used antipsychotics. PIMcog use was associated with higher number of comorbidities (adjusted OR 1.14; 95% CI: 1.04 ‐ 1.33), higher number of other medicines prescribed rather than PIMcog (adjusted OR 1.07; 95% CI: 1.01 ‐ 1.13) and types of prescribers.ConclusionUse of polypharmacy and medicines that can further impair cognition or reduce the effectiveness of CEIs in people with dementia was prevalent. Efforts to improve quality use of medicines for this population are warranted.