Evidence map›Paper›PMID 26553225›Full record

ArticleScandinavian journal of primary health care2015

Clinical impact of potentially inappropriate medications during hospitalization of acutely ill older patients with multimorbidity.

Hege Kersten, Lara T Hvidsten, Gløer Gløersen, Torgeir Bruun Wyller, Marte Sofie Wang-Hansen

Erratum issuedOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Scandinavian journal of primary health care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 22 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 2 pooled it
1.6field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 2 countries.

Hege Kerstena Department of Geriatric Medicine , Vestfold Hospital Trust , Tønsberg , Norway .
Lara T Hvidstena Department of Geriatric Medicine , Vestfold Hospital Trust , Tønsberg , Norway .
Gløer Gløersend The Hospital Pharmacies, Vestfold, South-Eastern Norway Regional Health Authority , Norway .
Torgeir Bruun Wyllere Institute of Clinical Medicine, University of Oslo , Oslo , Norway , and.
Marte Sofie Wang-Hansena Department of Geriatric Medicine , Vestfold Hospital Trust , Tønsberg , Norway .
Sykehuset i Vestfold · NONational Institute on Aging · USNorthern Norway Regional Health Authority · NOUniversity of Oslo · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo identify potentially inappropriate medications (PIMs), to compare drug changes between geriatric and other medical wards, and to investigate the clinical impact of PIMs in acutely hospitalized older adults. SETTING AND SUBJECTS: Retrospective study of 232 home-dwelling, multimorbid older adults (aged ≥75 years) acutely admitted to Vestfold Hospital Trust, Norway.

main outcome measuresPIMs were identified by Norwegian general practice (NORGEP) criteria and Beers' 2012 criteria. Clinical correlates were laboratory measures, functional and mental status, physical frailty, and length of stay.

resultsMean (SD) age was 86 (5.7) years, and length of stay was 6.5 (4.8) days. During the stay, the mean number of drugs used regularly changed from 7.8 (3.6) to 7.9 (3.6) (p = 0.22), and drugs used pro re nata (prn) changed from 1.4 (1.6) to 2.0 (1.7) (p < 0.001). The prevalence of any PIM changed from 39.2% to 37.9% (p = 0.076), while anticholinergics and benzodiazepines were reduced significantly (p ≤ 0.02). The geriatric ward reduced drug dosages (p < 0.001) and discontinued PIMs (p < 0.001) significantly more often than other medical wards. No relations between number of PIMS and clinical outcomes were identified, but the concomitant use of ≥3 psychotropic/opioid drugs was associated with reduced hand-grip strength (p ≤ 0.012).

conclusionHospitalization did not change polypharmacy or PIMs. Drug treatment was more appropriate on the geriatric than other medical wards. No clinical impact of PIMs was observed, but prescribers should be vigilant about concomitant prescription of ≥3 psychotropics/opioids. KEY POINTS: Acute hospitalization of older patients with multimorbidity did not increase polypharmacy or potentially inappropriate medications. Prescription of anticholinergics and benzodiazepines was significantly reduced. The geriatric ward reduced drug dosages and discontinued potentially inappropriate medications more frequently than the other medical wards.

Indexed as

AgedAged, 80 and overComorbidityDrug SubstitutionFemaleHospitalizationHumansInappropriate PrescribingLength of StayMaleMedication ErrorsNorwayPolypharmacyRetrospective StudiesAgedclinical pharmacistsgeneral practicegeneral practitionersgeriatric assessmentinappropriate prescribingNorwaypolypharmacypsychotropic drugs

Identifiers

PMID26553225
PMCPMC4750733
OpenAlexW2163524688

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.