Evidence map›Paper›PMID 27838819›Full record

ArticleDrugs & aging2017

Risk Factors for Initiation of Potentially Inappropriate Medications in Community-Dwelling Older Adults with and without Alzheimer's Disease.

Virva Hyttinen, Heidi Taipale, Antti Tanskanen, Jari Tiihonen, Anna-Maija Tolppanen, Sirpa Hartikainen, Hannu Valtonen

Abstract read
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In one paragraph

Article in Drugs & aging, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 19% 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

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

  1. Pooled it
  2. Observational
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 2 countries.

Virva HyttinenDepartment of Health and Social Management, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland. virva.hyttinen@uef.fi.ORCID 0000-0003-2022-1065
Heidi TaipaleKuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland.
Antti TanskanenDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Jari TiihonenDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Anna-Maija TolppanenSchool of Pharmacy, University of Eastern Finland, Kuopio, Finland.
Sirpa HartikainenKuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland.
Hannu ValtonenDepartment of Health and Social Management, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.
University of Eastern Finland · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVarious criteria have been created to define potentially inappropriate medications (PIMs) to help improve the quality and safety of medicine use in older patients. Individuals with Alzheimer's disease (AD) may be at higher risk of adverse drug events associated with PIMs (such as falls).

objectiveOur objective was to determine the risk factors for PIM initiation in a nationwide cohort of community dwellers aged ≥65 years with and without AD.

methodsThe Finnish nationwide MEDALZ cohort includes all patients diagnosed with AD in 2005-2011 (n = 70,718) and two comparison individuals without AD (non-AD) matched for age, sex and region of residence for each person with AD. After a 1-year washout period for PIM use and exclusion of those aged <65 years, we included 50,494 patients with AD and 106,306 comparison subjects. PIM use was defined according to Finnish criteria.

resultsSubjects without AD initiated PIMs more frequently than those with AD (16.4 vs. 12.2%, respectively; p < 0.001). The most common PIMs were muscle relaxants and urinary antispasmodics. Older individuals (aged ≥75 years) were less likely to initiate PIMs. In the AD group, women were less likely to initiate PIMs than men. More comorbidities were associated with PIM initiation, especially in the non-AD group. The use of opioids or psychotropic medicines was associated with PIM initiation in both cohorts. Regional differences between university hospital districts were observed.

conclusionPIM initiation was dependent on patient characteristics and possibly also some healthcare system-related factors such as differing regional treatment practices. It is important that medicines prescribed to the older vulnerable population are assessed regularly to avoid adverse effects and ensure safe pharmacotherapy, especially in those with multiple comorbidities.

Indexed as

Potentially Inappropriate Medication ListAccidental FallsAgedAged, 80 and overAlzheimer DiseaseComorbidityDrug-Related Side Effects and Adverse ReactionsFemaleFinlandHumansInappropriate PrescribingMaleRetrospective StudiesRisk Factors

Identifiers

PMID27838819
OpenAlexW2557129364

What OpenQuestion holds

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Registered trials

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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.