Evidence map›Paper›PMID 29322470›Full record

ArticleDrugs & aging2018

Associations between the Drug Burden Index, Potentially Inappropriate Medications and Quality of Life in Residential Aged Care.

Stephanie L Harrison, Lisa Kouladjian O'Donnell, Clare E Bradley, Rachel Milte, Suzanne M Dyer, Emmanuel S Gnanamanickam, Enwu Liu, Sarah N Hilmer, Maria Crotty

Abstract read
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Article in Drugs & aging, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 3 pooled it
–field-weighted citation impact
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

32 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  11. Polypharmacy in Older Adults with Alzheimer's Disease.Medicina (Kaunas, Lithuania) · 2022
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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

9 authors.

Stephanie L HarrisonDepartment of Rehabilitation, Aged and Extended Care, Faculty of Medicine, Nursing and Health Sciences, School of Health Sciences, Flinders University, Level 4, Rehabilitation building, Flinders Medical Centre, Flinders Drive, Bedford Park, SA, 5042, Australia. Stephanie.harrison@flinders.edu.au.ORCID http://orcid.org/0000-0002-8846-0946
Lisa Kouladjian O'DonnellNHMRC Cognitive Decline Partnership Centre, University of Sydney, Sydney, NSW, Australia.
Clare E BradleyDepartment of Rehabilitation, Aged and Extended Care, Faculty of Medicine, Nursing and Health Sciences, School of Health Sciences, Flinders University, Level 4, Rehabilitation building, Flinders Medical Centre, Flinders Drive, Bedford Park, SA, 5042, Australia.
Rachel MilteDepartment of Rehabilitation, Aged and Extended Care, Faculty of Medicine, Nursing and Health Sciences, School of Health Sciences, Flinders University, Level 4, Rehabilitation building, Flinders Medical Centre, Flinders Drive, Bedford Park, SA, 5042, Australia.
Suzanne M DyerDepartment of Rehabilitation, Aged and Extended Care, Faculty of Medicine, Nursing and Health Sciences, School of Health Sciences, Flinders University, Level 4, Rehabilitation building, Flinders Medical Centre, Flinders Drive, Bedford Park, SA, 5042, Australia.
Emmanuel S GnanamanickamDepartment of Rehabilitation, Aged and Extended Care, Faculty of Medicine, Nursing and Health Sciences, School of Health Sciences, Flinders University, Level 4, Rehabilitation building, Flinders Medical Centre, Flinders Drive, Bedford Park, SA, 5042, Australia.
Enwu LiuDepartment of Rehabilitation, Aged and Extended Care, Faculty of Medicine, Nursing and Health Sciences, School of Health Sciences, Flinders University, Level 4, Rehabilitation building, Flinders Medical Centre, Flinders Drive, Bedford Park, SA, 5042, Australia.
Sarah N HilmerNHMRC Cognitive Decline Partnership Centre, University of Sydney, Sydney, NSW, Australia.
Maria CrottyDepartment of Rehabilitation, Aged and Extended Care, Faculty of Medicine, Nursing and Health Sciences, School of Health Sciences, Flinders University, Level 4, Rehabilitation building, Flinders Medical Centre, Flinders Drive, Bedford Park, SA, 5042, Australia.

Funding

National Health and Medical Research Council GNT9100000
6 · The paper itself

Abstract

backgroundInappropriate polypharmacy may negatively impact the quality of life of residents in aged care facilities, but it remains unclear which medications may influence this reduced quality of life.

objectiveThe objective of this study was to examine whether the Drug Burden Index and potentially inappropriate medications were associated with quality of life in older adults living in residential care with a high prevalence of cognitive impairment and dementia.

methodsWe conducted cross-sectional analyses of 541 individuals recruited from 17 residential aged care facilities in Australia in the Investigating Services Provided in the Residential Environment for Dementia (INSPIRED) study. Quality of life was measured using the EuroQol Five Dimensions Questionnaire (a measure of generic quality of life) and the Dementia Quality of Life Questionnaire completed by the participant or a proxy.

resultsIn the 100 days prior to recruitment, 83.1% of the participants received at least one anticholinergic or sedative medication included in the Drug Burden Index and 73.0% received at least one potentially inappropriate medication according to the Beers Criteria. Multi-level linear models showed there was a significant association between a higher Drug Burden Index and lower quality of life according to the EuroQol Five Dimensions Questionnaire [β (standard error): - 0.034 (0.012), p = 0.006] after adjustment for potential confounding factors. Increasing numbers of potentially inappropriate medications were also associated with lower EuroQol Five Dimensions Questionnaire scores [- 0.030 (0.010), p = 0.003] and Dementia Quality of Life Questionnaire-Self-Report-Utility scores [- 0.020 (0.009), p = 0.029]. Exposure to both Drug Burden Index-associated medications and potentially inappropriate medications was associated with lower Dementia Quality of Life Questionnaire-Self-Report-Utility scores [- 0.034 (0.017), p = 0.049].

conclusionExposure to anticholinergic and sedative medications and potentially inappropriate medications occurred in over three-quarters of a population of older adults in residential care and was associated with a lower quality of life.

Indexed as

AgedAged, 80 and overAssisted Living FacilitiesAustraliaCholinergic AntagonistsCognitive DysfunctionCross-Sectional StudiesDementiaFemaleHumansInappropriate PrescribingMalePolypharmacyPotentially Inappropriate Medication ListPrevalenceQuality of LifeCholinergic Antagonists

Identifiers

PMID29322470

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.