Evidence map›Paper›PMID 30378088›Full record

ArticleDrugs & aging2019

Is the Drug Burden Index Related to Declining Functional Status at Follow-up in Community-Dwelling Seniors Consulting for Minor Injuries? Results from the Canadian Emergency Team Initiative Cohort Study.

Edeltraut Kröger, Marilyn Simard, Marie-Josée Sirois, Marianne Giroux, Caroline Sirois, Lisa Kouladjian-O'Donnell, Emily Reeve, Sarah Hilmer, Pierre-Hugues Carmichael, Marcel Émond

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Drugs & aging, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Patient-reported outcome measure use among older adults after emergency department care: A systematic review.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2024
    Pooled it
  2. Article
  3. Review
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

10 authors.

Edeltraut KrögerFaculté de pharmacie, Université Laval, Québec, Canada. edeltraut.kroger.ciussscn@ssss.gouv.qc.ca.ORCID 0000-0002-5653-3979
Marilyn SimardCentre d'excellence sur le vieillissement de Québec du Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSSCN), Québec, Canada.
Marie-Josée SiroisCentre d'excellence sur le vieillissement de Québec du Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSSCN), Québec, Canada.
Marianne GirouxCentre d'excellence sur le vieillissement de Québec du Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSSCN), Québec, Canada.
Caroline SiroisCentre d'excellence sur le vieillissement de Québec du Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSSCN), Québec, Canada.
Lisa Kouladjian-O'DonnellNHMRC Cognitive Decline Partnership Centre, University of Sydney, Sydney, NSW, Australia.
Emily ReeveNHMRC Cognitive Decline Partnership Centre, University of Sydney, Sydney, NSW, Australia.
Sarah HilmerNHMRC Cognitive Decline Partnership Centre, University of Sydney, Sydney, NSW, Australia.
Pierre-Hugues CarmichaelCentre d'excellence sur le vieillissement de Québec du Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSSCN), Québec, Canada.
Marcel ÉmondCentre d'excellence sur le vieillissement de Québec du Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSSCN), Québec, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Canadian Emergency Team Initiative (CETI) cohort showed that minor injuries like sprained ankles or small fractures trigger a downward spiral of functional decline in 16% of independent seniors up to 6 months post-injury. Such seniors frequently receive medications with sedative or anticholinergic properties. The Drug Burden Index (DBI), which summarises the drug burden of these specific medications, has been associated with decreased physical and cognitive functioning in previous research.

objectivesWe aimed to assess the contribution of the DBI to functional decline in the CETI cohort.

methodsCETI participants were assessed physically and cognitively at baseline during their consultations at emergency departments (EDs) for their injuries and up to 6 months thereafter. The medication data were used to calculate baseline DBI and functional status was measured with the Older Americans Resources and Services (OARS) scale. Multivariate linear regression models assessed the association between baseline DBI and functional status at 6 months, adjusting for age, sex, baseline OARS, frailty level, comorbidity count, and mild cognitive impairment.

resultsThe mean age of the 846 participants was 77 years and their mean DBI at baseline was 0.24. Complete follow-up data at 3 or 6 months was available for 718 participants among whom a higher DBI at the time of injury contributed to a lower functional status at 6 months. Each additional point in the DBI lead to a loss of 0.5 points on the OARS functional scale, p < 0.001. Among those with a DBI ≥ 1, 27.4% were considered 'patients who decline' at 3 or 6 months' follow-up, compared with 16.0% of those with a DBI of 0 (p = 0.06).

conclusionsED visits are considered missed opportunities for optimal care interventions in seniors; Identifying their DBI and adjusting treatment accordingly may help limit functional decline in those at risk after minor injury.

Indexed as

AgedAged, 80 and overCanadaCholinergic AntagonistsCognitionCognitive DysfunctionCohort StudiesEmergency Service, HospitalFemaleFollow-Up StudiesFractures, BoneHumansHypnotics and SedativesIndependent LivingMaleProspective StudiesCholinergic AntagonistsHypnotics and Sedatives

Identifiers

PMID30378088

What OpenQuestion holds

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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.