Evidence map›Paper›PMID 32445121›Full record

ArticleDrugs & aging2020

Potentially Inappropriate Medications, Drug-Drug Interactions, and Anticholinergic Burden in Elderly Hospitalized Patients: Does an Association Exist with Post-Discharge Health Outcomes?

Antonio De Vincentis, Paolo Gallo, Panaiotis Finamore, Claudio Pedone, Luisa Costanzo, Luca Pasina, Laura Cortesi, Alessandro Nobili, Pier Mannuccio Mannucci, Raffaele Antonelli Incalzi

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In one paragraph

Article in Drugs & aging, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 4 pooled it
3.4field-weighted citation impact, top 7% 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

24 citing papers in PubMed, 4 syntheses or guidelines pooled it, 44 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Antonio De VincentisUnit of Geriatrics, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, 00128, Rome, Italy.ORCID http://orcid.org/0000-0003-0220-0500
Paolo GalloUnit of Geriatrics, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, 00128, Rome, Italy. paolo.gallo@unicampus.it.ORCID http://orcid.org/0000-0001-8292-1134
Panaiotis FinamoreUnit of Geriatrics, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, 00128, Rome, Italy.ORCID http://orcid.org/0000-0002-8608-9223
Claudio PedoneUnit of Geriatrics, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, 00128, Rome, Italy.ORCID http://orcid.org/0000-0003-1847-9032
Luisa CostanzoUnit of Geriatrics, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, 00128, Rome, Italy.ORCID http://orcid.org/0000-0002-0711-2131
Luca PasinaDipartimento di Neuroscienze, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy.ORCID http://orcid.org/0000-0002-4777-1350
Laura CortesiDipartimento di Neuroscienze, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy.ORCID http://orcid.org/0000-0001-8950-8561
Alessandro NobiliDipartimento di Neuroscienze, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy.ORCID http://orcid.org/0000-0002-7813-0572
Pier Mannuccio MannucciIRCCS Ca' Granda Maggiore Hospital Foundation and University of Milan, Milan, Italy.ORCID http://orcid.org/0000-0002-1915-3897
Raffaele Antonelli IncalziUnit of Geriatrics, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, 00128, Rome, Italy.ORCID http://orcid.org/0000-0003-2100-2075
Università Campus Bio-Medico · ITMario Negri Institute for Pharmacological Research · ITUniversity of Milan · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPolypharmacy is very common in elderly patients and is associated with detrimental outcomes.

objectiveOur objective was to evaluate the associations between a large panel of therapy quality indicators, including explicit lists of potentially inappropriate medications (PIMs; Beers criteria and Screening Tool of Older Persons' potentially inappropriate Prescriptions [STOPP] criteria), the Anticholinergic Cognitive Burden (ACB) score, and the number of drug-drug interactions (DDIs), with respect to mortality, rehospitalization, and physical function decline within 3 months from hospital discharge in a cohort of hospitalized elderly patients.

methodsWe studied 2631 individuals aged ≥ 65 years (median age 79.6; males 48.6%) enrolled in the REPOSI registry. The relationships with mortality and rehospitalization were evaluated using Cox regressions, and relationships with functional status change (as percentage variation of Barthel Index [BI]) were evaluated using mixed linear models.

resultsNone of the studied indicators was associated with mortality and rehospitalization. Conversely, only ACB was associated with physical function decline, even after correction for confounders (adjusted mean BI variation of - 7.55%; 95% confidence interval [CI] - 12.37 to - 2.47). The number of medications at discharge, particularly polypharmacy (more than five drugs daily), were the only therapy-related factors associated with mortality (adjusted hazard ratio [aHR] 1.05 [95% CI 1.01-1.10] and 1.70 [95% CI 1.12-2.58], respectively) and rehospitalization (aHR 1.05 [95% CI 1.01-1.08] and 1.31 [95% CI 1.01-1.71], respectively).

conclusionPolypharmacy, a very simple measure, outperformed sophisticated PIM and DDI indicators of quality of therapy as a correlate of primary clinical outcomes, whereas ACB was associated with physical function decline. Thus, innovative approaches to the definition and research of PIMs and DDIs are eagerly awaited from the perspective of averaging the quantitative burden and qualitative interaction of drugs.

Indexed as

Potentially Inappropriate Medication ListAftercareAgedAged, 80 and overCholinergic AntagonistsCohort StudiesDrug InteractionsFemaleHospitalizationHumansInappropriate PrescribingItalyMaleOutcome Assessment, Health CarePatient DischargePatient ReadmissionCholinergic Antagonists

Identifiers

PMID32445121
OpenAlexW3028261250

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.