Evidence map›Paper›PMID 34282638›Full record

ArticleThe Annals of pharmacotherapy2022

Association Between Potentially Inappropriate Medications and 30-Day Post-Hospital Discharge Outcomes in US Veterans.

Heather G Allore, Danijela Gnjidic, Melissa Skanderson, Ling Han

Registry-linked trialAbstract read
In one paragraph

Article in The Annals of pharmacotherapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06273917 (Deprescribing Potentially Inappropriate Medications in the Emergency Department for Persons Living With Dementia), which is not on this map. Cited by 1 paper.

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

NCT06273917 nacompletednot on this mapstarted 2024, after this paper: background citation

Deprescribing Potentially Inappropriate Medications in the Emergency Department for Persons Living With Dementia

TypeinterventionalSponsorNational Institute on Aging (NIA)Ran2024 to 2025Enrolled300ConditionsDementiaArmsPRIDE
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. 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

4 authors.

Heather G AlloreYale University, New Haven, CT, USA.ORCID 0000-0001-7685-8175
Danijela GnjidicUniversity of Sydney, NSW, Australia.
Melissa SkandersonVeterans Administration Connecticut Healthcare System, West Haven, CT, USA.
Ling HanYale University, New Haven, CT, USA.

Funding

Yale Study Support Suite (YES3): Dashboard and Web Portal Software Supporting Research Workflow through integrated, customizable REDCap External ModulesP30AG021342 · NIA · YALE UNIVERSITY · PI Albert C Shaw · 2002 to 2026
$37.9M
Yale Alzheimer Disease Research CenterP30AG066508 · NIA · YALE UNIVERSITY · PI STEPHEN M STRITTMATTER, CHRISTOPHER H VAN DYCK · 2020 to 2026
$30.2M
Preparing For What Is Next With Aducanumab In Real World SettingsR33AG057806 · NIA · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI Christopher Barrett Bowling, Ana Roman Quinones · 2018 to 2026
$9.0M
Geriatrics Emergency care Applied Research Network 2.1 - AdvanCing and Expanding Dementia care (GEAR 2.1 - ACED)R33AG069822 · NIA · YALE UNIVERSITY · PI Ula Y Hwang, MANISH N SHAH · 2023 to 2026
$5.3M
Advancing Geriatrics Infrastructure & Network Growth - Admin Supplement: Designing and Testing an Informatics Tool to Aid Prescribers in Reducing Anticholinergic Burden in Older AdultsR24AG045050 · NIA · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI GURWITZ, JERRY H · 2014 to 2017
$3.6M
Geriatric Emergency care Applied Research network 2.0 - Advancing Dementia Care (GEAR 2.0 ADC)R61AG069822 · NIA · YALE UNIVERSITY · PI HWANG, ULA Y, SHAH, MANISH N · 2020 to 2021
$3.0M
Pain Care Quality and Integrated and Complementary Health ApproachesR01AT008448 · NCCIH · YALE UNIVERSITY · PI BRANDT, CYNTHIA A., KERNS, ROBERT D · 2014 to 2018
$2.6M
NCCIH NIH HHS R01 AT008448NIA NIH HHS P30 AG021342NIA NIH HHS P30 AG066508NIA NIH HHS R24 AG045050NIA NIH HHS R33 AG057806NIA NIH HHS R33 AG069822NIA NIH HHS R61 AG069822
6 · The paper itself

Abstract

backgroundPotentially inappropriate medication (PIMs) use is common in older inpatients and it may lead to increased risk of adverse drug events.

objectivesTo examine prevalence of PIMs at hospital discharge and its contribution to health care utilization and mortality within 30-days of hospital discharge.

methodsThis was a prospective cohort of 117 570 veterans aged ≥65 years and hospitalized in 2013. PIMs at discharge were categorized into central nervous system acting (CNS) and non-CNS. Outcomes within 30-days of hospital discharge were: (1) time to first acute care hospital readmission, and all-cause mortality, (2) an emergency room visit, and (3) ≥3 primary care clinic visits.

resultsThe cohort's mean age was 74.3 years (SD 8.1), with 51.3% exposed to CNS and 62.8% to non-CNS PIMs. Use of CNS and non-CNS PIMs, respectively, was associated with a reduced risk of readmission, with an adjusted hazard ratio (aHR) of 0.93 (95% CI = 0.89-0.96) for ≥2 (vs 0) CNS PIMs and an aHR of 0.85 (95% CI = 0.82-0.88) for ≥2 (vs 0) non-CNS PIMs. Use of CNS PIMs (≥2 vs 0) was associated with increased risk of mortality (aHR = 1.37 [95% CI = 1.25-1.51]), whereas non-CNS PIMs use was associated with a reduced risk of mortality (aHR = 0.75 [95% CI = 0.69-0.82]). CONCLUSION AND RELEVANCE: PIMs were highly common in this veteran cohort, and the association with outcomes differed by PIMs. Thus, it is important to consider whether PIMs are CNS acting to optimize short-term posthospitalization outcomes.

Indexed as

Potentially Inappropriate Medication ListVeteransAgedHospitalsHumansInappropriate PrescribingPatient DischargeProspective Studieshealthcare utilizationmedicationsmortalityolder adults

Identifiers

PMID34282638
PMCPMC8770754

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Registered trials

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.