Evidence map›Paper›PMID 36447741›Full record

ArticleJournal of Alzheimer's disease reports2022

Association Between Low- and High-Value Medication and Hospital Referrals by General Practitioners in Patients Living with Dementia.

Bernhard Michalowsky, Moritz Platen, Jens Bohlken, Karel Kostev

Abstract read
In one paragraph

Article in Journal of Alzheimer's disease reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the 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.

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

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.

Bernhard MichalowskyGerman Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany.
Moritz PlatenGerman Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany.
Jens BohlkenInstitute for Social Medicine, Occupational Medicine, and Public Health (ISAP) of the Medical Faculty, University of Leipzig, Leipzig, Germany.
Karel KostevEpidemiology, IQVIA, Frankfurt am Main, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Previous studies revealed that low-value medication (LvM), drugs that provide little or no benefit but have the potential to cause harm, are associated with hospitalizations in dementia. Recommended medications, referred to as high-value medication (HvM), can be used alternately. However, the effect of LvM and HvM on hospitalizations is uncertain. Objective: To determine the prevalence of LvM and HvM in hospitalized and non-hospitalized patients living with dementia (PwD) and the odds for hospital referrals in PwD receiving LvM or HvM. Methods: The analysis was based on 47,446 PwD who visited a general practitioner practice between 2017 and 2019. Different guidelines were used to elicit LvM and HvM, resulting in 185 LvM and HvM related recommendations. Of these, 117 recommendations (83 for LvM, 34 for HvM) were categorized into thirteen therapy classes. The association of hospital referrals issued by general practitioners and receiving LvM or HvM was assessed using multiple logistic regression models. Results: 20.4% of PWD received LvM. Most frequently prescribed LvM were non-recommended sedatives and hypnotics, analgesics, and antidepressants. Recommended HvM were 3.4 (69.9%) more frequently prescribed than LvM. Most commonly prescribed HvM were recommended antihypertensives, antiplatelet agents, and antiarrhythmics. Both receiving LvM and receiving HvM were associated with higher odds for hospital referrals. When receiving LvM were compared to HvM, no significant differences could be found in hospital referrals. Conclusion: LvM is highly prevalent but did not cause more likely hospital referrals than HvM. Further research should focus on acute hospitalizations, not only on planned hospital referrals.

Indexed as

Alzheimer’s diseasehealth-related quality of lifehospitalizationlow-value carepatient-centered outcomes

Identifiers

PMID36447741
PMCPMC9661347

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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.