Zaidi, AS and Peterson, GM and Bereznicki, LRE and Curtain, CM and Salahudeen, MS, Outcomes of medication misadventure among people with cognitive impairment or dementia: a systematic review and meta-analysis, The Annals of Pharmacotherapy, 55, (4) pp. 530-542. ISSN 1060-0280 (2020) [Refereed Article]
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Objective: To investigate mortality and hospitalization outcomes associated with medication misadventure (including medication errors [MEs], such as the use of potentially inappropriate medications [PIMs], and adverse drug events [ADEs]) among people with cognitive impairment or dementia.
Data Sources: Ovid MEDLINE, Ovid EMBASE, Ovid International Pharmaceutical Abstracts, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Central Register of Controlled Trials were searched from inception to December 2019.
Study Selection and Data Extraction: Relevant studies using any study design were included. Reviewers independently performed critical appraisal and extracted relevant data.
Data Synthesis: The systematic review included 10 studies that reported the outcomes of mortality or hospitalization associated with medication misadventure, including PIMs (n=5), ADEs (n=2), a combination of MEs and ADEs (n=2), and drug interactions (n=1). Five studies examining the association between PIMs and mortality/hospitalization were included in the meta-analyses. Exposure to PIMs was not associated with either mortality (odds ratio [OR]=1.36; 95%CI=0.79- 2.35) or hospitalization (OR=1.02; 95%CI=0.83-1.26). In contrast, single studies indicated that ADEs with cholinesterase inhibitors were associated with mortality and hospitalization.
Relevance to Patient Care and Clinical Practice: Individuals with cognitive impairment or dementia are at increased risk of medication misadventure; based on relatively limited published data, this does not necessarily translate to increased mortality and hospitalization.
Conclusions: Overall, medication misadventure was not associated with mortality or hospitalization in people with cognitive impairment or dementia, noting the limited number of studies, difficulty in controlling potential confounding variables, and that most studies focus on PIMs.
|Item Type:||Refereed Article|
|Keywords:||medication misadventure, medication errors, adverse drug events, cognitive impairment, dementia, mortality, hospitalization, meta-analysis|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Pharmacology and pharmaceutical sciences|
|Research Field:||Clinical pharmacy and pharmacy practice|
|Objective Group:||Evaluation of health and support services|
|Objective Field:||Evaluation of health outcomes|
|UTAS Author:||Zaidi, AS (Mr Anum Zaidi)|
|UTAS Author:||Peterson, GM (Professor Gregory Peterson)|
|UTAS Author:||Bereznicki, LRE (Professor Luke Bereznicki)|
|UTAS Author:||Curtain, CM (Mr Colin Curtain)|
|UTAS Author:||Salahudeen, MS (Dr Mohammed Salahudeen)|
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