Drug-related problems in older adults with mild...

Drug-related problems in older adults with mild cognitive impairment or dementia: A cross-sectional comparison of 2 different instruments

Abstract

Background: Up to 30% of hospital admissions in older adults may be attributed to drug-related problems (DRPs). DRPs encompass adverse drug reactions, interaction between medications, the use of potentially inappropriate medications, and non-adherence to prescribed medications. Objective: To evaluate and compare the average number of DRPs identified in older adults with cognitive impairment or dementia using the Medication Review in Cognitive Impairment and Dementia (MedRevCiD) checklist compared to the Medication Appropriateness Index (MAI) criteria. Methods: Forty-four participants from the Multi-specialty Interprofessional Team-based Memory Clinic were included in the study. The researcher used 2 distinct tools, the MAI criteria and MedRevCiD checklist, to perform a medication review. The Wilcoxon signed-rank test was applied to evaluate if a significant difference exists in the average number of DRPs identified by the MedRevCiD compared to the MAI. Bivariate logistic regression analysis was conducted to explore potential factors associated with the DRPs use. Results: In the study, a total of 134 DRPs were identified in 44 participants using the MedRevCiD checklist, averaging 3.05 DRPs per person ± standard deviation (SD) of 4.0. In comparison, 81 DRPs were identified with the use of the MAI in the same group of 44 participants, resulting in an average of 1.84 DRPs per person (SD ± 2.9). A significant difference was found in the average number of DRPs identified by the 2 instruments (Z = –4.8, p-value <0.001). Conclusion: The MedRevCiD Checklist demonstrated a heightened ability to uncover DRPs in this population.