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Medication Assessment in an Older Population during Acute Care Hospitalization and Its Effect on the Anticholinergic Burden: A Prospective Cohort Study

Author

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  • Mariona Espaulella-Ferrer

    (Servei Territorial de Geriatria i Cures Pal·Liatives d’Osona i el Ripollés, Hospital Universitari de la Santa Creu de Vic, Hospital Universitari de Vic, 08500 Vic, Spain
    Tissue Repair and Regeneration Laboratory (TR2Lab), Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IRIS-CC), 08500 Vic, Spain)

  • Nuria Molist-Brunet

    (Servei Territorial de Geriatria i Cures Pal·Liatives d’Osona i el Ripollés, Hospital Universitari de la Santa Creu de Vic, Hospital Universitari de Vic, 08500 Vic, Spain
    Central Catalonia Chronicity Research Group (C3RG), Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IRIS-CC), 08500 Vic, Spain)

  • Joan Espaulella-Panicot

    (Servei Territorial de Geriatria i Cures Pal·Liatives d’Osona i el Ripollés, Hospital Universitari de la Santa Creu de Vic, Hospital Universitari de Vic, 08500 Vic, Spain
    Central Catalonia Chronicity Research Group (C3RG), Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IRIS-CC), 08500 Vic, Spain)

  • Daniel Sevilla-Sánchez

    (Pharmacy Department, Parc Sanitari Pere Virgili, 08023 Barcelona, Spain)

  • Emma Puigoriol-Juvanteny

    (Epidemiology Department, Hospital Universitari de Vic, 08500 Vic, Spain
    Multidisciplinary Inflamations Research Group (MIRG), Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IRIS-CC), 08500 Vic, Spain)

  • Marta Otero-Viñas

    (Tissue Repair and Regeneration Laboratory (TR2Lab), Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IRIS-CC), 08500 Vic, Spain
    Faculty of Science, Technology and Engineering, University of Vic-Central University of Catalonia (UVic-UCC), 08500 Vic, Spain)

Abstract

(1) Background: Anticholinergic and sedative drugs (ASDs) contribute to negative health outcomes, especially in the frail population. In this study, we aimed to assess whether frailty increases with anticholinergic burden and to evaluate the effects of medication reviews (MRs) on ASD regimens among patients attending an acute care for the elderly (ACE) unit. (2) Methods: A cohort study was conducted between June 2019 and October 2020 with 150 consecutive patients admitted to our ACE unit. Demographic, clinical, and pharmacological data were assessed. Frailty score was determined using the Frail-VIG index (FI-VIG), and ASD burden was quantified using the drug burden index (DBI). In addition, the MR was performed using the patient-centered prescription (PCP) model. We used a paired T-test to compare the DBI pre- and post-MR and univariate and multivariate regression to identify the factors associated with frailty. (3) Results: Overall, 85.6% ( n = 128) of participants showed some degree of frailty (FI-VIG > 0.20) and 84% ( n = 126) of patients received treatment with ASDs upon admission (pre-MR). As the degree of frailty increased, so did the DBI ( p < 0.001). After the implementation of the MR through the application of the PCP model, a reduction in the DBI was noted (1.06 ± 0.8 versus 0.95 ± 0.7) ( p < 0.001). After adjusting for covariates, the association between frailty and the DBI was apparent (OR: 11.42, 95% (CI: 2.77–47.15)). (4) Conclusions: A higher DBI was positively associated with frailty. The DBI decreased significantly in frail patients after a personalized MR. Thus, MRs focusing on ASDs are crucial for frail older patients.

Suggested Citation

  • Mariona Espaulella-Ferrer & Nuria Molist-Brunet & Joan Espaulella-Panicot & Daniel Sevilla-Sánchez & Emma Puigoriol-Juvanteny & Marta Otero-Viñas, 2023. "Medication Assessment in an Older Population during Acute Care Hospitalization and Its Effect on the Anticholinergic Burden: A Prospective Cohort Study," IJERPH, MDPI, vol. 20(7), pages 1-13, March.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:7:p:5322-:d:1111476
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    References listed on IDEAS

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    1. Núria Molist-Brunet & Daniel Sevilla-Sánchez & Emma Puigoriol-Juvanteny & Mariona Espaulella-Ferrer & Jordi Amblàs-Novellas & Joan Espaulella-Panicot, 2021. "Factors Associated with the Detection of Inappropriate Prescriptions in Older People: A Prospective Cohort," IJERPH, MDPI, vol. 18(21), pages 1-17, October.
    2. Sebastià J. Santaeugènia & Joan C. Contel & Emili Vela & Montserrat Cleries & Paloma Amil & Eva M. Melendo-Azuela & Esther Gil-Sánchez & Victoria Mir & Jordi Amblàs-Novellas, 2021. "Characteristics and Service Utilization by Complex Chronic and Advanced Chronic Patients in Catalonia: A Retrospective Seven-Year Cohort-Based Study of an Implemented Chronic Care Program," IJERPH, MDPI, vol. 18(18), pages 1-20, September.
    3. Núria Molist-Brunet & Daniel Sevilla-Sánchez & Emma Puigoriol-Juvanteny & Lorena Bajo-Peñas & Immaculada Cantizano-Baldo & Laia Cabanas-Collell & Joan Espaulella-Panicot, 2022. "Individualized Medication Review in Older People with Multimorbidity: A Comparative Analysis between Patients Living at Home and in a Nursing Home," IJERPH, MDPI, vol. 19(6), pages 1-13, March.
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