Potentially Inappropriate Central Nervous System Active Medication Use in Persons With Dementia

2.50
Hdl Handle:
http://hdl.handle.net/10755/162114
Category:
Abstract
Type:
Presentation
Title:
Potentially Inappropriate Central Nervous System Active Medication Use in Persons With Dementia
Author(s):
Fick, Donna M.; Kolanowski, Ann M.; Waller, Jennifer L.
Author Details:
Donna M. Fick, PhD, APRN-BC, The Pennsylvania State University, University Park, Pennsylvania, USA, email: dmf21@psu.edu; Ann M. Kolanowski PhD, RN, FAAN; Jennifer L. Waller, PhD, Medical College of Georgia
Abstract:
Purpose: Very few recent studies have investigated the prevalence and outcomes for central nervous system-active (CNS-active) medication use in older persons with dementia (PWD) who live in the community. Thus, the purpose of this study was to describe the health outcomes and patterns of use of CNS-active drugs in persons with dementia living in the community. Theoretical Framework: We constructed the study framework based on the naranjo algorithm and an extensive review of the literature on medication use in older adults and the related adverse events associated with specific classes of drugs. Methods (Design, Sample, Setting, Measures, Analysis): A retrospective study design from a Southeastern managed care organization (MCO) was used. Claims data were collected for three years on all identified cases with dementia and included age, gender, payor status (HMO, PPO, FFS), medical diagnoses for each claim (International Classification of Disease [ICD-9 code]), and prescription drugs (National Drug Code [NDC]). From this N= 960 individuals who were continuously enrolled and had prescription drug coverage were selected. NDC codes were categorized into therapeutic classes including type of CNS-active drug per the 2005 American Hospital Formulary Service. We used ICD-9 codes for principal and secondary diagnoses related to health care services and drug-related problems. We measured comorbidity using the Deyo-adapted Charlson Comorbidity Index. Results: Over 79% of persons with dementia in this sample were on a CNS-active medication during the three-year time period, and 35% were on a benzodiazepine. The highest number of drug-related problems within 45 days after receiving a CNS drug prescription were for syncope, fatigue, altered level of consciousness, delirium, constipation, falls, and fractures. Conclusions and Implications: This study illustrates the need to further examine inappropriate CNS-active medication use in PWD using prospective outcome assessment and to test nursing and other non-pharmacologic therapies for the clinical problems that initiate their use in PWD.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2007
Conference Name:
19th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
Providence, Rhode Island, USA
Description:
Conference theme: Building Communities of Scholarship and Research, held April 12-14, 2007 at The Westin Providence.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titlePotentially Inappropriate Central Nervous System Active Medication Use in Persons With Dementiaen_GB
dc.contributor.authorFick, Donna M.en_US
dc.contributor.authorKolanowski, Ann M.en_US
dc.contributor.authorWaller, Jennifer L.en_US
dc.author.detailsDonna M. Fick, PhD, APRN-BC, The Pennsylvania State University, University Park, Pennsylvania, USA, email: dmf21@psu.edu; Ann M. Kolanowski PhD, RN, FAAN; Jennifer L. Waller, PhD, Medical College of Georgiaen_US
dc.identifier.urihttp://hdl.handle.net/10755/162114-
dc.description.abstractPurpose: Very few recent studies have investigated the prevalence and outcomes for central nervous system-active (CNS-active) medication use in older persons with dementia (PWD) who live in the community. Thus, the purpose of this study was to describe the health outcomes and patterns of use of CNS-active drugs in persons with dementia living in the community. Theoretical Framework: We constructed the study framework based on the naranjo algorithm and an extensive review of the literature on medication use in older adults and the related adverse events associated with specific classes of drugs. Methods (Design, Sample, Setting, Measures, Analysis): A retrospective study design from a Southeastern managed care organization (MCO) was used. Claims data were collected for three years on all identified cases with dementia and included age, gender, payor status (HMO, PPO, FFS), medical diagnoses for each claim (International Classification of Disease [ICD-9 code]), and prescription drugs (National Drug Code [NDC]). From this N= 960 individuals who were continuously enrolled and had prescription drug coverage were selected. NDC codes were categorized into therapeutic classes including type of CNS-active drug per the 2005 American Hospital Formulary Service. We used ICD-9 codes for principal and secondary diagnoses related to health care services and drug-related problems. We measured comorbidity using the Deyo-adapted Charlson Comorbidity Index. Results: Over 79% of persons with dementia in this sample were on a CNS-active medication during the three-year time period, and 35% were on a benzodiazepine. The highest number of drug-related problems within 45 days after receiving a CNS drug prescription were for syncope, fatigue, altered level of consciousness, delirium, constipation, falls, and fractures. Conclusions and Implications: This study illustrates the need to further examine inappropriate CNS-active medication use in PWD using prospective outcome assessment and to test nursing and other non-pharmacologic therapies for the clinical problems that initiate their use in PWD.en_GB
dc.date.available2011-10-27T11:01:05Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:01:05Z-
dc.conference.date2007en_US
dc.conference.name19th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationProvidence, Rhode Island, USAen_US
dc.descriptionConference theme: Building Communities of Scholarship and Research, held April 12-14, 2007 at The Westin Providence.en_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.