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Outcomes of medication misadventure among people with cognitive impairment or dementia: A systematic review and meta-analysis

Zaidi, AS, Peterson, GM ORCID: 0000-0002-6764-3882, Bereznicki, LRE ORCID: 0000-0003-3974-3437, Curtain, CM ORCID: 0000-0001-5029-7541 and Salahudeen, MS ORCID: 0000-0001-9131-7465 2020 , 'Outcomes of medication misadventure among people with cognitive impairment or dementia: A systematic review and meta-analysis' , The Annals of Pharmacotherapy , pp. 1-13 , doi: 10.1177/1060028020949125.

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Objective: To investigate mortality and hospitalization outcomes associated with medication misadventure (includingmedication 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 InternationalPharmaceutical Abstracts, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Central Register ofControlled Trials were searched from inception to December 2019. Study Selection and Data Extraction: Relevantstudies using any study design were included. Reviewers independently performed critical appraisal and extracted relevantdata. Data Synthesis: The systematic review included 10 studies that reported the outcomes of mortality or hospitalizationassociated with medication misadventure, including PIMs (n=5), ADEs (n=2), a combination of MEs and ADEs (n=2), anddrug interactions (n=1). Five studies examining the association between PIMs and mortality/hospitalization were includedin 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 cholinesteraseinhibitors 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 relativelylimited 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 ordementia, noting the limited number of studies, difficulty in controlling potential confounding variables, and that moststudies focus on PIMs.

Item Type: Article
Authors/Creators:Zaidi, AS and Peterson, GM and Bereznicki, LRE and Curtain, CM and Salahudeen, MS
Keywords: medication misadventure, medication errors, adverse drug events, cognitive impairment, dementia, mortality, hospitalization, meta-analysis
Journal or Publication Title: The Annals of Pharmacotherapy
Publisher: Harvey Whitney Books Co
ISSN: 1060-0280
DOI / ID Number: 10.1177/1060028020949125
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