PMID- 19019261
OWN - NLM
STAT- MEDLINE
DCOM- 20090323
LR  - 20161020
IS  - 1041-6102 (Print)
IS  - 1041-6102 (Linking)
VI  - 21
IP  - 1
DP  - 2009 Feb
TI  - Reduction of suboptimal prescribing and clinical outcome for dementia patients in 
      a senior behavioral health inpatient unit.
PG  - 195-9
LID - 10.1017/S104161020800803X [doi]
AB  - BACKGROUND: Suboptimal prescribing in older psychiatric patients causes 
      iatrogenic morbidity. The objectives of this study were to compare the prevalence 
      of suboptimal prescribing before and after admission to a geropsychiatry 
      inpatient unit and to evaluate a possible correlation between optimal medication 
      use and functional improvement in patients with dementia. METHODS: The study 
      sample comprised 118 consecutively admitted patients to a 14-bed university 
      hospital-based geropsychiatry inpatient unit over a period of 20 months who met 
      the DSM-IVTR criteria for an Axis I psychiatric illness and co-morbid dementia. 
      At admission demographic information, Mini-mental State Examination (MMSE) Score, 
      Mattis Dementia Rating Scale Score (DRS), and number of active medical illnesses 
      were recorded. At admission and discharge the number and type of medications, 
      number of Revised Beers Criteria (RBC) medications (a published list of 
      potentially inappropriate medications in older adults independent of diagnoses or 
      conditions), Global Assessment of Functioning (GAF) scores, and Scale of 
      Functioning (SOF) scores were tabulated. chi2 tests, paired t-tests and Pearson 
      correlations were used to test the medication prevalence and associations between 
      measures of clinical function and other variables. RESULTS: The mean age 
      (standard deviation) of the sample was 81.5 (6.2) years. The mean scores on the 
      MMSE and DRS were 22.1 (6.2) and 116.6 (18.7), respectively. From admission to 
      discharge, the mean number of RBC medications per patient decreased significantly 
      from 0.8 (1.1) to 0.4 (0.6). There was also a significant correlation between 
      reduction in Beers criteria medications and improved SOF score from time of 
      admission to time of discharge. CONCLUSION: Suboptimal medication use is a 
      potential source of decreased function in older patients with dementia.
FAU - Chan, Virginia T
AU  - Chan VT
AD  - Department of Psychiatry, University of California, San Diego, CA 92103-8631, 
      USA.
FAU - Woo, Benjamin K P
AU  - Woo BK
FAU - Sewell, Daniel D
AU  - Sewell DD
FAU - Allen, E Clark
AU  - Allen EC
FAU - Golshan, Shahrokh
AU  - Golshan S
FAU - Rice, Valerie
AU  - Rice V
FAU - Minassian, Arpi
AU  - Minassian A
FAU - Daly, John W
AU  - Daly JW
LA  - eng
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20081120
PL  - England
TA  - Int Psychogeriatr
JT  - International psychogeriatrics
JID - 9007918
RN  - 0 (Psychotropic Drugs)
SB  - IM
MH  - Activities of Daily Living/classification
MH  - California
MH  - Chronic Disease/epidemiology
MH  - Comorbidity
MH  - Dementia/*drug therapy/epidemiology
MH  - Disability Evaluation
MH  - Drug Therapy, Combination
MH  - Drug Utilization/statistics & numerical data
MH  - Hospitalization/*statistics & numerical data
MH  - Hospitals, University
MH  - Humans
MH  - Iatrogenic Disease
MH  - Mental Disorders/*drug therapy/epidemiology
MH  - Mental Status Schedule
MH  - Prescriptions/*statistics & numerical data
MH  - Psychiatric Department, Hospital/statistics & numerical data
MH  - Psychotropic Drugs/adverse effects/*therapeutic use
MH  - Quality Assurance, Health Care/standards
MH  - Utilization Review/statistics & numerical data
EDAT- 2008/11/21 09:00
MHDA- 2009/03/24 09:00
CRDT- 2008/11/21 09:00
PHST- 2008/11/21 09:00 [pubmed]
PHST- 2009/03/24 09:00 [medline]
PHST- 2008/11/21 09:00 [entrez]
AID - S104161020800803X [pii]
AID - 10.1017/S104161020800803X [doi]
PST - ppublish
SO  - Int Psychogeriatr. 2009 Feb;21(1):195-9. doi: 10.1017/S104161020800803X. Epub 
      2008 Nov 20.