Potentially Inappropriate Medication Use and Related Hospital Admissions in Aged Care Residents: the Impact of Dementia.

AIMS: To determine the prevalence of potentially inappropriate medication (PIM) use at hospital admission and discharge, and the contribution to hospital admission among residential aged care facility (RACF) residents with and without dementia.

METHODS: We conducted a secondary analysis using data from a multi-hospital prospective cohort study involving consecutively admitted older adults, aged 75 years or older, who were taking five or more medications prior to hospital admission and discharged to a RACF in South Australia. PIM use was identified using the 2015 Screening Tool for Older Persons' Prescription (STOPP) and 2019 Beers Criteria. An expert panel of clinicians with geriatric medicine expertise evaluated the contribution of PIM to hospital admission.

RESULTS: In total, 181 participants were included, the median age was 87.5 years and 54.7% were female. Ninety-one (50.3%) had a diagnosis of dementia. Participants with dementia had less PIMs, according to at least one of the two screening criteria, than those without dementia, at admission (dementia: 76 (83.5%) vs no dementia: 84 (93.3%), p=0.04) and discharge (78 (85.7%) vs 83(92.2%), p=0.16). PIM use was causal or contributory to the admission in 28.1% of study participants (n=45) who were taking at least one PIM at admission.

CONCLUSIONS: Over 80% of acutely admitted older adults took PIMs at hospital admission and discharge and for over a quarter of these people the admissions were attributable to PIM use. Hospitalisation presents an opportunity for comprehensive medication reviews, and targeted interventions that enhance such a process could reduce PIM use and related harm.