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Impact of inappropriate drug use on mortality and functional status in representative community dwelling elders.
Hanlon, Joseph T; Fillenbaum, Gerda G; Kuchibhatla, Maggie; Artz, Margaret B; Boult, Chad; Gross, Cynthia R; Garrard, Judith; Schmader, Kenneth E.
Afiliación
  • Hanlon JT; Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA. hanlo004@tc.umn.edu
Med Care ; 40(2): 166-76, 2002 Feb.
Article en En | MEDLINE | ID: mdl-11802089
BACKGROUND: The predictive validity of Drug Utilization Review (DUR) and drugs-to-avoid criteria in elders is unknown. OBJECTIVES: To evaluate the relationship between use of inappropriate drugs as determined by these explicit criteria and mortality and decline in functional status in community dwelling elders. RESEARCH DESIGN: Cohort study. SUBJECTS: The fourth wave (3234 participants) of the Duke Established Populations for Epidemiologic Studies of the Elderly. MEASURES: Two sets of inappropriate drug-use criteria: (1) DUR with respect to dosage, duplication, drug-drug interactions, duration, and drug-disease interactions; and (2) Beers-modified criteria regarding drugs-to-avoid were applied to drug use reported in an in-home interview. Death was identified from the National Death Index; change in four functional status measures (basic self-care, intermediate self-care, complex self-management, physical function) was determined during the following 3 years. RESULTS: Use of inappropriate drugs identified by either set of criteria was not significantly associated with mortality. The drugs-to-avoid criteria identified no significant associations between use of these drugs and decline in functional status. With DUR criteria, however, the association between use of inappropriate drugs and basic self-care was significant and pronounced among those with drug-drug or drug-disease interaction problems (Adj. OR 2.04; 95% CI 1.32-3.16). CONCLUSIONS: Identifying the impact of inappropriate drug use may depend on the criteria applied. Further studies are needed that measure additional outcomes and use alternate measures of inappropriate drug use.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Actividades Cotidianas / Mortalidad / Revisión de la Utilización de Medicamentos / Errores de Medicación Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: Med Care Año: 2002 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Buscar en Google
Añadir a Mi BVS
Imprimir
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PubMed Links

Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Actividades Cotidianas / Mortalidad / Revisión de la Utilización de Medicamentos / Errores de Medicación Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: Med Care Año: 2002 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos