Antidementia medication use by aged care facility residents with dementia

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objectives: Little is known about the use of antidementia medications in Australia. Other countries have reported sociodemographic disparities in use. Our objective was to estimate prevalence, duration, and time to initiation of antidementia medication (cholinesterase inhibitors or memantine) among Australians with dementia in residential aged care facilities and to evaluate resident and facility factors associated with use.

Methods: Dynamic retrospective cohort study of people with dementia in 68 residential aged care facilities during 2014 to 2017 using electronic health record and medication administration data. Regression evaluated relationships between medication use (prevalence, duration, and time to initiation) and resident and facility characteristics.

Results: Five thousand three hundred fifty‐four residents with dementia were included in the analyses. Annual prevalence of antidementia medication use was less than 10% each year and decreased during the study period by 2‐percentage points by 2017 (relative to 2014). Antidementia medication use varied by sociodemographic characteristics (3‐points lower for single, 4‐points lower for divorced relative to married residents, and 3‐points higher for Australian‐born). Each point in ADL score was associated with 0.1‐point lower medication use. Antidementia medication use was lower in outer regional facilities. Most comorbidities were associated with lower antidementia medication use (myocardial infarction, cerebrovascular disease and heart failure 3‐points lower, respiratory disease, and diabetes 2‐points lower). Age had a complex relationship with antidementia medication use that varied by sex and if medication was started before or after admission. After admission, males initiated antidementia medication earlier than females.

Conclusions: Antidementia medication use in Australian facilities was lower than in other countries and varied by clinical and sociodemographic factors.
LanguageEnglish
Pages1029-1040
Number of pages12
JournalInternational Journal of Geriatric Psychiatry
Volume34
Issue number7
Early online date25 Mar 2019
DOIs
Publication statusPublished - Jul 2019

Fingerprint

Dementia
Memantine
Cerebrovascular Disorders
Divorce
Electronic Health Records
Cholinesterase Inhibitors
Activities of Daily Living
Type 2 Diabetes Mellitus
Comorbidity
Cohort Studies
Heart Failure
Retrospective Studies
Myocardial Infarction

Keywords

  • CEI
  • ChEI
  • cholinesterase inhibitor
  • dementia medication
  • memantine

Cite this

@article{6136dd60221148babc1cd94863bd17fc,
title = "Antidementia medication use by aged care facility residents with dementia",
abstract = "Objectives: Little is known about the use of antidementia medications in Australia. Other countries have reported sociodemographic disparities in use. Our objective was to estimate prevalence, duration, and time to initiation of antidementia medication (cholinesterase inhibitors or memantine) among Australians with dementia in residential aged care facilities and to evaluate resident and facility factors associated with use. Methods: Dynamic retrospective cohort study of people with dementia in 68 residential aged care facilities during 2014 to 2017 using electronic health record and medication administration data. Regression evaluated relationships between medication use (prevalence, duration, and time to initiation) and resident and facility characteristics. Results: Five thousand three hundred fifty‐four residents with dementia were included in the analyses. Annual prevalence of antidementia medication use was less than 10{\%} each year and decreased during the study period by 2‐percentage points by 2017 (relative to 2014). Antidementia medication use varied by sociodemographic characteristics (3‐points lower for single, 4‐points lower for divorced relative to married residents, and 3‐points higher for Australian‐born). Each point in ADL score was associated with 0.1‐point lower medication use. Antidementia medication use was lower in outer regional facilities. Most comorbidities were associated with lower antidementia medication use (myocardial infarction, cerebrovascular disease and heart failure 3‐points lower, respiratory disease, and diabetes 2‐points lower). Age had a complex relationship with antidementia medication use that varied by sex and if medication was started before or after admission. After admission, males initiated antidementia medication earlier than females. Conclusions: Antidementia medication use in Australian facilities was lower than in other countries and varied by clinical and sociodemographic factors.",
keywords = "CEI, ChEI, cholinesterase inhibitor, dementia medication, memantine",
author = "Lind, {Kimberly E.} and Gray, {Leonard C.} and Raban, {Magdalena Z.} and Andrew Georgiou and Westbrook, {Johanna I.}",
year = "2019",
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language = "English",
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Antidementia medication use by aged care facility residents with dementia. / Lind, Kimberly E.; Gray, Leonard C.; Raban, Magdalena Z.; Georgiou, Andrew; Westbrook, Johanna I.

In: International Journal of Geriatric Psychiatry, Vol. 34, No. 7, 07.2019, p. 1029-1040.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Antidementia medication use by aged care facility residents with dementia

AU - Lind,Kimberly E.

AU - Gray,Leonard C.

AU - Raban,Magdalena Z.

AU - Georgiou,Andrew

AU - Westbrook,Johanna I.

PY - 2019/7

Y1 - 2019/7

N2 - Objectives: Little is known about the use of antidementia medications in Australia. Other countries have reported sociodemographic disparities in use. Our objective was to estimate prevalence, duration, and time to initiation of antidementia medication (cholinesterase inhibitors or memantine) among Australians with dementia in residential aged care facilities and to evaluate resident and facility factors associated with use. Methods: Dynamic retrospective cohort study of people with dementia in 68 residential aged care facilities during 2014 to 2017 using electronic health record and medication administration data. Regression evaluated relationships between medication use (prevalence, duration, and time to initiation) and resident and facility characteristics. Results: Five thousand three hundred fifty‐four residents with dementia were included in the analyses. Annual prevalence of antidementia medication use was less than 10% each year and decreased during the study period by 2‐percentage points by 2017 (relative to 2014). Antidementia medication use varied by sociodemographic characteristics (3‐points lower for single, 4‐points lower for divorced relative to married residents, and 3‐points higher for Australian‐born). Each point in ADL score was associated with 0.1‐point lower medication use. Antidementia medication use was lower in outer regional facilities. Most comorbidities were associated with lower antidementia medication use (myocardial infarction, cerebrovascular disease and heart failure 3‐points lower, respiratory disease, and diabetes 2‐points lower). Age had a complex relationship with antidementia medication use that varied by sex and if medication was started before or after admission. After admission, males initiated antidementia medication earlier than females. Conclusions: Antidementia medication use in Australian facilities was lower than in other countries and varied by clinical and sociodemographic factors.

AB - Objectives: Little is known about the use of antidementia medications in Australia. Other countries have reported sociodemographic disparities in use. Our objective was to estimate prevalence, duration, and time to initiation of antidementia medication (cholinesterase inhibitors or memantine) among Australians with dementia in residential aged care facilities and to evaluate resident and facility factors associated with use. Methods: Dynamic retrospective cohort study of people with dementia in 68 residential aged care facilities during 2014 to 2017 using electronic health record and medication administration data. Regression evaluated relationships between medication use (prevalence, duration, and time to initiation) and resident and facility characteristics. Results: Five thousand three hundred fifty‐four residents with dementia were included in the analyses. Annual prevalence of antidementia medication use was less than 10% each year and decreased during the study period by 2‐percentage points by 2017 (relative to 2014). Antidementia medication use varied by sociodemographic characteristics (3‐points lower for single, 4‐points lower for divorced relative to married residents, and 3‐points higher for Australian‐born). Each point in ADL score was associated with 0.1‐point lower medication use. Antidementia medication use was lower in outer regional facilities. Most comorbidities were associated with lower antidementia medication use (myocardial infarction, cerebrovascular disease and heart failure 3‐points lower, respiratory disease, and diabetes 2‐points lower). Age had a complex relationship with antidementia medication use that varied by sex and if medication was started before or after admission. After admission, males initiated antidementia medication earlier than females. Conclusions: Antidementia medication use in Australian facilities was lower than in other countries and varied by clinical and sociodemographic factors.

KW - CEI

KW - ChEI

KW - cholinesterase inhibitor

KW - dementia medication

KW - memantine

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UR - http://purl.org/au-research/grants/arc/LP120200814

UR - http://purl.org/au-research/grants/nhmrc/1143941

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DO - 10.1002/gps.5105

M3 - Article

VL - 34

SP - 1029

EP - 1040

JO - International Journal of Geriatric Psychiatry

T2 - International Journal of Geriatric Psychiatry

JF - International Journal of Geriatric Psychiatry

SN - 0885-6230

IS - 7

ER -