Polypharmacy following Dementia Diagnoses in Vietnam: Results from Real-World Data in Outpatient Settings
Notice bibliographique
Résumé
Introduction: Polypharmacy might be clinically appropriate if it improves health outcomes of people with dementia. However, polypharmacy was associated with higher risks of impairment in cognitive, physical, and emotional abilities. Several studies on polypharmacy among people with dementia were performed globally but not in Vietnam. This study aimed to investigate the epidemiology of polypharmacy among people with dementia in Vietnam. METHODS: This retrospective cohort study included outpatient individuals who were diagnosed with dementia between January 1, 2023, and April 15, 2024, in the Vietnam National Geriatric Hospital. Data were extracted from medical records, including dementia diagnosis, drug utilization, medical history before dementia diagnosis, comorbidities, and sociodemographic. The monthly quantity of drugs used was categorized as "no polypharmacy" 0-4 drugs, "polypharmacy" ≥5 drugs, and "hyperpolypharmacy" ≥10 drugs. The primary outcome was the incidence of polypharmacy following dementia diagnosis. The prescription of potentially inappropriate medications in people with dementia, identified using the American Geriatrics Society Beers criteria, was also evaluated. Multivariable logistic regression was employed to find associated risk factors of polypharmacy. RESULTS: During the follow-up from dementia diagnosis to June 30, 2024, there were 64 people having polypharmacy (median age at dementia diagnosis 73.5, 68.8% females) and 342 people without polypharmacy (median age at dementia diagnosis 74.0, 64.0% females). Age at dementia diagnosis, sex, regions of residence, and education were not associated with having polypharmacy in people with dementia. Compared to people with Alzheimer's disease, significantly higher probabilities of having polypharmacy were seen in people with vascular dementia (odds ratio [OR] 4.63, 95% confidence interval [CI] 2.16-9.92) and other dementias (OR 4.61, 95% CI 2.31-9.18). People with dementia at severe stage were at lower chance of having polypharmacy (OR 0.19, 95% CI 0.05-0.63). Potentially inappropriate medications were more frequent in the polypharmacy group (n = 27, 42.2%), compared to the non-polypharmacy group (n = 59, 17.3%). Prescribing antipsychotics in the polypharmacy group doubled that in the non-polypharmacy group (34.4% versus 16.1%). CONCLUSION: Lower incidence of polypharmacy among people with dementia compared to previous studies might either imply the improvement in managing the prescription of potentially inappropriate medications or be underestimated by not including inpatient individuals. Future studies are necessary to clarify the impact of polypharmacy on health outcomes of people with dementia. .
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».