Development, validation and evaluation of an electronic pharmacological tool: The Drug Burden Index Calculator©

Kouladjian, Lisa; Gnjidic, Danijela; Chen, Timothy; Hilmer, Sarah N.

doi:10.1016/j.sapharm.2015.11.002

Cited by 29 publications

(40 citation statements)

References 40 publications

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“…A number of studies support the validity of the DBI as an aid to prescribing. (6,9,10) Ours is the first study to examine the relationship between hip fractures in older people and the DBI at a population level. The rich source of data made available through the interRAI-HC data base in New Zealand, linked to pharmaceutical, fracture and mortality data allowed us to include confounders that have previously been unavailable to other population based studies of the most frail and vulnerable older people.…”

Section: Discussionmentioning

confidence: 99%

“…(6,8,9) The Drug Burden Index (DBI) was developed as a pharmacological risk assessment tool. (10) Unlike other tools that identify potentially inappropriate medication use, (11,12) the DBI calculates the cumulative sedative and anticholinergic load of an individual's prescribed medications. (13) Previous work has highlighted the relationship between a high DBI score and functional decline in older populations, and falls and fractures.…”

Section: Abstract Polypharmacy Medications Rai Fallsmentioning

confidence: 99%

See 1 more Smart Citation

Drug Burden Index and Its Association With Hip Fracture Among Older Adults: A National Population-Based Study

Jamieson

Nishtala

Scrase

et al. 2018

The Journals of Gerontology: Series A

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Section: Discussionmentioning

confidence: 99%

Section: Abstract Polypharmacy Medications Rai Fallsmentioning

confidence: 99%

Drug Burden Index and Its Association With Hip Fracture Among Older Adults: A National Population-Based Study

Jamieson

Nishtala

Scrase

et al. 2018

The Journals of Gerontology: Series A

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“…(2) to clarify key concepts and definitions in the published papers; (3) to examine how the research or study was done or conducted on our topic; (4) to identify the characteristics of each included study; (5) and to identify and analyse the gap needing to be covered in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

A Comprehensive Evaluation of Studies on the Adverse Effects of Medications in Australian Aged care Facilities: A Scoping Review

et al. 2020

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Aim: this scoping review was designed to identify studies that assess adverse drug reactions (ADRs) for older people in Australian aged care facilities. This review critically evaluates each published study to identify the risk of, or actual, adverse drug events in older people. Inclusion criteria: this review considered any clinical studies that examined the adverse effects of medications in older people who were living in aged care facilities. This review considered qualitative studies, analytical studies, randomized controlled trials (RCTs), descriptive cross-sectional studies, and analytic observational studies that explored the use of medications and their adverse effects on older people in clinical settings (including aged care facilities). Methods: an initial search of the PubMed (United State National Library of Medicine), OvidSP, EBSCOHost, ScienceDirect, Wiley Online, SAGE, and SCOPUS databases, with full text was performed, followed by an analysis of the article’s title and abstract. Additionally, MeSH (Medical Subject Headings) was used to describe the article. The initial round of the database search was based on inclusion criteria from studies that assessed tools or protocols aiming to identify the adverse effects of medications on the elderly population suffering chronic conditions or multiple co-morbidities. Two reviewers screened the retrieved papers for inclusion. The data presented in this review are in tabular forms and accompanied by a narrative summary which aligns with the review’s objectives. Results: seven studies were identified, and the extracted data from these studies were grouped according their characteristics and the auditing results of each study. Conclusion: it would be beneficial to design a comprehensive or broadly adverse drug reaction assessment tool derived from Australian data that has been used on the elderly in an Australian healthcare setting.

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“…DBI calculations incorporate cumulative effects of psychoactive medications each of which has its own minimum effective dose and are therefore not standardized per se. Work is underway to develop and validate online DBI calculators for clinical use 41. Such applications generate reports that guide prescribers on which medications contribute to the DBI, to what extent, and how DBIs decrease with down titration/discontinuation 41.…”

mentioning

confidence: 99%

“…Work is underway to develop and validate online DBI calculators for clinical use 41. Such applications generate reports that guide prescribers on which medications contribute to the DBI, to what extent, and how DBIs decrease with down titration/discontinuation 41. A recent feasibility study found that 3 months after DBI calculator reports were shared with prescribers, median DBIs significantly decreased with reductions in 36.4% of patients with anticholinergic/sedative drug exposure 24.…”

mentioning

confidence: 99%

Anticholinergic/sedative drug burden predicts worse memory acquisition in older racially/ethnically diverse patients with type 2 diabetes mellitus

Margolis

Sears

Daiello

et al. 2019

Int J Geriat Psychiatry

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Objective Anticholinergic/sedative drug use, measured by the Drug Burden Index (DBI), is linked to cognitive impairment in older adults. Yet, studies on the DBI's association with neuropsychological functioning are lacking, especially in underserved groups at increased risk of cognitive impairment. We examined cross‐sectional relationships between total DBI (DBIT) and an age‐adjusted analogue (Adj DBIT) with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in diverse adults with type 2 diabetes mellitus (T2DM). Based on results of a prior study, we anticipated higher DBIs would be associated with worse memory at older ages. Methods One hundred five adults with T2DM (age = 57 ± 9 years, 65% female, 62% Black, 27% Hispanic/Latino, HbA1c = 7.8 ± 1.8) participated. Although memory outcomes were normally distributed, DBIT values were positively skewed. Spearman correlations assessed their bivariate relationships with RBANS. Adjusting for comorbidities, polypharmacy, HbA1c, and education, we tested the moderating effect of age on DBI‐RBANS associations at mean ±1 standard deviations of age. Results One third of the participants endorsed current sedative/anticholinergic use. Mean DBIT was 0.385, and mean Adj DBIT was 0.393 (ranges = 0.00‐4.22). Drug burden negatively correlated with RBANS Immediate Memory (DBIT rs = −0.237, P = .013; Adj DBIT rs = −0.239, P = .014) but no other indices. There was a significant DBI*Age interaction; the negative effect of drug burden on Immediate Memory was significant for ages greater than or equal to 55 years old. Conclusions Sedative/anticholinergic drug exposure was prevalent in these diverse T2DM patients. Adjusting for covariates, greater drug burden was associated with worse memory acquisition among older adults only. Prospective studies should examine these relationships over time and assess whether dementia biomarkers affect the interaction.

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Development, validation and evaluation of an electronic pharmacological tool: The Drug Burden Index Calculator©

Cited by 29 publications

References 40 publications

Drug Burden Index and Its Association With Hip Fracture Among Older Adults: A National Population-Based Study

Drug Burden Index and Its Association With Hip Fracture Among Older Adults: A National Population-Based Study

A Comprehensive Evaluation of Studies on the Adverse Effects of Medications in Australian Aged care Facilities: A Scoping Review

Anticholinergic/sedative drug burden predicts worse memory acquisition in older racially/ethnically diverse patients with type 2 diabetes mellitus

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