Geriatrie in Bayern-Datenbank (GiB-DAT)

Trögner, Jens; Tümena, Thomas; Schramm, Alexander; Heinrich, Richard; Sieber, Cornel; GiB-DAT-Gruppe,

doi:10.1007/s00391-006-0338-x

Cited by 14 publications

(2 citation statements)

References 10 publications

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“…If the patients had pathological MMSE values (i.e. MMSE < 25) and at least one of the following issues (general weakness, aphasia, depression, hemiparesis, hypacusis, nervousness, neuropsychological deficits, refusal), these MMSE values were not used for analyses as they are not meaningful due to the patients underlying condition.To assess severity of impairment of geriatric patients, the AFGIB (Ärztliche Arbeitsgemeinschaft zur Förderung der Geriatrie in Bayern) developed the 4D+S scale assessing dementia, depression, dysphagia and dysphasia as well as need for social action [ 23 ]. For this analysis, only the item dementia was used divided in no, mild, moderate and severe (for details please see S1 Table ).…”

Section: Methodsmentioning

confidence: 99%

Anticholinergic burden and cognitive function in a large German cohort of hospitalized geriatric patients

Pfistermeister

Tümena²,

Gaßmann

et al. 2017

PLoS ONE

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PurposePrevious studies suggest an association between use of anticholinergic drugs in elderly patients and cognitive impairment. However, there are still limited data on the association of anticholinergic drug use and cognitive impairment as well as contribution of individual drugs to anticholinergic load using large, well-documented patient cohorts treated in geriatric units from Europe.MethodsWe investigated 797,440 prescriptions to 89,579 hospitalized patients treated in geriatric units within the GiB-DAT database. Data of all patients discharged between 1 January 2013 and 30 June 2015 was included. The Anticholinergic Cognitive Burden (ACB) scale was used to classify anticholinergic drugs as definite (score 2 or 3) and possible anticholinergics (score 1). Cognitive function was determined using Mini-Mental State Examination (MMSE) and the standardized scale for dementia (4D+S).ResultsIn two multivariable logistic regression models age, sex, number of drugs and ACB total scores were identified as variables independently associated with cognitive impairment as measured by MMSE (odds ratio per ACB unit 1.114, 95% CI 1.099–1.130) or the diagnosis dementia (odds ratio 1.159 per ACB unit, 95% CI 1.144–1.173, both p < 0.0001). High anticholinergic load was associated with patients with severe cognitive impairment (p < 0.05 for all pairwise comparisons). ACB score 3 anticholinergic drugs contributed 77.9% to the cumulative amount of ACB points in patients with an anticholinergic load of 3 and higher.ConclusionsUsing a cross-sectional study design, a significant positive association between anticholinergic drug load and cognitive impairment in European patients treated in specialised geriatric units was found. The most frequently used definitve anticholinergic drugs were quetiapine, amitriptyline and carbamazepine.

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Section: Methodsmentioning

confidence: 99%

Anticholinergic burden and cognitive function in a large German cohort of hospitalized geriatric patients

Pfistermeister

Tümena²,

Gaßmann

et al. 2017

PLoS ONE

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“…This network provides uniform standards for the documentation of clinical and medication data [ 19 ]. With more than 100 geriatric units GiB-DAT covers about 91% of the geriatric rehabilitation clinics and about 55% of all acute geriatric wards in Bavaria [ 20 , 21 ]. Currently, approximately 50,000 data records are transferred annually to the central data base in an anonymized form.…”

Section: Methodsmentioning

confidence: 99%

Co-Prescription of QT-Interval Prolonging Drugs: An Analysis in a Large Cohort of Geriatric Patients

Schächtele

Tümena²,

Gaßmann³

et al. 2016

PLoS ONE

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BackgroundDrug-induced QT-interval prolongation is associated with occurrence of potentially fatal Torsades de Pointes arrhythmias (TdP). So far, data regarding the overall burden of QT-interval prolonging drugs (QT-drugs) in geriatric patients are limited.ObjectiveThis study was performed to assess the individual burden of QT-interval prolonging drugs (QT-drugs) in geriatric polymedicated patients and to identify the most frequent and risky combinations of QT-drugs.MethodsIn the discharge medication of geriatric patients between July 2009 and June 2013 from the Geriatrics in Bavaria–Database (GiB-DAT) (co)-prescriptions of QT-drugs were investigated. QT-drugs were classified according to a publicly available reference site (CredibleMeds®) as ALL-QT-drugs (associated with any QT-risk) or High-risk-QT-drugs (corresponding to QT-drugs with known risk of Torsades de Pointes according to CredibleMeds®) and in addition as SmPC-high-risk-QT-drugs (according to the German prescribing information (SmPC) contraindicated co-prescription with other QT-drugs).ResultsOf a cohort of 130,434 geriatric patients (mean age 81 years, 67% women), prescribed a median of 8 drugs, 76,594 patients (58.7%) received at least one ALL-QT-drug. Co-prescriptions of two or more ALL-QT-drugs were observed in 28,768 (22.1%) patients. Particularly risky co-prescriptions of High-risk-QT-drugs or SmPC-high-risk-QT-drugs with at least on further QT-drug occurred in 55.9% (N = 12,633) and 54.2% (N = 12,429) of these patients, respectively. Consideration of SmPCs (SmPC-high-risk-QT-drugs) allowed the identification of an additional 15% (N = 3,999) patients taking a risky combination that was not covered by the commonly used CredibleMeds® classification. Only 20 drug-drug combinations accounted for more than 90% of these potentially most dangerous co-prescriptions.ConclusionIn a geriatric study population co-prescriptions of two and more QT-drugs were common. A considerable proportion of QT-drugs with higher risk only could be detected by using more than one classification-system. Local adaption of international classifications can improve identification of patients at risk.

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Medizin Des Alterns Und Des Alten Menschen

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Geriatrie in Bayern-Datenbank (GiB-DAT)

Cited by 14 publications

References 10 publications

Anticholinergic burden and cognitive function in a large German cohort of hospitalized geriatric patients

Anticholinergic burden and cognitive function in a large German cohort of hospitalized geriatric patients

Co-Prescription of QT-Interval Prolonging Drugs: An Analysis in a Large Cohort of Geriatric Patients

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