Ten-year trends in adverse drug reaction–related hospitalizations among people with dementia

Zaidi, Anum Saqib; Peterson, Gregory M.; Bereznicki, Lre; Curtain, Colin; Salahudeen, Mohammed Saji

doi:10.1177/20420986221080796

Cited by 9 publications

(13 citation statements)

References 33 publications

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“…Adverse drug reactions constitute an emerging issue for public health due to their increasing incidence over time, at least in Westernised countries [ 1 , 2 ]. Population aging along with the growing prevalence of dementia and multi-organ morbidity are associated with frequent institutionalisation and enhanced drug prescribing and may account for this trend [ 3 ]. Hospitalisation-related adverse drug reactions are particularly relevant from an epidemiological and economic standpoint and can occur in up to 30% of patients entering ordinary wards [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Focus on the Pathophysiological and Diagnostic Role of Viruses

et al. 2023

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Drug reaction with eosinophilia and systemic symptoms (DRESS) is a heterogeneous, multiorgan and potentially life-threatening drug-hypersensitivity reaction (DHR) that occurs several days or weeks after drug initiation or discontinuation. DHRs constitute an emerging issue for public health, due to population aging, growing multi-organ morbidity, and subsequent enhanced drug prescriptions. DRESS has more consistently been associated with anticonvulsants, allopurinol and antibiotics, such as sulphonamides and vancomycin, although new drugs are increasingly reported as culprit agents. Reactivation of latent infectious agents such as viruses (especially Herpesviridae) plays a key role in prompting and sustaining aberrant T-cell and eosinophil responses to drugs and pathogens, ultimately causing organ damage. However, the boundaries of the impact of viral agents in the pathophysiology of DRESS are still ill-defined. Along with growing awareness of the multifaceted aspects of immune perturbation caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the ongoing SARS-CoV-2-related disease (COVID-19) pandemic, novel interest has been sparked towards DRESS and the potential interactions among antiviral and anti-drug inflammatory responses. In this review, we summarised the most recent evidence on pathophysiological mechanisms, diagnostic approaches, and clinical management of DRESS with the aim of increasing awareness on this syndrome and possibly suggesting clues for future research in this field.

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Section: Introductionmentioning

confidence: 99%

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Focus on the Pathophysiological and Diagnostic Role of Viruses

et al. 2023

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“…Thirty articles underwent full-text screening, and fourteen studies were excluded because they did not meet the inclusion criteria. Reasons for exclusion included the age of people with dementia being as young as 30 years old [30], a study based on hospital discharge issues with no relation to hospital readmissions [31], studies investigating initial hospitalisations instead of recurrent admissions [7,24,[32][33][34][35][36][37], and the research being published as PhD theses [38,39]. The full-text versions of two articles could not be located [40,41].…”

Section: Summary Of Resultsmentioning

confidence: 99%

Determinants of hospital readmissions in older people with dementia: a narrative review

Browne,

Ali,

Ford

et al. 2024

BMC Geriatr

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Introduction Over 50% of hospitalised older people with dementia have multimorbidity, and are at an increased risk of hospital readmissions within 30 days of their discharge. Between 20-40% of these readmissions may be preventable. Current research focuses on the physical causes of hospital readmissions. However, older people with dementia have additional psychosocial factors that are likely to increase their risk of readmissions. This narrative review aimed to identify psychosocial determinants of hospital readmissions, within the context of known physical factors. Methods Electronic databases MEDLINE, EMBASE, CINAHL and PsychInfo were searched from inception until July 2022 and followed up in February 2024. Quantitative and qualitative studies in English including adults aged 65 years and over with dementia, their care workers and informal carers were considered if they investigated hospital readmissions. An inductive approach was adopted to map the determinants of readmissions. Identified themes were described as narrative categories. Results Seventeen studies including 7,194,878 participants met our inclusion criteria from a total of 6369 articles. Sixteen quantitative studies included observational cohort and randomised controlled trial designs, and one study was qualitative. Ten studies were based in the USA, and one study each from Taiwan, Australia, Canada, Sweden, Japan, Denmark, and The Netherlands. Large hospital and insurance records provided data on over 2 million patients in one American study. Physical determinants included reduced mobility and accumulation of long-term conditions. Psychosocial determinants included inadequate hospital discharge planning, limited interdisciplinary collaboration, socioeconomic inequalities among ethnic minorities, and behavioural and psychological symptoms. Other important psychosocial factors such as loneliness, poverty and mental well-being, were not included in the studies. Conclusion Poorly defined roles and responsibilities of health and social care professionals and poor communication during care transitions, increase the risk of readmission in older people with dementia. These identified psychosocial determinants are likely to significantly contribute to readmissions. However, future research should focus on the understanding of the interaction between a host of psychosocial and physical determinants, and multidisciplinary interventions across care settings to reduce hospital readmissions.

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Section: Summary Of Resultsmentioning

confidence: 99%

Determinants of hospital readmissions in older people with dementia: A narrative review

Browne,

Ali,

Ford

et al. 2023

Preprint

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Introduction Over 50% of hospitalised older people with dementia have multimorbidity, and are at an increased risk of hospital readmission within 30 days from discharge. Between 20-40% of these readmissions may be preventable. Current research focuses on the physical causes of readmissions. However, older people with dementia have additional psychosocial factors that are likely to increase the risk of readmissions. This narrative review aimed to identify psychosocial determinants for hospital readmissions, within the context of known physical factors. Methods Electronic databases MEDLINE, EMBASE, CINAHL and PsychInfo were searched from inception until July 2022. Quantitative and qualitative studies in English including adults aged 65 years and over with dementia, their care workers and informal carers were considered if they investigated hospital readmissions. An inductive approach was adopted to map the determinants of readmissions. Identified themes were described as narrative categories. Results Sixteen studies including 7,194,878 participants met our inclusion criteria from a total of 4736 articles. Fifteen quantitative studies included observational cohorts and randomised controlled trial designs, and one study was qualitative. Nine studies were based in the USA, and one study each from Taiwan, Australia, Canada, Sweden, Japan, Denmark, and The Netherlands. Large hospital and insurance records provided data on over 2 million patients in one American study. Physical determinants included reduced mobility and accumulation of long-term conditions. However, identified psychosocial determinants were restricted to inadequate hospital discharge planning, limited interdisciplinary collaboration, and socioeconomic inequalities among ethnic minorities. Other important psychosocial factors such as loneliness, poverty and mental well-being, were not included in the studies. Conclusion Poorly defined roles and responsibilities of health and social care professionals and poor communication during care transitions increase the risk of readmission in older people with dementia. These identified psychosocial determinants are likely to significantly contribute to readmissions. Frequent use of antipsychotic medications might also explain the interplay between physical and psychosocial determinants. However, future research should also focus on the understanding of the interaction between a host of psychosocial and physical determinants, and multidisciplinary interventions across care settings to reduce hospital readmissions.

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Ten-year trends in adverse drug reaction–related hospitalizations among people with dementia

Cited by 9 publications

References 33 publications

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Focus on the Pathophysiological and Diagnostic Role of Viruses

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Focus on the Pathophysiological and Diagnostic Role of Viruses

Determinants of hospital readmissions in older people with dementia: a narrative review

Determinants of hospital readmissions in older people with dementia: A narrative review

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