TY - JOUR
T1 - Impact of Geriatrician-Performed Comprehensive Geriatric Care on Medication Use and Cognitive Function in Older Adults Referred to a Non-Hospital-Based Rehabilitation Unit
AU - Zintchouk, Dmitri
AU - Gregersen, Merete
AU - Lauritzen, Torsten
AU - Damsgaard, Else Marie
PY - 2019/1
Y1 - 2019/1
N2 - Background and Purpose: Eighty-eight percent of older adults referred to Danish non-hospital-based rehabilitation units used ≥5 regular drugs per day at the beginning of rehabilitation. The aim of the study was to explore whether geriatrician-performed comprehensive geriatric care had an impact on medication use and cognitive function in older adults after a 90-day follow-up. Methods: There were 368 individuals aged ≥65 years recruited from 2 Danish non-hospital-based rehabilitation units and randomized to geriatric care (the intervention group) or usual care (the control group). The medication adjustment was the key element of the geriatric intervention. The control group received standard rehabilitation with general practitioners as back-up. The outcomes were prevalence of hyperpolypharmacy (≥10 regular medications prescribed concurrently), the change in medication profile, and cognitive function measured using the Mini-Mental State Examination. Results: In the intervention group, fewer persons were exposed to hyperpolypharmacy (odds ratio 0.5; 95% confidence interval, 0.3-0.9) compared with the control group after 90 days. The prevalence of use of proton pump inhibitors, loop diuretics, or antiasthmatic inhalers was lower, while the prevalence of cholecalciferol use was higher in the intervention group compared with the control group. The prevalence of other drug use and cognitive function between groups were not different. Conclusions: Geriatrician-performed comprehensive geriatric care may reduce the prevalence of hyperpolypharmacy and optimize the medication profile in older adults referred to a non-hospital-based rehabilitation. No impact on cognitive function was found.
AB - Background and Purpose: Eighty-eight percent of older adults referred to Danish non-hospital-based rehabilitation units used ≥5 regular drugs per day at the beginning of rehabilitation. The aim of the study was to explore whether geriatrician-performed comprehensive geriatric care had an impact on medication use and cognitive function in older adults after a 90-day follow-up. Methods: There were 368 individuals aged ≥65 years recruited from 2 Danish non-hospital-based rehabilitation units and randomized to geriatric care (the intervention group) or usual care (the control group). The medication adjustment was the key element of the geriatric intervention. The control group received standard rehabilitation with general practitioners as back-up. The outcomes were prevalence of hyperpolypharmacy (≥10 regular medications prescribed concurrently), the change in medication profile, and cognitive function measured using the Mini-Mental State Examination. Results: In the intervention group, fewer persons were exposed to hyperpolypharmacy (odds ratio 0.5; 95% confidence interval, 0.3-0.9) compared with the control group after 90 days. The prevalence of use of proton pump inhibitors, loop diuretics, or antiasthmatic inhalers was lower, while the prevalence of cholecalciferol use was higher in the intervention group compared with the control group. The prevalence of other drug use and cognitive function between groups were not different. Conclusions: Geriatrician-performed comprehensive geriatric care may reduce the prevalence of hyperpolypharmacy and optimize the medication profile in older adults referred to a non-hospital-based rehabilitation. No impact on cognitive function was found.
KW - Cognitive function
KW - Comprehensive geriatric care
KW - Hyperpolypharmacy
KW - Randomized controlled trial
KW - Rehabilitation
UR - http://www.scopus.com/inward/record.url?scp=85057021961&partnerID=8YFLogxK
U2 - 10.1016/j.amjmed.2018.09.030
DO - 10.1016/j.amjmed.2018.09.030
M3 - Journal article
C2 - 30367848
SN - 0002-9343
VL - 132
SP - 93
EP - 102
JO - American Journal of Medicine
JF - American Journal of Medicine
IS - 1
ER -