Exposure to Anticholinergic and Sedative Drugs and Healthcare Costs in Older Patients with Neurocognitive Disorders
BACKGROUND: Literature supports an increasing number of older patients living with neurocognitive disorders alongside with their annual worldwide costs. Therapeutic management of behavioral and psychological symptoms includes the use of anticholinergic and sedative drugs for which significant exposure is negatively associated with clinical outcomes.
OBJECTIVE: The aim of this study was to assess the healthcare costs differences related to an increase in the exposure to anticholinergic and sedative drugs in older patients with neurocognitive disorder.
METHODS: A longitudinal study was conducted during 3 years on 1,604 participants of the MEMORA cohort linked with both regional public health insurance and hospital discharge databases between 2012 and 2017. Direct medical and non-medical costs were included. Exposure to anticholinergic and sedative drugs was measured by the drug burden index (DBI).
RESULTS: Costs difference associated with a DBI≥0.5 were + 338€ (p < 0.001). After adjustment on comorbidities, NCD stage, cognitive impairment, functional limitation, polypharmacy, and sociodemographic characteristics, a DBI≥0.5 was found to be an independent predictor of an increase of total healthcare costs by 22%(p < 0.001).
CONCLUSION: Anticholinergic and sedative drugs have a substantial economic burden among older patients with neurocognitive disorder. More studies are required to assess the clinical and economic impact of an efficient strategy based on the reduction of the exposure to anticholinergic and sedative drugs and the promotion of non-pharmacological interventions.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:80 |
|---|---|
| Enthalten in: |
Journal of Alzheimer's disease : JAD - 80(2021), 4 vom: 15., Seite 1515-1524 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Gervais, Frederic [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 17.09.2021 Date Revised 17.09.2021 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.3233/JAD-201127 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM32277604X |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM32277604X | ||
| 003 | DE-627 | ||
| 005 | 20231225182743.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.3233/JAD-201127 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1075.xml |
| 035 | |a (DE-627)NLM32277604X | ||
| 035 | |a (NLM)33720884 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Gervais, Frederic |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Exposure to Anticholinergic and Sedative Drugs and Healthcare Costs in Older Patients with Neurocognitive Disorders |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 17.09.2021 | ||
| 500 | |a Date Revised 17.09.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Literature supports an increasing number of older patients living with neurocognitive disorders alongside with their annual worldwide costs. Therapeutic management of behavioral and psychological symptoms includes the use of anticholinergic and sedative drugs for which significant exposure is negatively associated with clinical outcomes | ||
| 520 | |a OBJECTIVE: The aim of this study was to assess the healthcare costs differences related to an increase in the exposure to anticholinergic and sedative drugs in older patients with neurocognitive disorder | ||
| 520 | |a METHODS: A longitudinal study was conducted during 3 years on 1,604 participants of the MEMORA cohort linked with both regional public health insurance and hospital discharge databases between 2012 and 2017. Direct medical and non-medical costs were included. Exposure to anticholinergic and sedative drugs was measured by the drug burden index (DBI) | ||
| 520 | |a RESULTS: Costs difference associated with a DBI≥0.5 were + 338€ (p < 0.001). After adjustment on comorbidities, NCD stage, cognitive impairment, functional limitation, polypharmacy, and sociodemographic characteristics, a DBI≥0.5 was found to be an independent predictor of an increase of total healthcare costs by 22%(p < 0.001) | ||
| 520 | |a CONCLUSION: Anticholinergic and sedative drugs have a substantial economic burden among older patients with neurocognitive disorder. More studies are required to assess the clinical and economic impact of an efficient strategy based on the reduction of the exposure to anticholinergic and sedative drugs and the promotion of non-pharmacological interventions | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Adverse effects | |
| 650 | 4 | |a aging | |
| 650 | 4 | |a cholinergic antagonists | |
| 650 | 4 | |a cost of illness | |
| 650 | 4 | |a drug effects | |
| 650 | 4 | |a hypnotics and sedatives | |
| 650 | 4 | |a longitudinal studies | |
| 650 | 7 | |a Cholinergic Antagonists |2 NLM | |
| 650 | 7 | |a Hypnotics and Sedatives |2 NLM | |
| 700 | 1 | |a Dauphinot, Virginie |e verfasserin |4 aut | |
| 700 | 1 | |a Mouchoux, Christelle |e verfasserin |4 aut | |
| 700 | 1 | |a Krolak-Salmon, Pierre |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of Alzheimer's disease : JAD |d 1998 |g 80(2021), 4 vom: 15., Seite 1515-1524 |w (DE-627)NLM097527327 |x 1875-8908 |7 nnns |
| 773 | 1 | 8 | |g volume:80 |g year:2021 |g number:4 |g day:15 |g pages:1515-1524 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.3233/JAD-201127 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 80 |j 2021 |e 4 |b 15 |h 1515-1524 | ||