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ORIGINAL RESEARCH article

Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1474986

Drug prescriptions in elderly hospitalized patients with cognitive impairment in the Italian dementia friendly hospital project

Provisionally accepted
Stefano Govoni Stefano Govoni 1Alessia Rosi Alessia Rosi 2Stefania Preda Stefania Preda 1Cristina Lanni Cristina Lanni 1,3*Stefano F. Cappa Stefano F. Cappa 4Nicola Allegri Nicola Allegri 5
  • 1 Department of Drug Sciences, Pharmacology section, University of pavia, Pavia, Italy, Pavia, Italy
  • 2 Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Lombardy, Italy
  • 3 University of Pavia, Pavia, Italy
  • 4 Institute of Advanced University Education-IUSS, Pavia, Italy, Pavia, Italy
  • 5 Neurological Institute Foundation Casimiro Mondino (IRCCS), Pavia, Lombardy, Italy

The final, formatted version of the article will be published soon.

    Objective: The aim was to characterize drug prescription patterns in elderly patients hospitalized in acute wards as a function of cognitive status and staff training. Methods: We recorded clinical parameters reflecting health status and drug prescriptions at admission, during hospital stay and at discharge before and after a short staff training on the needs of aged cognitively impaired patients. Participants aged 65 and older had a Mini-Mental State Examination (MMSE) score > 16. The number of prescriptions, sedative and anticholinergic load, and drug–drug interactions were evaluated. 116 older patients were analysed; 59 patients were cognitively impaired and 57 were cognitively normal with a MMSE value >24; 59 patients were assisted by the hospital health staff after training. Results: Participants presented a widespread polypharmacy. Cognitively impaired patients received more prescriptions, more inappropriate prescriptions, had a greater sedative load and were exposed to more interactions. The training of the staff had no effect on the prescription pattern. Conclusions: The results suggest that hospitalized cognitively impaired patients are overprescribed psychotropic drugs and have an excessive sedative and anticholinergic load. Intervention on improving dementia care practices in health staff, but not designed to manage drug polypharmacy, do not modify prescription patterns.

    Keywords: Aging, cognitive impairment, drug appropriateness, Sedative load, anticholinergic load, Drug Interactions

    Received: 07 Aug 2024; Accepted: 21 Oct 2024.

    Copyright: © 2024 Govoni, Rosi, Preda, Lanni, Cappa and Allegri. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Cristina Lanni, University of Pavia, Pavia, Italy

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