SeniorJournal.com - Daily News for Senior Citizens

  FRONT PAGE • Aging • Health • Alzheimer's - Mental • Nutrition • Medicare & Medicaid • Politics  • Fitness  • Social Security • Alerts • Sex Health • Features • Retirement • Elder Care  >Search  >Senior Links

 

Alzheimer's, Dementia & Mental Health

Advanced Dementia Patients Given Medications of Questionable Benefit, High Cost

Questionably medications account for more than one third of their medication expenditures

Nov. 3, 2014 – A nationwide study of 5046 patients with advanced dementia – mostly white females and more than half age 85 or older – has found that most nursing home residents with advanced dementia receive medications with questionable benefit that incur substantial associated costs.

“For such residents, questionably beneficial medications account for more than one third of their medication expenditures,” wrote the authors of the study to be published in JAMA Internal Medicine, November 3, 2014.

The researcher note that “Lower use of questionably beneficial medications was found among residents with advance directives who were enrolled in the hospice setting.”

 

Related Stories

 

 

Discovery Opens Door for Possible Treatment of a Common Dementia

Damage to white matter in brain may be due to many unnoticed strokes

Oct. 30, 2014

Read the latest news on Alzheimer's, Dementia & Mental Health

 

Advanced dementia in this study was defined as a terminal illness characterized by no longer recognizing family, bedridden and able to speak fewer than five words. Generally, they had frequent problems with dysphagia and aspiration but received an average of five to 15 medications daily.

Standards of care require patients’ goals of care should guide the prescribing of medication during such terminal illness. Medications that do not promote the primary goal of care should be minimized.

The goal of the researchers, according to lead author Jennifer Tjia, MD, MSCE, Department of Quantitative Health Sciences, University of Massachusetts Medical School, was to estimate the prevalence of medications with questionable benefit used by nursing home residents with advanced dementia, identify resident- and facility-level characteristics associated with such use, and estimate associated medication expenditures.

They conducted a cross-sectional study of medication use by nursing home residents with advanced dementia using a nationwide long-term care pharmacy database linked to the Minimum Data Set (460 facilities) between October 1, 2009, and September 30, 2010.

They identified the use of medication deemed of questionable benefit in advanced dementia based on previously published criteria and the mean 90-day expenditures attributable to these medications per resident.

Of 5406 nursing home residents with advanced dementia, 2911 (53.9%) received at least one medication with questionable benefit (range, 44.7% in the Mid-Atlantic census region to 65.0%in the West South Central census region).

Cholinesterase inhibitors (36.4%), memantine hydrochloride (25.2%), and lipid-lowering agents (22.4%) were the most commonly prescribed.

There were reasons to adjust the analysis for some special considerations that lowered the likelihood of receiving these medications, including:

 ● having eating problems,
 ● a feeding tube, or
 ● a do-not-resuscitate order, and
 ● enrolling in hospice.

High facility-level use of feeding tubes increased the likelihood of receiving these medications.

The mean 90-day expenditure for medications with questionable benefit was $816 ($553), accounting for 35.2%of the total average 90-day medication expenditures for residents with advanced dementia who were prescribed these medications.

“Our findings have important implications at the policy level, and show that little progress has been made with respect to meeting the intent of the F329 section of the Nursing Home Reform Act, which calls for all nursing home residents to be free of unnecessary medications,” the authors write in their conclusion.

Note: This report was published by JAMA Internal Medicine online September 8, 2014

Follow on  and 

 

Financial Relief for Volkswagen Diesel Owners

You may be eligible for money damages if you owned or leased one of these VW, Porsche or Audi vehicles.

In the major scandal of 2015, Volkswagen cheated you and the world. They rigged diesel emission controls so you, nor regulators, would know how much pollution their cars were adding to our environment.

They were caught and have reserved $7.3 billion to help "make it right" with victims.

If you owned or leased one of these vehicles, contact us now.

 Beth Janicek, Board Certified Personal Injury Attorney Janicek Law attorneys are actively pursuing these cases against VW. Do Not Wait...

Janicek Law Firm, PC

Free Consultation

(Call toll free)

1-877-795-3425 or Email

Vehicles Involved

VW Jetta (2009–2015)

VW Jetta SportWagen (2009–2014)

VW Golf (2010-2015)

VW Golf SportWagen (2015)

VW Beetle (2012–2015)

VW Passat (2012-2015)

Audi A3 (2010-2015)

VW Touareg (2009–2016)

Porsche Cayenne (2015)

Audi A6, A7, A8, Q5 Quattro (2016)

 

Search for more about this topic on SeniorJournal.com

Google Web SeniorJournal.com

Keep up with the latest news for senior citizens, baby boomers

Click to More Senior News on the Front Page

Copyright: SeniorJournal.com

 

 

Published by New Tech Media - www.NewTechMedia.com

Other New Tech Media sites include CaroleSutherland.com, BethJanicek.com, SASeniors.com, DrugDanger.com, etc.