Adverse events among nursing home residents with Alzheimer's disease and psychosis Journal Article
| Authors: | Oliveria, S. A.; Liperoti, R.; L'Italien, G.; Pugner, K.; Safferman, A.; Carson, W.; Lapane, K. |
| Article Title: | Adverse events among nursing home residents with Alzheimer's disease and psychosis |
| Abstract: | Purpose: The objective of this study was to quantify rates of adverse events in a high-risk multi-morbid population of institutionalized patients with Alzheimer's disease (AD). Methods: We conducted a retrospective cohort study among nursing home residents diagnosed with AD and psychosis during January 1998 to October 1999. Using the Medicare Minimum Data Set (MDS) and Medicare inpatient claims (ICD-9 codes), 7728 nursing home residents aged 55-95 years with AD and psychosis were identified for study. Potential adverse events of interest were identified from the MDS and Medicare inpatient claims (ICD-9 codes). We estimated the incidence rate (IR) and 95% confidence interval (CI) for each adverse event dating a 2-year follow-up period. Results: Of the 7728 residents studied, nearly 30% were considered 'dependent' by the activities of daily living (ADL) score and approximately 15% exhibited severe cognitive impairment at baseline. At least 90% had comorbid psychiatric disorders. The most common adverse event was accidental injury, occurring at a rate of 97.7 per 100 person-years (95%CI = 94.7-100.7). Other common adverse events were death (IR = 44.6/100 person-years; 95%CI = 42.9-46.4), infection (IR = 41.8/100 person-years; 95%CI = 39.7-43.8), pain (IR = 43.5/100 person-years; 95%CI = 41.2-45.9), anorexia (41.3/100 person-years; 95%CI = 39.1-43.6), and weight change (IR = 40.2/100 person-years; 95%CI = 38.7-41.7). Conclusions: This information on the occurrence of adverse outcomes among nursing home patients with AD and psychosis provides useful context for any safety event observed among patients treated for psychosis. Copyright © 2006 John Wiley & Sons, Ltd. |
| Keywords: | adult; aged; aged, 80 and over; retrospective studies; major clinical study; constipation; mortality; diarrhea; drug safety; united states; follow up; follow-up studies; anorexia; drug eruption; pain; cohort studies; dehydration; akathisia; delirium; incidence; cohort analysis; risk factors; weight reduction; medical record review; risk assessment; outcome assessment (health care); asthenia; pneumonia; syncope; confidence interval; medicaid; medicare; confusion; insomnia; hospitalization; population research; urine incontinence; cardiovascular disease; stroke; patient safety; comorbidity; transient ischemic attack; peripheral edema; antidepressant agent; neuroleptic agent; anxiety disorder; extrapyramidal syndrome; nausea and vomiting; cognitive defect; daily life activity; somnolence; psychosis; postmarketing surveillance; tremor; gallstone; cholecystitis; respiratory tract infection; alzheimer disease; injury; cross infection; activities of daily living; aspiration pneumonia; geriatric assessment; international classification of diseases; cellulitis; ecchymosis; nursing home; hypnotic sedative agent; weight gain; skin injury; alzheimer's disease; gait disorder; institutional care; conjunctivitis; weight change; adl disability; dystonia; skin bruising; safety management; restlessness; pharmacoepidemiology; psychotic disorders; tardive dyskinesia; nursing homes; accident proneness; body weight disorder; choreoathetosis; accidental falls; insurance claim reporting |
| Journal Title: | Pharmacoepidemiology and Drug Safety |
| Volume: | 15 |
| Issue: | 11 |
| ISSN: | 1053-8569 |
| Publisher: | John Wiley & Sons |
| Date Published: | 2006-11-01 |
| Start Page: | 763 |
| End Page: | 774 |
| Language: | English |
| DOI: | 10.1002/pds.1274 |
| PUBMED: | 16823890 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 3" - "Export Date: 4 June 2012" - "CODEN: PDSAE" - "Source: Scopus" |
