Research Abstract: Free Paper - Poster Presentation Only Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2023

Drug Burden Index And Its Association With Clinical And Prescribing Outcomes: A Systematic Review With Preliminary Analysis Of Falls-Related Outcomes (#106)

Bonnie M Liu 1 2 , Lisa Kouladjian 1 , Mitchell R Redston 3 , Kenji Fujita 1 , Janani Thillainadesan 4 5 , Danijela Gnjidic 1 , Sarah N Hilmer 1 2
  1. Department of Clinical Pharmacology and Ageing, Kolling Institute, The University of Sydney and the Northern Sydney Local Health District, Sydney, NSW, Australia
  2. Aged Care Department, Royal North Shore Hospital, Sydney, NSW, Australia
  3. St George and Sutherland Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
  4. Sydney Medical School, University of Sydney and Centre for Education and Research on Ageing, Sydney, NSW, Australia
  5. Department of Geriatric Medicine, Concord Hospital, Sydney, NSW, Australia

Aims

The Drug Burden Index (DBI) measures a person’s total exposure to anticholinergic and sedative drugs. This systematic review aims to identify the association between DBI and clinical and/or prescribing outcomes.

 

Methods

A systematic search of nine electronic databases, citation indexes and grey literature was performed from 1/4/2007 to 1/4/2022. Studies that reported primary data on DBI and its association with clinical and/or prescribing outcomes conducted in any setting in humans aged ≥18 years or animals were included. Preliminary findings were narratively synthesised. The Joanna Briggs Institute Critical Appraisal Tools checklists were used to assess study quality.

 

Results

Of 2141 studies screened, 74 met the inclusion criteria (69 in humans, five in animals). Studies were heterogeneous in their setting (community/nursing home/hospital/laboratory), design, definition of DBI and outcome measures. On preliminary analysis, clinical and prescribing outcomes reported included falls (n=16, all human observational studies), function (n=26), cognition (n=19), frailty (n=11), quality of life (n=7), mortality (n=11), polypharmacy (n=3) and other clinical (n=27) and prescribing (n=10) outcomes. Falls-related outcomes included number of falls, falls history, hospitalisation for falls, risk of falls and in-hospital falls. Preliminary subgroup analysis investigating association between DBI and falls-related outcomes, found that six studies (three with low risk of bias) showed a positive association, eight (three with low risk of bias) showed no association and two (one with low risk of bias) showed mixed results.

 

Conclusions

Heterogeneity in the setting and in measurement of DBI and of outcomes such as falls in the included studies limits data synthesis.