Affiliations: [a] German Centre for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Greifswald, Germany
| [b] Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
Correspondence:
[*]
Correspondence to: Bernhard Michalowsky, German Centre for Neurodegenerative Diseases (DZNE), site
Rostock/Greifswald, Ellernholzstrasse 1-2, 17489, Greifswald, Germany. Tel.: +49 3834 86 75 07;
E-mail: bernhard.michalowsky@dzne.de.
Abstract: Background:Drug-related problems (DRP) are common in the elderly population, especially in people living with dementia (PwD). DRP are associated with adverse outcomes that could result in increased costs. Objective:The objective of the study was to analyze the association between DRP and healthcare costs in PwD. Methods:The analysis was based on the cross-sectional data of 424 PwD. Compliance, adverse effects, and drug administration of prescribed and over-the-counter drugs taken were assessed. DRP were identified and classified by pharmacists using an adapted German version of “PIE-Doc®”. Healthcare utilization was assessed retrospectively used to calculated costs from a public payer perspective using standardized unit costs. The associations between DRP and healthcare costs were analyzed using multiple linear regression models. Results:394 PwD (93%) had at least one DRP. An inappropriate drug choice was significantly associated with increased total costs (b = 2,718€; CI95% 1,448–3,988) due to significantly higher costs for hospitalization (b = 1,936€; 670–3,202) and for medications (b = 417€; 68–765). Problems with medication dosage and drug interactions were significantly associated with higher medication costs (b = 679€; 31–1,328; and b = 630€; 259–1,001, respectively). Conclusions:DRP could significantly lead to adverse outcomes for PwD and healthcare payers, reflected by a higher hospitalization and costs, respectively. Further research is needed to clarify on interventions and approaches efficiently avoiding DRP and on the effect on patient-reported and economic outcomes.
Keywords: Dementia, health economics, hospitalization, potential inadequate medication
