Table 2.
Treatment effects for primary and secondary medication outcome measuresa
| Mean (SD) | ||||||
|---|---|---|---|---|---|---|
| Care Ecosystem N = 304 |
Usual Care N = 186 |
Difference between means (95% CI)b | P | |||
| Baseline | Follow-up | Baseline | Follow-up | |||
| Primary Medication Outcome | ||||||
| Number of PIMsc | 1.49 (1.59) | 1.43 (1.51) | 1.42 (1.48) | 1.72 (1.69) | −0.35 (−0.49 to −0.20) | <.0001 |
| Secondary Medication Outcomes | ||||||
| Number of medications | 10.43 (5.23) | 10.68 (5.38) | 10.28 (5.01) | 11.03 (5.42) | −0.53 (−0.92 to −0.14) | .008 |
| PIMs for dementia or cognitive impairmentc | 0.44 (0.76) | 0.45 (0.78) | 0.39 (0.74) | 0.56 (1.04) | −0.14 (−0.23 to −0.05) | .002 |
| CNS-active PIMsc | 1.40 (1.42) | 1.41 (1.36) | 1.33 (1.28) | 1.63 (1.61) | −0.28 (−0.42 to −0.14) | <.0001 |
| ACB Scale scored | 1.62 (1.98) | 1.64 (1.99) | 1.40 (1.56) | 1.69 (1.97) | −0.20 (−0.39 to −0.01) | .035 |
| Antipsychoticsc | 0.15 (0.37) | 0.17 (0.40) | 0.15 (0.40) | 0.21 (0.47) | −0.03 (−0.08 to 0.00) | .126 |
| Benzodiazepinesc | 0.13 (0.33) | 0.12 (0.34) | 0.11 (0.34) | 0.16 (0.43) | −0.05 (−0.09 to −0.01) | .008 |
| Opioidsc | 0.20 (0.50) | 0.18 (0.49) | 0.16 (0.44) | 0.23 (0.52) | −0.09 (−0.14 to −0.03) | .002 |
Abbreviations: PIMs, potentially inappropriate medications; CNS, central nervous system; ACB Scale, Anticholinergic Cognitive Burden Scale
Differences in medication outcomes at follow-up between groups using analysis of covariance. Covariates were baseline values of the medication outcome variable, age, gender, region of residence, dementia stage, and number of comorbidities.
Difference in medication outcomes means between groups using analysis of covariance. A negative value indicates that the outcome was reduced in the Care Ecosystem group when compared with the Usual Care group.
PIMs were defined using American Geriatrics Society 2019 Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults. CNS-active PIMs include PIMs for persons with dementia or cognitive impairment, delirium, or history of falls or fractures were also defined by the 2019 Beers Criteria and include antipsychotics, benzodiazepines and opioids.[23]
Medications with anticholinergic properties were defined using the Anticholinergic Cognitive Burden (ACB) Scale.[27] ACB scores were summarized by participant for each anticholinergic medication prescribed.