Table 3.
Studies of the Drug Burden Index in clinical practice
| Study setting, population age | Country (n) | Intervention or audit | DBI score at baseline and post-intervention or audit | DBI association with outcomes | Resource used to identify minimum effective dose (δ) of medications |
|---|---|---|---|---|---|
| Residential aged care home patients, ≥65 years | Australia (500) | RMMR33 | Median (IQR) Pre 0.50 (0–1.0) Post 0.33 (0–0.67) |
RMMR intervention resulted in a statistically significant decrease in median DBI score35 | FDA |
| Community-dwelling older people, ≥65 years | Australia (372) | HMR33 | Median (IQR) Pre 0.50 (0–0.89) Post 0.22 (0–0.66) |
Statistically significant decrease in the total DBI scores for all patients receiving an HMR service34 | FDA |
| Self-care retirement village older adults, ≥70 years | Australia (115) | Intervention targeting GP prescribing practices | Prevalence % DBI >0, pre, post; Intervention group 33%, 32% Control group 53%, 19% |
Intervention did not achieve anticipated outcomes. DBI decreased in both control and intervention groups37 | TGA |
| Hospitalized patients, ≥65 years | Australia (329) | Retrospective audit of medical records | Mean (95% CI) On admission 0.41 (0.34–0.47) On discharge 0.36 (0.30–0.41) |
DBI was associated with an increased risk of hospital admission for delirium92 | TGA sourced from the MIMS85 |
| Hospitalized patients, ≥65 years | USA (229) | Retrospective audit of medical records | Mean ± SD On admission 1.00±0.92 On readmission 1.55±1.26 |
DBI scores were higher in patients readmitted to hospital93 | FDA |
Abbreviations: DBI, Drug Burden Index; IQR, interquartile range; CI, confidence interval; SD, standard deviation; FDA, US Food and Drug Administration; TGA, Therapeutic Goods Administration of Australia; MIMS, Monthly Index of Medical Specialties; RMMR, Residential Medication Management Review; HMR, Home Medicine Review; GP, general practitioner.