Table 4.

Results from studies utilising PEACE criteria to determine appropriateness of medications in individuals with advanced dementia

Authors	Country	N at baseline	Mean (SD) medications per resident at baseline	N (%) using ‘never’ appropriate medicationsa	Most common ‘never’ appropriate medications	Factors associated with using ‘never’ appropriate medications	Factors measured but did not show an association with using ‘never’ appropriate medications
Holmes et al. 2008 [16]	USA	34	6.5 (2.7)	10 (29 %)	Cardiovascular agents	Not measured	Not measured
Tjia et al. 2010 [17]	USA	323	6.2 (3.33)	121 (37.5 %)	Lipid lowering agents Anticholinesterase inhibitors	Male Shorter length of stay# Higher functional abilityc Diabetes mellitus DNH order (inverse)	Age Ethnicity (non-white race vs white) In special care dementia unit Dementia due to Alzheimer’s disease Test for Severe Impairment score > 0d Cardiovascular diseasee Cancer Acute illness in prior 90 daysf Recent hospitalizationg Recent physician/nurse professional visits in prior 90 days No feeding tube No hospice referral
Colloca et al. 2012 [20]	7 EU countries (Czech Republic, England, Finland, France, Germany, Italy, The Netherlands) and Israel	1449	4 (not reported)	388 (26.8 %)	Lipid lowering agents Antiplatelets Anticholinesterase inhibitors	Stroke	Age Gender Shorter length of stayb Ethnicity (non-white vs white) ADL Hierarchy Scale scoreh Behavioural symptoms Falls Number of diseases Ischaemic heart disease Diabetes Heart failure Cancer Parkinson’s disease Urinary tract infections Pneumonia Fractures Recent hospitalizationg Presence of a geriatrician Presence of a pharmacist
Toscani et al. 2013 [18]	Italy	245	Not reported	9 (2.2 %)	Antihypertensives Antiplatelets	Not measured	Not measured
Tjia et al. 2014 [22]	USA	5406	7.33 (3.5)	2911 (53.9 %)	Lipid lowering agents Memantine Anticholinesterase inhibitors	High facility use of feeding tubes	Age Gender Ethnicity (non-white vs white) DNR order Hospice enrolment Whether Medicaid is primary payor In special care dementia unit Recent hospitalizationg Recent physician visit (last 14 days) Diabetes mellitus Heart Failure Hypertension Stroke Osteoporosis Depression Nutritional problems Oral problems Behavioural issues Functional status

^aas defined by the Palliative Excellence in Alzheimer Care Efforts (PEACE) criteria reported by Holmes et al. (2008) [13]

^bLess than 1 year in nursing home

^cBedford Alzheimer Nursing Scale – Severity Subscale, possible range 7–28, higher scores indicate greater functional disability

^dpossible range 0–24, lower scores indicate greater cognitive impairment

^eCardiovascular disease includes history of coronary artery disease and cerebrovascular accident

^fAcute illnesses include infectious episodes myocardial infarction, stroke, any bone fracture, gastrointestinal bleed, and seizure

^gany hospitalization occurring in the last 90 days

^hADL hierarchical scale score ranges from 0 (no impairment) to 6 (total dependence in self-care)

ADL Activities of Daily Living, DNH Do Not Hospitalize, DNR Do Not Resuscitate, N number, SD standard deviation