OMITTED MEDICATIONS AMONG HOSPITALIZED OLDER ADULTS AND PERSONS WITH DEMENTIA - Using MIMIC-IV

Q: What does “omitted medication” mean in this study?

It refers to cases where a prescribed drug is not administered. The study evaluates omitted medications documented in the medication record events.

Q: How was dementia status identified for participants?

Participants were identified as persons with dementia (PWD) using ICD diagnosis codes in the dataset.

Q: What factors were found to be associated with a higher proportion of omitted medications among PWD?

Delirium was independently associated with a higher proportion of omitted medications among PWD after adjusting for age and length of stay.

Sep 29, 2026

Uploaded by MrHarris58

Omitted medication occurs when a prescribed drug is not administered, and hospitalized persons with dementia (PWD) may be at higher risk due to delirium, reduced routine familiarity, and limited dementia-specific clinician training. This study assessed the association between dementia diagnosis and omitted medications using the MIMIC-IV-Hosp de-identified EHR dataset (2008–2019). Among 95,421 admissions, PWD showed a higher omitted-medication proportion; delirium further increased omissions among PWD. Effect sizes were small but statistically significant, motivating further work to identify medication types most affected and underlying mechanisms.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Abstract citation ID: igaf122.3987

Study aim and rationale

Data source and methods

Key preliminary findings

Implications and future research

Innovation in Aging, 2025, Vol. 9, No. S2 1191 Omitted medication occurs when a prescribed drug is not administered. Hospitalized persons with dementia (PWD) may experience omitted medications due to delirium, lack of routine/ familiarity, and/or lack of dementia-specific training among clinicians. The impact of omitted medications ranges from negligible to fatal, but little research has been done on omitted medications focused on hospitalized persons with dementia. This study aimed to examine the association between having a dementia diagnosis and omitted medications and explore factors that may influence this relationship. We utilized the MIMIC-IV-Hosp dataset, de-identified EHR data from adults admitted to Beth Israel Deaconess Medical Center from 2008-2019. Our sample included admission-level data for adults aged >60 with hospital stays >48 hours. PWD were identified using ICD diagnosis codes. Omitted medications were identified based on event documentation in the medication record. Preliminary findings: Among 95,421 admissions, 10,921 (11.4%) were PWD. In unadjusted comparisons, PWD had a 2.65% higher proportion of omitted medications (p < 0.001). After adjusting for age and length of stay (LOS), PWD had a 1.95% higher proportion of omitted medications (p < 0.001) . While statistically significant, the effect size was small, and the model explained only 2.3% of the variance. Among PWD, delirium was independently associated with a higher proportion of omitted medications (β = 2.61, p < 0.001), adjusting for age and LOS. This model explained 3.9% of the variance in omitted medications among PWD. Further research is warranted to identify types of medications most affected by omissions among PWD and to clarify the underlying mechanisms. Abstract citation ID: igaf122.3987 OMITTED MEDICATIONS AMONG HOSPITALIZED OLDER ADULTS AND PERSONS WITH DEMENTIA USING MIMIC-IV Ellen Munsterman1, Jiyoun Song1, Marie Boltz2, and Pamela Cacchione3, 1. University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, United States, 2. Pennsylvania State University, University Park, Pennsylvania, United States, 3. University of Pennsylvania, Philadelphia, Pennsylvania, United States

FAQs

What does “omitted medication” mean in this study?

It refers to cases where a prescribed drug is not administered. The study evaluates omitted medications documented in the medication record events.

How was dementia status identified for participants?

Participants were identified as persons with dementia (PWD) using ICD diagnosis codes in the dataset.

What factors were found to be associated with a higher proportion of omitted medications among PWD?

Delirium was independently associated with a higher proportion of omitted medications among PWD after adjusting for age and length of stay.

Sep 29, 2026

Uploaded by MrHarris58