{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T19:29:51Z","timestamp":1791660591481,"version":"4.3.4"},"reference-count":30,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Support Palliat Care"],"accepted":{"date-parts":[[2026,4,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Polypharmacy can increase symptom burden and reduce quality of life in palliative care patients. The Drug Burden Index (DBI) measures patients\u2019 exposure to anticholinergic and sedative medications, but has not previously been validated in the palliative care population. This study aimed to quantify the DBI in an older palliative care inpatient population, and examine its associated functional, symptom and delirium outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted on patients aged 65 years and older admitted to a specialist palliative care unit in Sydney, Australia, over a 3-month period. Demographic data, admission characteristics, medication exposure and clinical scores were collected via medical record review. Patients\u2019 DBI on admission and at 24 hours post-admission were calculated based on regular and pro re nata (PRN) medications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>79 patients were enrolled, who used a mean of 6.3 (SD 4.4) regular medications on admission, with a corresponding mean DBI of 0.69 (SD 0.55). At 24 hours post-admission, the DBI increased in 37% of patients and the resultant mean DBI was 0.82 (SD 0.58), which increased to 1.01 (SD 0.64) when administered PRN medications were included. There was no significant correlation on univariate analysis between patients\u2019 DBI on admission and their functional, symptom or delirium scores or length of hospital stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Older palliative care patients are frequently exposed to anticholinergic and sedative medications. The DBI is a practical tool which can prompt medication review and inform safe, individualised prescribing in the palliative care setting in line with patients\u2019 goals of care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/spcare-2025-005461","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T17:20:14Z","timestamp":1776360014000},"page":"spcare-2025-005461","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Drug Burden Index in older palliative care inpatients: a medication safety retrospective cohort study"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8221-9418","authenticated-orcid":false,"given":"Simone C","family":"Cheung","sequence":"first","affiliation":[{"name":"Department of Palliative Care, Greenwich Hospital, HammondCare, Sydney, New South Wales, Australia"},{"name":"Department of Supportive and Palliative Care, Westmead Hospital, Western Sydney Local Health District, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie R","family":"Lovell","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Greenwich Hospital, HammondCare, Sydney, New South Wales, Australia"},{"name":"Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah N","family":"Hilmer","sequence":"additional","affiliation":[{"name":"Kolling Institute, Northern Sydney Local Health District and The University of Sydney, Sydney, New South Wales, Australia"},{"name":"Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"2026041610200637000_spcare-2025-005461v1.1","unstructured":"World Health Organization . 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