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Effect of a Financial Incentive Scheme for Medication Review on Polypharmacy in Elderly Inpatients With Dementia: A Retrospective Before-and-After Study
Morita Takahito, Sasabuchi Yusuke, Yamana Hayato, Hosoi Tatsuya, Ogawa Sumito, Ohbe Hiroyuki, Matsui Hiroki, Fushimi Kiyohide et al.. Journal of patient safety, 2024-10-18
Topic: Risk, prevention and care in population studies
Polypharmacy is an important healthcare issue, especially in elderly patients with dementia. As an incentive to reduce polypharmacy, a health insurance reimbursement scheme was introduced in 2016 for medication review and the reduction of medications for inpatients in Japan. However, the effects of these incentive schemes were not evaluated. We identified 1,465,881 inpatients aged ≥65 years with dementia. An interrupted time-series analysis was conducted by fitting a Prais-Winsten linear regression model. The outcome measure was the number of classes of medications prescribed during discharge. No significant changes were observed in the average number of medication classes at discharge immediately after the introduction of the scheme (coefficient: -0.022, 95% confidence interval [CI]: -0.17 to 0.13). The slope change, representing the effect of the intervention over time, was also not significant (coefficient: -0.00053, 95% confidence interval: -0.0012 to 0.00018). The incentive scheme was not associated with a reduction in the number of medication classes at discharge among older inpatients with dementia.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Takahito, M., Yusuke, S., Hayato, Y., Tatsuya, H., Sumito, O., Hiroyuki, O., et al. (2025). Effect of a Financial Incentive Scheme for Medication Review on Polypharmacy in Elderly Inpatients With Dementia: A Retrospective Before-and-After Study. Journal of patient safety. https://doi.org/10.1097/PTS.0000000000001294
Vancouver
Takahito M, Yusuke S, Hayato Y, Tatsuya H, Sumito O, Hiroyuki O, et al. Effect of a Financial Incentive Scheme for Medication Review on Polypharmacy in Elderly Inpatients With Dementia: A Retrospective Before-and-After Study. Journal of patient safety. 2025. doi:10.1097/PTS.0000000000001294. PMID: 39422523.
BibTeX
@article{takahito2025-39422523,
author = {Takahito, Morita and Yusuke, Sasabuchi and Hayato, Yamana and Tatsuya, Hosoi and Sumito, Ogawa and Hiroyuki, Ohbe and Hiroki, Matsui and Kiyohide, Fushimi and others},
title = {{Effect of a Financial Incentive Scheme for Medication Review on Polypharmacy in Elderly Inpatients With Dementia: A Retrospective Before-and-After Study}},
journal = {Journal of patient safety},
year = {2025},
doi = {10.1097/PTS.0000000000001294},
pmid = {39422523},
url = {https://doi.org/10.1097/PTS.0000000000001294}
}
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Key findings
- No significant changes were observed in the average number of medication classes at discharge immediately after the introduction of the scheme (coefficient: -0.022, 95% confidence interval [CI]: -0.17 to 0.13).
- The slope change, representing the effect of the intervention over time, was also not significant (coefficient: -0.00053, 95% confidence interval: -0.0012 to 0.00018).
- The incentive scheme was not associated with a reduction in the number of medication classes at discharge among older inpatients with dementia.
Why it matters
This study found that a financial incentive scheme for medication review was not associated with a reduction in the number of medication classes at discharge among older inpatients with dementia. No significant changes were observed immediately after the scheme's introduction or over time.
Study details
- Evidence strengthLow
How this study scored 28/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of patient safety) |
| Journal's citation record | 0 / 4 | Journal of Patient Safety: journal h-index 70 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Hideo Yasunaga: h-index 8 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | The University of Tokyo: institution h-index 1,463 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 39422523) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 28 / 100 | — |
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