Polypharmacy and potentially inappropriate prescribing of benzodiazepines in older nursing home residents

被引:1
作者
Kummer, Ingrid [1 ]
Reissigova, Jindra [2 ]
Lukacisinova, Anna [1 ]
Hadziabdic, Maja Ortner [3 ]
Stuhec, Matej [4 ,5 ]
Liperoti, Rosa [6 ]
Finne-Soveri, Harriet [7 ]
Onder, Graziano [6 ]
van Hout, Hein [8 ]
Fialova, Daniela [1 ,9 ]
机构
[1] Charles Univ Prague, Fac Pharm Hradec Kralove, Dept Social & Clin Pharm, Heyrovskeho 1203, Hradec Kralove 50005, Czech Republic
[2] Czech Acad Sci, Dept Stat Modelling, Inst Comp Sci, Prague, Czech Republic
[3] Univ Zagreb, Fac Pharm & Biochem, Ctr Appl Pharm, Zagreb, Croatia
[4] Univ Maribor, Dept Pharmacol, Fac Med, Maribor, Slovenia
[5] Ormoz Psychiat Hosp, Dept Clin Pharm, Ormoz, Slovenia
[6] Univ Cattolica Sacro Cuore, Fdn Policlin Univ A Gemelli IRCCS, Rome, Italy
[7] Natl Inst Hlth & Welf, Helsinki, Finland
[8] Locat Vrije Univ, Amsterdam Univ Med Ctr, Amsterdam Publ Hlth Res Inst, Dept Gen Practice & Med Older People, Amsterdam, Netherlands
[9] Charles Univ Prague, Fac Med 1, Dept Geriatr & Gerontol, Heyrovskeho 1203, Prague 50005, Czech Republic
关键词
Nursing home residents; polypharmacy/hyperpolypharmacy; psychiatric polypharmacy/hyperpolypharmacy; inappropriate benzodiazepine prescribing; geriatric deprescribing; MEDICATION USE; PREVALENCE; ADULTS; PHARMACOTHERAPY; POPULATION; PATTERNS; SCALE; RISK; CARE;
D O I
10.1080/07853890.2024.2357232
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
IntroductionPrevious research has raised concerns about high prevalence of drug-related problems, polypharmacy and inappropriate benzodiazepine prescribing in nursing homes (NHs) and confirmed lack of studies from Central and South-Eastern Europe. The aim of our study was to determine the prevalence and characteristics of polypharmacy, hyperpolypharmacy and inappropriate benzodiazepine prescribing in NH residents in Croatia.MethodsData from 226 older NH residents from five Croatian NHs were collected using the InterRAI Long-Term Care Facilities assessment form. The prevalence and determinants of polypharmacy/hyperpolypharmacy and patterns of inappropriate benzodiazepine prescribing were documented.ResultsThe prevalence of polypharmacy (49.6%) and hyperpolypharmacy (25.7%) among NH residents was high. In our study, 72.1% of NH residents were prescribed at least one psychotropic agent, 36.7% used 2-3 psychotropics and 6.6% used 4+ psychotropics. Among benzodiazepine users (55.8%), 28% of residents were prescribed benzodiazepines in higher than recommended geriatric doses, 75% used them for the long term and 48% were prescribed concomitant interacting medications. The odds of being prescribed polypharmacy/hyperpolypharmacy were significantly higher for older patients with polymorbidity (6+ disorders, proportional odds ratio (POR) = 19.8), type II diabetes (POR = 5.2), ischemic heart disease (POR = 4.6), higher frailty (Clinical Frailty Scale (CFS >= 5); POR = 4.3) and gastrointestinal problems (POR = 4.8).ConclusionsOur research underscores the persistent challenge of inappropriate medication use and drug-related harms among older NH residents, despite existing evidence and professional campaigns. Effective regulatory and policy interventions, including the implementation of geriatrician and clinical pharmacy services, are essential to address this critical issue and ensure optimal medication management for vulnerable NH populations.
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页数:14
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