Evaluation of changes in prescription among Japanese elderly patients before and after transition to home care

被引：3

作者：

Masumoto, Shoichi ^{[1
,2
]}

Sato, Mikiya ^{[3
,4
]}

Yamakawa, Tomotsugu ^{[5
]}

Hamada, Shuhei ^{[6
]}

Inaba, Takashi ^{[1
]}

Kataoka, Yoshihiro ^{[1
]}

Ozone, Sachiko ^{[1
]}

Yokoya, Shoji ^{[1
]}

Hamano, Jun ^{[7
]}

机构：

[1] Univ Tsukuba, Fac Med, Dept Family Med Gen Practice & Community Hlth, 1-1-1 Tennodai, Tsukuba, Ibaraki 3058577, Japan

[2] Tsukuba Cent Hosp, Dept Gen Med, Ushiku, Japan

[3] Univ Tsukuba, Fac Med, Dept Hlth Serv Res, Tsukuba, Ibaraki, Japan

[4] Sumitomo Heavy Ind Ltd, Human Resources Grp, Hlth Serv Ctr, Tokyo, Japan

[5] Univ Tsukuba, Grad Sch Comprehens Human Sci, Tsukuba, Ibaraki, Japan

[6] Yamato Clin, Sakuragawa, Japan

[7] Univ Tsukuba, Fac Med, Div Clin Med, Tsukuba, Ibaraki, Japan

来源：

JOURNAL OF GENERAL AND FAMILY MEDICINE | 2022年 / 23卷 / 02期

基金：

日本学术振兴会;

关键词：

family physician; home care; medication regimen complexity; polypharmacy; potentially inappropriate medications; MEDICATION REGIMEN COMPLEXITY; OLDER-PEOPLE; OUTCOMES; POLYPHARMACY; RISK; ASSOCIATION; PREVALENCE; MEDICINES; CRITERIA;

D O I：

10.1002/jgf2.506

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Most patients receiving home care have multimorbidity and tend to be prescribed multiple drugs with the complicated regimen. Family physicians (FPs) are responsible for patients' prescriptions after transition to home care. This study aimed to assess changes in medication regimen complexity and potentially inappropriate medications (PIMs) made by FPs before and after transition to home care. Methods: A retrospective cohort study was conducted in six home care clinics in Ibaraki Prefecture, Japan. Data from patients aged 65 years and older taking any medication who initiated home care between April 2018 and March 2019 were collected using medical records. The medication regimen complexity index-Japanese version (MRCI-J) score and the presence of PIMs were assessed before and 3 months after transition to home care. Results: The mean age of 169 patients was 84.0 years. MRCI-J score and percentage of PIMs remained unchanged between before and 3 months after home care initiation. However, MRCI-J score significantly decreased among patients with polypharmacy, but significantly increased among patients with nonpolypharmacy. In multiple regression analysis, a greater number of medications before home care initiation was associated with a decreasing MRCI-J score, but pharmacist home visit services were not associated with changes in MRCI-J score. Conclusions: Our results suggest that FPs involved in home care are trying to adjust prescriptions by simplifying the medication regimen of patients with polypharmacy, and adding symptomatic drugs to those with nonpolypharmacy.

引用

页码：94 / 100

页数：7

共 31 条

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Xing, Xiao Xuan ;

Zhu, Chen ;

Liang, Hua Yu ;

Wang, Ke ;

Chu, Yan Qi ;

Zhao, Li Bo ;

Jiang, De Chun ;

Wang, Yu Qin ;

Yan, Su Ying .

ANNALS OF PHARMACOTHERAPY, 2019, 53 (10) :1005-1019

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