Prevalence of inappropriate medication using Beers criteria in Japanese long-term care facilities

被引:55
作者
Niwata S. [1 ]
Yamada Y. [1 ,2 ]
Ikegami N. [1 ]
机构
[1] Department of Health Policy and Management, Keio University, School of Medicine, Tokyo
[2] Department of System Management in Nursing, Graduate School of Health Sciences, Tokyo Medical and Dental University, Tokyo
关键词
Clopidogrel; Psychotropic Drug; Ticlopidine; Multiple Logistic Regression Analysis; Medication Class;
D O I
10.1186/1471-2318-6-1
中图分类号
学科分类号
摘要
Background: The prevalence and risk factors of potentially inappropriate medication use among the elderly patients have been studied in various countries, but because of the difficulty of obtaining data on patient characteristics and medications they have not been studied in Japan. Methods: We conducted a retrospective cross-sectional study in 17 Japanese long-term care (LTC) facilities by collecting data from the comprehensive MDS assessment forms for 1669 patients aged 65 years and over who were assessed between January and July of 2002. Potentially inappropriate medications were identified on the basis of the 2003 Beers criteria. Results: The patients in the sample were similar in terms of demographic characteristics to those in the national survey. Our study revealed that 356 (21.1%) of the patients were treated with potentially inappropriate medication independent of disease or condition. The most commonly inappropriately prescribed medication was ticlopidine, which had been prescribed for 107 patients (6.3%). There were 300 (18.0%) patients treated with at least 1 inappropriate medication dependent on the disease or condition. The highest prevalence of inappropriate medication use dependent on the disease or condition was found in patients with chronic constipation. Multiple logistic regression analysis revealed psychotropic drug use (OR = 1.511), medication cost of per day (OR = 1.173), number of medications (OR = 1.140), and age (OR = 0.981) as factors related to inappropriate medication use independent of disease or condition. Neither patient characteristics nor facility characteristics emerged as predictors of inappropriate prescription. Conclusion: The prevalence and predictors of inappropriate medication use in Japanese LTC facilities were similar to those in other countries. © 2006 Niwata et al; licensee BioMed Central Ltd.
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页数:7
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共 58 条
[1]  
Bootman J.L., Harrison D.L., Cox E., The health care cost of drug-related morbidity and mortality in nursing facilities, Arch Intern Med, 157, pp. 2089-2096, (1997)
[2]  
McLeod P.J., Huang A.R., Tamblyn R.M., Gayton D.C., Defining inappropriate practices in prescribing for elderly people: A national consensus panel, CMAJ, 156, pp. 385-391, (1997)
[3]  
Oborne C.A., Batty G.M., Maskrey V., Swift C.G., Jackson S.H., Development of prescribing indicators for elderly medical inpatients, Br J Clin Pharmacol, 43, pp. 91-97, (1997)
[4]  
Brown N.J., Griffin M.R., Ray W.A., Meredith S., Beers M.H., Marren J., Robles M., Stergachis A., Wood A.J., Avorn J., A model for improving medication use in home health care patients, J Am Pharm Assoc (Wash), 38, pp. 696-702, (1998)
[5]  
Hanlon J.T., Schmader K.E., Boult C., Artz M.B., Gross C.R., Fillenbaum G.G., Ruby C.M., Garrard J., Use of inappropriate prescription drugs by older people, J Am Geriatr Soc, 50, pp. 26-34, (2002)
[6]  
Beers M.H., Ouslander J.G., Rollingher I., Reuben D.B., Brooks J., Beck J.C., Explicit criteria for determining inappropriate medication use in nursing home residents, Arch Intern Med, 151, pp. 1825-1832, (1991)
[7]  
Beers M.H., Explicit criteria for determining potentially inappropriate medication use by the elderly. An update, Arch Intern Med, 13, pp. 1531-1536, (1997)
[8]  
Fick D.M., Cooper J.W., Wade W.E., Waller J.L., Maclean J.R., Beers M.H., Updating the Beers criteria for potentially inappropriate medication use in older adults: Results of a US consensus panel of experts, Arch Intern Med, 59, pp. 2716-2724, (2003)
[9]  
Beers M.H., Ouslander J.G., Fingold S.F., Morgenstern H., Reuben D.B., Rogers W., Zeffren M.J., Beck J.C., Inappropriate medication prescribing in skilled-nursing facilities, Ann Intern Med, 117, pp. 684-689, (1992)
[10]  
Stuck A.E., Beers M.H., Steiner A., Aronow H.U., Rubenstein L.Z., Beck J.C., Inappropriate medication use in community-residing older persons, Arch Intern Med, 154, pp. 2195-2200, (1994)