Older patients with more affected CIRS-G categories were at higher risk for PO. Polypharmacy was not an independent risk factor for the presence of PO. A possible reason is that in multimorbid older people, physicians and patients set individual priorities to treatment instead of treating all diseases and conditions.
IntroductionAnticholinergic burden in older adults has been correlated with cognitive decline, delirium, dizziness and confusion, falls and hospitalisations. Nevertheless, anticholinergic-acting medications remain commonly prescribed in up to a third of older adults in primary care population. Our aim was to study the anticholinergic burden in older adults in Slovenian ambulatory setting and explore the most commonly involved medications which could be avoided by the physicians.MethodsA cross-sectional study was conducted in 30 general practices in Slovenia as part of a larger trial. Data on prescribed medications were collected for randomly chosen adults of over 65 years of age visiting general practice, who were taking at least one regularly prescribed medication. Anticholinergic burden was calculated using Duran’s scale and Drug Burden Index.ResultsAltogether, 622 patients were included, 356 (57.2%) female, average age of 77.2 (±6.2), with an average of 5.6 medications. At least one anticholinergic medication was present in 78 (12.5 %) patients. More than half (N=41, 52.6%) of anticholinergic prescriptions were psychotropic medications. Most common individual medications were diazepam (N=10, 1.6%), quetiapine (N=9, 1.4%) and ranitidine (N=8, 1.3%).ConclusionsThough the prevalence of anticholinergic medications was low compared to international research, the most commonly registered anticholinergic prescriptions were medications that should be avoided according to guidelines of elderly prescriptions. It would be probably clinically feasible to further decrease the anticholinergic burden of older adults in Slovenian primary care setting by avoiding or replacing these medications with safer alternatives.
AimTo determine the prevalence of psychotropic medication prescribing in elderly nursing home residents in Slovenia and to explore the residents’, physicians’, and nursing home characteristics associated with prescribing.MethodsIn a cross-sectional study, we collected the data for 2040 nursing home residents aged 65 years and older in 12 nursing homes in Slovenia between September 25 and November 30, 2006. Prescribed medications lists were retrieved from patients’ medical records. Psychotropic medications were coded according to Anatomical Therapeutic Chemical Classification 2005, which we adjusted for the purposes of the study. Multivariate logistic regression analysis was performed to determine the residents’, physicians’, and nursing home characteristics associated with prescribing.ResultsResidents were from 65 to 104 years old (median, 83 years) and 1606 (79%) of them were female. A total of 970 (48%) residents had dementia and 466 had depression (23%). In 1492 (73%) residents, at least one psychotropic medication was prescribed. Nine hundred sixty residents were prescribed hypnotics and sedatives (47%), 572 (28%) antipsychotics, 460 (23%) antidepressants, and 432 (21%) anxiolytics. Residents’ characteristics associated with psychotropic medication use were female sex (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.03-1.80), age (OR, 0.97; 95% CI, 0.95-0.98), permanent restlessness (OR, 2.54; 95% CI, 1.71-3.78), dementia (OR, 1.76; 95% CI, 1.33-2.34), depression (OR, 5.51; 95% CI, 3.50-7.58), and the number of prescribed medications (OR, 1.29; 95% CI, 1.23-1.35). Of physicians’ characteristics (sex, age, specialization in general practice, years of working experiences as a general practitioner, and years of experiences working in a nursing home), male sex was associated with psychotropic medication prescribing (OR, 1.80; 95% CI, 1.17-2.76).ConclusionFrequency of psychotropic medication prescribing in elderly nursing home residents in Slovenia is high and is comparable to Western European countries. Our next step should be optimizing the prescribing in patients with the highest prescription rate.
Osnovna zdravstvena dejavnost in z njo družinska medicina predstavljata temelj vsakega zdravstvenega sistema. V Sloveniji imamo sistem osnovne zdravstvene dejavnosti, ki je konceptualno priznan kot zelo dober s strani mednarodnih strokovnjakov in organizacij. Ob tem se soočamo z resnimi kritikami in težavami. Prispevek predstavlja pregled izzivov, s katerimi se sooča družinska medicina v Sloveniji zdaj. V devetih točkah so zbrani predlogi ukrepov, ki bi jih bilo potrebno izpolniti, če želimo, da se stanje na področju družinske medicine izboljša.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.