Factors Influencing the Number of Drugs among Elderly Patients Hospitalized in a Rehabilitation Ward

Ogawa, Yukari; Sakoh, Masaharu; Mihara, Kiyoshi; Ogawa, Ryuichi; Echizen, Hirotoshi

doi:10.5649/jjphcs.42.56

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…In order to avoid drug interactions and severe adverse drug effects, "high-risk drugs" that require safety management (e.g., anticoagulants, antidiabetic drugs, and anti-epileptic agents) require the implementation of pharmaceutical management services such as continuous drug administration guidance and adverse drug effect management [11]. Ogawa et al reported that approximately 70% of patients in convalescence rehab wards received high-risk drugs and that pharmacist involvement was therefore an important aspect of appropriate drug administration to ensure safety during rehabilitation [2]. Fujiwara et al found that convalescence rehab wards implemented drug administration guidance, test value checks, adverse drug effect monitoring, and other ward services at significantly lower rates than general hospital wards [12], and reported that both physicians and nurses were strongly in favor of providing drug administration guidance and adverse drug effect monitoring when self-management was in practice and when prescriptions were changed [13].…”

Section: Discussionmentioning

confidence: 99%

“…There is therefore a high risk of adverse drug reactions among the elderly [1]. In addition, a study of elderly patients in convalescence rehab wards showed that 70% of patients used at least one "high-risk drug," such as anticoagulants and cardiovascular agents [2]. Between 37% and 78% of patients who have had a stroke suffer from dysphagia [3].…”

Section: Introductionmentioning

confidence: 99%

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Survey of pharmacist services and status of drug administration to patients with dysphagia in convalescence rehabilitation wards

Otsubo

Kishimoto

Kumaki

et al. 2019

Jpn J Compr Rehabil Sci

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Otsubo H, Kishimoto K, Kumaki R, Akagawa K, Kurata N. Survey of pharmacist services and status of drug administration to patients with dysphagia in convalescence rehabilitation wards. Jpn J Compr Rehabil Sci 2019; 10: 108-116. Objective: To investigate the role of pharmacists through a survey on pharmacist services and the status of drug administration to patients with dysphagia. Methods: A survey of members of the Kaifukuki Rehabilitation Ward Association was conducted using a questionnaire. Results: Investigation of the pharmacist services indicated that in wards in which pharmacist services were provided to ≥90% of in-hospital patients, drugs brought to the hospital by the patients were checked 88.1% of the time, guidance with regard to drug administration was provided 10.5% of the time, and guidance was provided at discharge 35.5% of the time. In many cases, patients with dysphagia were administered drugs in thickener after grinding or as a simple suspension. At 91.4% of the facilities surveyed, this was confirmed by the medical staff, but was directly confirmed by the pharmacist at 26% of facilities. Swallowing ability was assessed at 21.2% of facilities, the name and type of thickener used was checked at 39.3%, and the type of feeding tube used was checked at 73.1%. These implementation rates were positively correlated with the time at which the pharmacist made rounds in the convalescence rehabilitation ward. Conclusion:To increase the involvement of pharmacists in providing drug-taking guidance and caring for patients with dysphagia in convalescence rehabilitation wards throughout the country, measures should be taken to increase their time in the ward.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Survey of pharmacist services and status of drug administration to patients with dysphagia in convalescence rehabilitation wards

Otsubo

Kishimoto

Kumaki

et al. 2019

Jpn J Compr Rehabil Sci

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“…Therefore, it is often the case that stroke patients with CKD are necessarily associated with polypharmacy. Adverse drug reactions or the risk of adverse drug interactions caused by polypharmacy has been reported globally and has become a major obstacle in the safe and reliable treatment of a stroke [20]. In particular in the convalescent rehabilitation ward, we cannot deny the possibility that the expression of adverse drug reactions affects FIM.…”

Section: Discussionmentioning

confidence: 99%

Impact of Polypharmacy on the Rehabilitation Outcome of Japanese Stroke Patients in the Convalescent Rehabilitation Ward

Kose

Maruyama

Okazoe

et al. 2016

Journal of Aging Research

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Background. A risk factor associated with stroke onset is chronic kidney disease (CKD). To prevent stroke reoccurrence, it is necessary to strictly manage blood pressure, lipids, and plasma glucose. Therefore, some cases are forced to polypharmacy, elderly patients in particular. Polypharmacy often leads to adverse drug reactions and has the potential to negatively affect the rehabilitation of stroke patients. The aim of the present study was to investigate the effects of polypharmacy using a functional independence measure (FIM). Methods. A total of 144 stroke patients with CKD were included in the present analysis. We divided stroke patients into those taking six or more drugs (polypharmacy group) and those taking less than six drugs (nonpolypharmacy group) upon admission. Patient background features, laboratory data, and FIM scores were compared. Results. FIM-Motor (FIM-M) efficiency, age, and diabetes mellitus were positively associated with polypharmacy. FIM-M efficiency in the polypharmacy group was significantly lower than in the nonpolypharmacy group. Conclusion. Polypharmacy interferes with the effect of rehabilitation in stroke patients with CKD. Pharmacists and doctors should make efforts to optimize medications to be able to respond to the outcome of each patient.

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“…About 85% of inpatients are elderly, aged ≥ 65 years [1], most of whom have underlying diseases such as hypertension and diabetes mellitus. Furthermore, they are at higher risk of polypharmacy (the number of drugs used exceeds 5 to 6) because of the use of anticoagulants, analgesics, and anti-ulcer drugs in the acute stage ward, and sleep disorders during hospitalization [2,3]. Convalescent rehabilitation wards are more appropriate than acute stage wards for pharmacists to examine the types, use, and dosage of medical drugs for patients with long-term hospitalization.…”

Section: Introductionmentioning

confidence: 99%

Relationship between cognitive function affecting motor Functional Independence Measure and hypnotics

Otsubo

Kishimoto

Hirano³

et al. 2022

Jpn J Compr Rehabil Sci

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Purpose:The purpose of this study was to examine the relationship between cognitive dysfunction affecting motor Functional Independence Measure (FIM) and hypnotics. Methods: This was a retrospective study involving 509 patients aged ≥ 65 years who were discharged from a convalescent rehabilitation ward. Results: Multiple regression analysis was performed with motor FIM efficiency and motor FIM effectiveness (motor FIM-e) as independent variables and the presence or absence of cognitive dysfunction as the dependent variable. The use of hypnotics in patients with cognitive dysfunction showed a positive relationship with motor FIM efficiency (β = 0.147, P = 0.019) and motor FIM-e (β = 0.141, P = 0.026). Multiple regression analyses were performed after further classifying hypnotics by therapeutic class into hypnotics with new mechanisms, non-benzodiazepine (BZ) hypnotics, and BZ hypnotics. Non-BZ hypnotics (β = 0.141, P = 0.021) showed a positive relationship with motor FIM efficiency. Non-BZ hypnotics (β = 0.158, P = 0.009) and BZ hypnotics (β = 0.178, P = 0.003) showed a positive relationship with motor FIM-e, whereas hypnotics with new mechanisms of action did not. In contrast, none of the three combinations of hypnotics showed any significant relationship with either motor FIM efficiency or motor FIM-e in patients without cognitive dysfunction. Conclusion:The results suggested that the use of hypnotics in patients with cognitive dysfunction increases motor FIM efficiency and motor FIM-e.

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Factors Influencing the Number of Drugs among Elderly Patients Hospitalized in a Rehabilitation Ward

Cited by 8 publications

References 19 publications

Survey of pharmacist services and status of drug administration to patients with dysphagia in convalescence rehabilitation wards

Survey of pharmacist services and status of drug administration to patients with dysphagia in convalescence rehabilitation wards

Impact of Polypharmacy on the Rehabilitation Outcome of Japanese Stroke Patients in the Convalescent Rehabilitation Ward

Relationship between cognitive function affecting motor Functional Independence Measure and hypnotics

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