Polypharmacy in Assisted Living and Impact on Clinical Outcomes

Galik, Elizabeth; Boltz, Marie; Holmes, Sarah; Fix, Steven; Vigne, Erin; Zhu, Shijun; Lewis, Regina

doi:10.4140/tcp.n.2018.321

Cited by 12 publications

(14 citation statements)

References 35 publications

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“…The FFC-AL-EIT is a dissemination and implementation study focused on helping assisted living settings integrate Function Focused Care into routine care (Resnick et al, in press). Function Focused Care is a philosophy of care in which older adults are encouraged to engage in physical activity at their highest level during all care interactions.…”

Section: Methodsmentioning

confidence: 99%

“…This study used baseline data from the first cohort of a study titled Dissemination and Implementation of Function Focused Care for Assisted Living Using the Evidence Integration Triangle (FFC-AL-EIT). The FFC-AL-EIT is a dissemination and implementation study focused on helping assisted living settings integrate function-focused care into routine care (Resnick et al, in press). Function-focused care is a philosophy of care in which older adults are encouraged to engage in physical activity at their highest level during all care interactions.…”

Section: Methodsmentioning

confidence: 99%

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Physical Activity and Function in Assisted Living Residents

et al. 2018

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The purpose of this study was to consider the feasibility, reliability and validity of MotionWatch 8. A total of 249 residents were recruited from 26 assisted living. Data collection included demographics, comorbidities, function (Barthel Index), physical activity (MotionWatch 8), and falls. The mean age of participants was 86.86 (SD=7.0), the majority were women 179 (74%) and white (N=232, 96%). A total of 86% of participants wore the MotionWatch 8. There were no significant differences in physical activity over three days of testing. The MotionWatch 8 findings were significantly associated with ADL function. There were no significant differences in ADL function or physical activity between those who did and did not fall. The study provides additional support for the feasibility, reliability and validity of the MotionWatch 8 and confirms that older adults living in assisted living settings spend the majority of their time in sedentary activity.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Physical Activity and Function in Assisted Living Residents

et al. 2018

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Section: Introductionmentioning

confidence: 99%

“…Polypharmacy (PP) is defined as the co-prescribing of multiple medications or concurrent use of more than five drugs [1][2][3][4][5]. Studies have found a positive correlation between patients experiencing PP and higher age, lower levels of education, and female gender [1]. PP can increase the risk of falls in patients, adverse drug reactions (ADR) caused by drug interaction, medication non-compliance, hospitalization, and damage to physiological capacity [1,[6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…Studies have found a positive correlation between patients experiencing PP and higher age, lower levels of education, and female gender [1]. PP can increase the risk of falls in patients, adverse drug reactions (ADR) caused by drug interaction, medication non-compliance, hospitalization, and damage to physiological capacity [1,[6][7][8][9][10]. Thus, ADRs may be caused by additional drugs to treat adverse effects from another medication, or lack of strong evidence to discontinue certain drugs [1].…”

Section: Introductionmentioning

confidence: 99%

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Potentially Inappropriate Medication among Older Patients Who Are Frequent Users of Outpatient Services

Hsu¹,

Kuan

et al. 2021

IJERPH

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Aging is accompanied by changes in organ degeneration, and susceptibility to multiple diseases, leading to the frequent occurrence of adverse drug reactions resulting from polypharmacy (PP) and potentially inappropriate medications (PIM) in older patients. This study employs a retrospective cohort design and investigates the association of PP with PIM among older patients with high rates of medical utilization. Using records from a national pharmaceutical care database, an experimental group is formed from patients meeting these criteria, who are then offered home pharmaceutical care. Correspondingly, a control group is formed by identifying older patients with regular levels of use of medical services who had been dispensed medications at community pharmacies. Multivariate logistic regression is performed to assess the association between the rate of PIM and variables, including age, gender, and PP. The study finds that experimental PP participants had a higher rate of PIM prescription (odds ratio (OR) = 5.4) than non-PP control participants (all p < 0.001). In clinical practice, additional caution is required to avoid PIMs. Patients engaged in continuously using long-term medication should take precautions in daily life to alleviate related discomforts. Pharmacists should serve as a bridge between patients and physicians to enhance their health and improve their quality of life.

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Mixed Bag “Polypharmacy”: Methodological Pitfalls and Challenges of This Exposure Definition

et al. 2019

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Purpose of Review The use of multiple medications is common in older adults but is associated with negative health outcomes. However, polypharmacy is not uniformly defined, and there is scant data on how the variety of definitions and their limitations hinder the development of sound scientific knowledge. The article intends to illustrate the challenges of this exposure definition. Recent Findings The array of thresholds for defining polypharmacy renders comparisons between results difficult. Few studies take into account the fact that polypharmacy is a changing exposure over time. In addition, although studies tend to recognize the confounding effect of multimorbidity, residual bias remains a concern. Summary Current studies in polypharmacy often ignore basic epidemiological principles for defining exposure. Future research should integrate time-varying exposure and methods to better control confounding bias. This will help determine the positive/ negative impacts of polypharmacy and help establish if polypharmacy conveys information beyond being a marker of health status.

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Polypharmacy in Assisted Living and Impact on Clinical Outcomes

Abstract: Continued research is needed to explore the factors that influence polypharmacy. Identification of these factors will help guide deprescribing so that medication management does not harm older adults physically or cause unnecessary financial burden.

Cited by 12 publications

References 35 publications

Physical Activity and Function in Assisted Living Residents

Physical Activity and Function in Assisted Living Residents

Potentially Inappropriate Medication among Older Patients Who Are Frequent Users of Outpatient Services

Mixed Bag “Polypharmacy”: Methodological Pitfalls and Challenges of This Exposure Definition

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