Potentially inappropriate medication use and associated factors in residents of long-term care facilities: A nationwide cohort study

Jang, Suhyun; Ah, Young‐Mi; Jang, Sunmee; Kim, Yeji; Lee, Ju‐Yeun; Kim, Jung-Ha

doi:10.3389/fphar.2022.1092533

Cited by 5 publications

(8 citation statements)

References 42 publications

(48 reference statements)

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“…In this cross-sectional study, we estimated the nationwide prevalence of PIM use based on the Beers and Korean criteria and assessed their association with the increased risk of hospitalization or ED visits in older adults living in NHs. We found that more than two-thirds of the NH residents are exposed to PIMs regardless of the type of criteria used, which is consistent with previous studies [ 21 – 23 ]. One study analyzing claims data with a sample of 8,835 NH residents found that 81.6% of residents were exposed to PIMs according to the 2019 Beers criteria during the first year after NH admission [ 21 ].…”

Section: Discussionsupporting

confidence: 92%

“…We found that more than two-thirds of the NH residents are exposed to PIMs regardless of the type of criteria used, which is consistent with previous studies [ 21 – 23 ]. One study analyzing claims data with a sample of 8,835 NH residents found that 81.6% of residents were exposed to PIMs according to the 2019 Beers criteria during the first year after NH admission [ 21 ]. Similarly, a research team in Belgium reported that among 1,410 residents in 54 NHs participating in a cluster-controlled trials, 88.3% of them were prescribed PIMs based on the Beers and STOPP/START criteria [ 22 ].…”

Section: Discussionsupporting

confidence: 92%

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Potentially inappropriate medication use as predictors of hospitalization for residents in nursing home

Chae

Zhao

et al. 2023

BMC Geriatr

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Background Hospitalization of nursing home (NH) residents impose a significant healthcare burden. However, there is still a lack of information regarding the risk of hospitalization from inappropriate prescribing in NH residents. We aimed to estimate the nationwide prevalence of potentially inappropriate medication (PIM) use among NH residents using the Korean tool and 2019 Beers criteria and to assess their associations with hospitalization or emergency department (ED) visits. Methods We included older adults aged 65 years or above who were admitted to NHs between July 2008 and December 2018 using national senior cohort database. The prevalence of PIM use based on the Korean medication review tool and Beers criteria on the date of admission to NH was estimated. And the adjusted hazard ratios (aHRs) of polypharmacy, numbers of PIM, each PIM category for hospitalization/ED visits within 30 days of admission to NH was calculated using Cox proportional hazard model to show the association. Results Among 20,306 NH residents, the average number of medications per person was 7.5 ± 4.7. A total of 89.3% and 67.9% of the NH residents had at least one PIM based on the Korean tool and 2019 Beers criteria, respectively. The risk of ED visits or hospitalization significantly increased with the number of PIMs based on the Korean tool (1–3: aHR = 1.24, CI 1.03–1.49; ≥4: aHR = 1.46, CI 1.20–1.79). Having four or more PIMs based on the Beers criteria increased the risk significantly (aHR = 1.30, CI 1.06–1.53) while using 1–3 PIMs was not significantly associated (aHR = 1.07, CI 0.97–1.19). Residents with any potential medication omission according to the Korean criteria, were at 23% higher risk of hospitalization or ED visits (aHR = 1.23, CI 1.07–1.40). Conclusions This study demonstrated that PIMs, based on the Korean tool and Beers criteria, were prevalent among older adults living in NHs and the use of PIMs were associated with hospitalization or ED visits. The number of PIMs based on the Korean tool showed dose-response increase in the risk of hospitalization or ED visits.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Potentially inappropriate medication use as predictors of hospitalization for residents in nursing home

Chae

Zhao

et al. 2023

BMC Geriatr

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“…PRISCUS list had the lowest identification rate (35.5%), followed by the Beers criteria (90.8%) and finally, the tool with the highest identification rate (96.3%) was the STOPP Criteria [59]. This variability points to a generally high tendency toward prescribing PIM in institutionalized settings, confirmed by our findings (86.5%) and literature suggesting prevalence rates from 79.1% to 96.8% [23,60,61].…”

Section: Discussionsupporting

confidence: 84%

Potentially Inappropriate Medication: A Pilot Study in Institutionalized Older Adults

Andrade,

Nascimento,

Cabrita

et al. 2024

Preprint

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Institutionalized older adults often face complex medication regimens, increasing their risk of adverse drug events due to polypharmacy, overprescribing, medication interactions or the use of Potentially Inappropriate Medications (PIM). However, data on medication use and associated risks in this population remain scarce. This pilot study aimed to characterize the sociodemographic, clinical and pharmacotherapeutic profiles and the use of PIM among institutionalized elders residing in Residential Structures for Elderly People (ERPI) in the Faro municipality, located in the Portuguese region of the Algarve. We conducted a cross-sectional study in a non-randomized sample of 96 participants (mean age: 86.6 ±7.86 years) where trained researchers reviewed medication profiles and identified potentially inappropriate medications using the EU(7)-PIM list. Over 90% of participants exhibited polypharmacy (≥5 medications), with an average of 9.1 ± 4.15 medications per person. About 92% had potential drug interactions, including major and moderate interactions. More than 86% used at least one potentially inappropriate medication, most commonly central nervous system drugs. This pilot study demonstrates that institutionalized older adults may be at high risk of potential medication-related problems. Implementing comprehensive medication review programs and promoting adapted prescribing practices are crucial to optimize medication use and improve the well-being of this vulnerable population.

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“…This may be because constipation in older adults is considered a common symptom of daily life or a physiological consequence of aging [26] or because it has received less research and clinical attention than other geriatric conditions [38]. However, 170,000 people aged 70 and above are reported receiving medical treatment for constipation [39], and the prevalence of constipation is higher in institutionalized older adults, who have more comorbidities and hospitalizations, take an average of 6.1 medications per day, and are more functionally dependent and frail than community-dwelling older adults [40]. Therefore, there is an urgent need for research on constipation in institutionalized older adults.…”

Section: Discussionmentioning

confidence: 99%

Constipation among Korean older adults in long-term care facilities: A scoping review

Jeong,

Jung,

Choi

2024

J Korean Gerontol Nurs

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Purpose: This study synthesized the literature on constipation among Korean older adults in long-term care (LTC) facilities. Methods: This scoping review utilized the Joanna Briggs Institute protocol. We conducted a literature search using Cumulative Index to Nursing and Allied Health, PubMed, PsycINFO, Korean databases Research Information Sharing Service, Korean Studies Information Service System, and ScienceON. Two reviewers independently selected the studies and extracted their characteristics using pretested forms to determine the final inclusion. In total, 473 articles were identified, and eight were used for the final analysis. Results: Quasi-experimental design was the most common research design. Sex, age, state of mobility, admission periods, LTC classification, sleep satisfaction, depressive symptoms, diet type, daily fluid intake, and history of digestion were identified as factors related to constipation. The most widely used constipation measurement method is measuring the frequency of defecation per week. Massage is the most commonly used nursing intervention to relieve constipation. Conclusion: The diversification of research on constipation is necessary to improve the quality of life of older adults living in LTC facilities. Therefore, the use of reliable tools to determine constipation in older adults in LTC facilities should be expanded. There is a need to develop and implement diverse non-pharmacological interventions for older adults in LTC facilities. The results of this study are intended to serve as a basis for the development of constipation programs for Korean older adults in LTC facilities.

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Potentially inappropriate medication use and associated factors in residents of long-term care facilities: A nationwide cohort study

Cited by 5 publications

References 42 publications

Potentially inappropriate medication use as predictors of hospitalization for residents in nursing home

Potentially inappropriate medication use as predictors of hospitalization for residents in nursing home

Potentially Inappropriate Medication: A Pilot Study in Institutionalized Older Adults

Constipation among Korean older adults in long-term care facilities: A scoping review

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