Potentially Inappropriate Medication Use in Community Residential Care Facilities

Gray, Shelly L.; Hedrick, Susan C.; Rhinard, Ellen E; Sales, Anne; Sullivan, Jean H.; Tornatore, Jane B.; Curtis, Michael

doi:10.1345/aph.1c365

Cited by 36 publications

(18 citation statements)

References 23 publications

(40 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…34 Three of the nine studies 20,25,27,29–34 investigating race found racial determinants of PIM use, but the directions differed by the studied population. 25,31,33 Marital status, 26,33 poverty, 26 education, 26,30,31,34 and length of stay 26,28,33 were not significant determinants of PIM use.…”

Section: Resultsmentioning

confidence: 91%

“…20,24–26,30,32–34 Less impairment in activities of daily living was associated with PIM use in three. 25,26,32 Among residents with severe dementia, severe medical illness as indicated by hospitalization in the last 90 days or a recent physician visit were associated with more PIM use.…”

Section: Resultsmentioning

confidence: 93%

“…20,26,28–31,34 Although in one survey this was significant only among those with advanced dementia, not those with mild to moderate dementia. 31 Lesser cognitive impairment among nursing home residents without dementia was predictive of PIM use in three 20,24,28 of the four studies 30 that investigated this. Mental health diagnoses increased risk of PIM use in four 25,26,31,33 of five studies.…”

Section: Resultsmentioning

confidence: 94%

See 2 more Smart Citations

Determinants of Potentially Inappropriate Medication Use in Long-Term and Acute Care Settings: A Systematic Review

Nothelle

Sharma

Oakes

et al. 2017

Journal of the American Medical Directors Association

View full text Add to dashboard Cite

Background Potentially inappropriate medications (PIM) are widely used in institutionalized older adults, yet the key determinants that drive their use are incompletely characterized. Methods We systematically searched published literature within MEDLINE® and Embase® from January 1998 to March 2017. We searched for studies conducted in the United States that described determinants of PIM use in adults ≥60 years of age in a nursing home or residential care facility, in the Emergency Department (ED), or in the hospital. Paired reviewers independently screened abstracts and full text articles, assessed quality and extracted data. Results Among 30 included articles, 12 examined PIM use in the nursing home or residential care settings, 4 in the ED, 12 in acute-care hospitals, and 2 across settings. The Beers criteria were most frequently used to identify PIM use, which ranged from 3.6 to 92%. Across all settings, the most common determinants of PIM use were medication burden and geographic region. In the nursing home, the most common additional determinants were younger age, and diagnoses of depression or diabetes. In both the ED and hospital, patients receiving care in the West, Midwest, and South, relative to the Northeast, were at greater risk of receiving a PIM. Very few studies examined clinician determinants of PIM use; geriatricians used fewer PIMs in the hospital than other clinicians. Conclusions Among older adults, those who are on many medications are at increased risk for PIM use across multiple settings. We propose that careful testing of interventions that target modifiable determinants are indicated to assess their impact on PIM use.

show abstract

Section: Resultsmentioning

confidence: 91%

Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 94%

See 1 more Smart Citation

Determinants of Potentially Inappropriate Medication Use in Long-Term and Acute Care Settings: A Systematic Review

Nothelle

Sharma

Oakes

et al. 2017

Journal of the American Medical Directors Association

View full text Add to dashboard Cite

show abstract

“…The use of residential care in this population, and errors involving psychotropics in residential care facilities are both common (Sloane et al, 2002;Gray et al, 2003Gray et al, , 2006. A cohort study of adverse drug events (an injury from either an error in prescribing/ physician ordering, dispensing, administration or monitoring, or an adverse drug reaction not associated with an error) in 1,247 long-term care residents (mean age 86 years) found that of all medication classes, anti-psychotics were associated with the greatest risk of an error (adjusted OR 3.4; 95% CI: 2.0 to 5.0; Gurwitz et al, 2005).…”

Section: Potential Risk Factorsmentioning

confidence: 99%

Medication errors in older people with mental health problems: a review

Maidment

Haw

Stubbs

et al. 2007

Int J Geriat Psychiatry

View full text Add to dashboard Cite

show abstract

“…Inappropriate or suboptimal drug prescribing has been documented in older adults who are indigent, homeless, community dwellers, nursing home residents, assisted-living residents, and inpatients. 133,[177][178][179][180][181][182][183][184] Pharmacist impact on inappropriate or suboptimal prescribing and ADRs has been examined either as economic savings or changes in health care outcomes. However, more research is needed to document the impact of a pharmacist on eliminating drugrelated problems and the development of new types of pharmacy services.…”

Section: Research Gaps and Opportunities For Pharmacy And Older Adultsmentioning

confidence: 99%

Pharmacy Practice, Research, Education, and Advocacy for Older Adults

et al. 2005

View full text Add to dashboard Cite

In the United States, older adults have become the fastest growing segment of the population and are expected to double in number to 70 million by 2030. As a whole, older adults have different health care needs than younger patients, and some of these needs should be met by pharmacists. Clinical pharmacy practice affecting older adults occurs in a variety of settings, including community, ambulatory care, primary care, hospital, assisted living, nursing home, home health care, hospice, and Alzheimer's disease units. Although specialty training in geriatrics or gerontology is not required for pharmacists to care for older adults, it is extremely helpful. Pharmacy education related to the care of older adults has improved slightly in the past several years but will need to increase even more to provide all pharmacists with the basic skills and knowledge to care for this unique group of patients. In addition, pharmacotherapy research targeting older adults needs to increase. Although it can be challenging, funding for this type of research is available. Patient and political advocacy is also important to support this growing population.

show abstract

Potentially Inappropriate Medication Use in Community Residential Care Facilities

Abstract: Potentially inappropriate medication use is common among residents in CRC facilities. A comprehensive periodic review may be beneficial for reducing potentially inappropriate use, especially for patients taking multiple drugs.

Cited by 36 publications

References 23 publications

Determinants of Potentially Inappropriate Medication Use in Long-Term and Acute Care Settings: A Systematic Review

Determinants of Potentially Inappropriate Medication Use in Long-Term and Acute Care Settings: A Systematic Review

Medication errors in older people with mental health problems: a review

Pharmacy Practice, Research, Education, and Advocacy for Older Adults

Contact Info

Product

Resources

About