Prevalence and Associated Factors of Polypharmacy in Nursing Home Residents: A Cross-Sectional Study

Cadenas, Raquel; Diez, M. José; Fernández, Nélida; García, José Alejos; Sahagún, Ana M.; Sierra, Matilde; López, Cristina; Susperregui, Julen; Díez, Raquel

doi:10.3390/ijerph18042037

Cited by 12 publications

(16 citation statements)

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“…The study confirms a high rate of polypharmacy in the NH residents evaluated, which is in line with other studies [ 20 , 21 , 22 ]. Prevalence of polypharmacy has been estimated by the WHO in 38.1–91.2% of long-term care facilities [ 5 , 27 ].…”

Section: Discussionsupporting

confidence: 92%

“…Over the counter (OTC) medications, nutritional supplements, and herbal medicines were not considered. According to previous studies, polypharmacy status was categorised into three groups: non-polypharmacy (0–4 medicines), polypharmacy (5–9 medicines), and excessive polypharmacy (at least 10 medicines) [ 18 , 19 , 20 , 21 , 22 ]. Medications, demographic characteristics (age and gender) and pathologies (International Classification of Diseases, Tenth Revision, ICD-10) of the NH residents were registered.…”

Section: Methodsmentioning

confidence: 99%

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Drug-Related Problems and Polypharmacy in Nursing Home Residents: A Cross-Sectional Study

Díez

Cadenas

Susperregui

et al. 2022

IJERPH

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At present, 19.2% of the Spanish population is aged 65 or older. Polypharmacy is a frequent condition among the elderly, especially in those living in nursing homes, which is associated with adverse outcomes, such as adverse drug events or drug-drug interactions. This study aimed to assess the pattern of polypharmacy in a nursing home in Leon, one of Spain’s most ageing regions, and its relationship with different drug-related problems. A descriptive, observational, and cross-sectional study design was used; 222 residents were involved in this study. Data on drug use were collected from medical charts. Information was screened with the software CheckTheMeds, BOT PLUS and Drug-Reax. Residents were on a median of 7 medicines. Polypharmacy and inappropriate medications were present in 78.8% and 96.8% of residents, respectively. Drug-related problems were present in almost all the populations evaluated. Drug-drug interactions were very common in participants (81.1%), being severe/moderate in 24.7%. A high prevalence of polypharmacy and drug-related problems in the nursing home population assessed has been observed. A significantly higher risk of suffering drug-drug interactions was revealed for increasing polypharmacy and anticholinergic risk. A regular evaluation of drug prescribing in nursing home residents is necessary to minimize drug-related problems risk.

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Section: Discussionsupporting

confidence: 92%

Section: Methodsmentioning

confidence: 99%

Drug-Related Problems and Polypharmacy in Nursing Home Residents: A Cross-Sectional Study

Díez

Cadenas

Susperregui

et al. 2022

IJERPH

Self Cite

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“…The non-polypharmacy group includes residents prescribed zero drugs as this definition has been used in other literature concerning polypharmacy in care homes. 12 , 13 …”

Section: Methodsmentioning

confidence: 99%

“…In the SHELTER study, spanning the Czech Republic, England, Finland, France, Germany, Italy, and the Netherlands, 50% of care homes residents were prescribed 5 to 9 drugs and 24% were prescribed 10 or more drugs. 12 In Spain, 77% of 326 care home residents were prescribed five drugs or more 13 and in Sweden, 65% of nursing home residents in Gothenburg was prescribed 10 or more drugs. 14 Finally, 32% of care homes residents from 147 homes in the United Kingdom were prescribed 10 or more drugs in 2017.…”

Section: Introductionmentioning

confidence: 99%

Polypharmacy and potential drug–drug interactions among Greenland’s care home residents

Albertsen

Sommer

Olsen

et al. 2022

Therapeutic Advances in Drug Safety

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Background: As lifetime expectancy in Greenland is steadily increasing, so is the proportion of elderly Greenlanders. Old age is associated with polypharmacy, and in this study, we aim to describe the prevalence and characteristics of polypharmacy among the care home residents in Greenland. Methods: Eight care homes in Greenland were visited between 2010 and 2016. Questionnaires including information on prescribed medication and comorbidities were collected and analyzed. Drugs were categorized according to Anatomical Therapeutic Chemical (ATC) category, and potential drug–drug interactions (pDDIs) were assessed using the Danish Interaction Database. Polypharmacy was defined as five or more prescribed drugs. Results: All 244 eligible residents were included in the study. The median number of prescribed drugs per resident was six, and women were prescribed more drugs than men (median six versus five). More than 60% of all residents fulfilled the criteria for polypharmacy. The residents in the polypharmacy group had a higher body mass index (26.9 versus 24.3) and more chronic diseases (median two versus one), and more often pulmonary (14% versus 1%) or endocrine disease (22% versus 2%) than in the non-polypharmacy group. The most prescribed drugs belonged to ATC category N (nervous system, 78% of the residents). Finally, pDDIs were found among 61% of the residents and were more common in the capital (77%), which also had the highest proportion of residents with polypharmacy (77%). Conclusion: This is the first study to describe the patterns of polypharmacy and pDDIs among the elderly in care homes in Greenland. Our findings indicate that polypharmacy is as common in Greenland as elsewhere in the Western world, but there are local differences in the prevalence. Plain Language Summary Polypharmacy among the elderly in care homes in Greenland The lifetime expectancy of the Greenlandic population is increasing, and so is the number of elderly Greenlanders. Previous studies have shown that the elderly have a higher risk of being treated with five drugs or more which is called polypharmacy. Polypharmacy can cause unwanted interactions and side effects. In this study, we examine the characteristics of the residents in Greenlandic care homes belonging to this group. Using questionnaires, we gathered information from 244 residents from care homes in eight different towns and settlements in Greenland. Data included types of medication prescribed to the resident, age, gender, cause of stay, and medical history, which allowed us to compare the results between genders and towns. We found that among 244 residents, more than half of all residents were prescribed five or more different drugs, and women were generally prescribed more drugs than men. Those prescribed five or more drugs had a higher body mass index and more diseases than those prescribed fewer drugs. We also found that certain types of medication, mainly painkillers, were the most prescribed. Finally, residents in the care home in Greenland’s capital Nuuk were more often prescribed five or more drugs than elsewhere in Greenland, indicating local differences in Greenland. Our results give an essential insight into the health and medication of the most fragile elderly in Greenland. Polypharmacy seems to be as common here as elsewhere in the Western world and is a point of focus.

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“…Nursing homes are one of the most vulnerable places during the coronavirus (COVID-19) pandemic. Nursing homes accommodate older patients who require exceptional care, and these patients with polypharmacy and multimorbidity are vulnerable to various infections [ 1 , 2 ]. Older patients with COVID-19 have been shown to have a high mortality, and there have been numerous casualties in this population during the pandemic [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Implementation of Infection Control Measures against COVID-19 on the Condition of Japanese Rural Nursing Homes

Ohta¹,

Ryu²,

Sano

2021

IJERPH

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This study aimed to clarify the effect of coronavirus disease (hereafter, COVID-19) control on patients’ health conditions and staff’s working conditions in rural nursing homes. An interventional study including all staff and patients in a rural nursing home was performed from 1 April 2019 to 31 March 2021. Infection control measures against COVID-19 were initiated on 1 April 2020. The primary outcome was the frequency of patients’ medical care visits to the outpatient and emergency departments. The secondary outcome was the number of days-off taken by staff. Each group (pre- and post-COVID-19 control groups) had 48 participants. The number of visits to the outpatient department reduced from the pre-COVID-19 to post-COVID-19 control period the difference in number of visits to the emergency department was not significant, due to the low statistical power. The number of days-off taken by the staff was increased from the pre-COVID-19 to post-COVID-19 control period. This is the first study investigating COVID-19 control measures in a rural nursing home. It may help reduce the number of patient visits to medical facilities without increasing the risk of emergencies. A strict health check of the staff can allow staff to take more days off in rural contexts.

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Prevalence and Associated Factors of Polypharmacy in Nursing Home Residents: A Cross-Sectional Study

Cited by 12 publications

References 50 publications

Drug-Related Problems and Polypharmacy in Nursing Home Residents: A Cross-Sectional Study

Drug-Related Problems and Polypharmacy in Nursing Home Residents: A Cross-Sectional Study

Polypharmacy and potential drug–drug interactions among Greenland’s care home residents

Effects of Implementation of Infection Control Measures against COVID-19 on the Condition of Japanese Rural Nursing Homes

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