J Am Med Dir Assoc. 2023;24(2):242-249.e7.
Medication-Related Acute Care Admission and Inappropriate Polypharmacy of Nursing Home Residents.
제1저자 김우연 · 교신저자 김광일, 이주연
소속 (5)
- Department of Pharmacy, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea; College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea.
- College of Pharmacy, Yeungnam University, Gyeongsangbuk-do, Republic of Korea.
- Department of Internal Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea.
- Department of Internal Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: kikim907@snubh.org.
- Department of Pharmacy, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea; College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea. Electronic address: jypharm@snu.ac.kr.
Abstract
OBJECTIVES To evaluate the prevalence of medication-related admissions (MRAs) and their association with potentially inappropriate medications (PIMs) used by nursing home residents admitted to the geriatric center of a tertiary hospital.
DESIGN Cross-sectional study.
SETTING AND PARTICIPANTS Older patients admitted from nursing homes to the geriatric center of the Seoul National University Bundang Hospital who had undergone comprehensive geriatric assessment from January 1, 2016, to December 31, 2020.
METHODS MRAs were determined and verified using a previously described MRA adjudication guide. The PIMs in the preadmission medication lists were identified according to each of the following criteria (as well as the combined criteria), the Beers, NORGEP-NH, STOPP/START-NH, and STOPPFrail criteria. Medication use factors associated with MRAs were analyzed using multivariate logistic regression.
RESULTS Among the 304 acute care admissions, 32.2% were MRAs. The main cause of MRAs was acute kidney injury related with use of renin-angiotensin system inhibitors. Approximately 81% of the patients used at least 1 PIM according to the combined criteria. The use of 1 or more PIMs, renin-angiotensin system inhibitors, diuretics, nonsteroidal anti-inflammatory drugs, and benzodiazepines was significantly associated with MRAs. The combined criteria were able to predict MRAs better than the individual criteria.
CONCLUSIONS AND IMPLICATIONS Approximately one-third of acute admissions of nursing home residents may be MRAs. Interventions for the optimal use of medication among nursing home residents are needed.
Copyright © 2022 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
Keywords
Beers criteriaPotentially inappropriate medicationSTOPP/START-NHSTOPPFrailmedication-related admissionnursing home
그 밖의 정보
- 출판 형태
- Journal Article, Research Support, Non-U.S. Gov't
- 저널
- Journal of the American Medical Directors Association · eISSN 1538-9375
- 전자 출판
- 2022-12-15
- MeSH
- Humans · Aged · Inappropriate Prescribing* · Polypharmacy* · Cross-Sectional Studies · Potentially Inappropriate Medication List · Nursing Homes