Potentially inappropriate prescribing in older patients discharged from acute care hospitals to residential aged care facilities
Poudel, Arjun, Peel, Nancye M., Nissen, Lisa, Mitchell, Charles, Gray, Len C., & Hubbard, Ruth E. (2014) Potentially inappropriate prescribing in older patients discharged from acute care hospitals to residential aged care facilities. The Annals of Pharmacotherapy, 48(11), pp. 1425-1433.
The frequency of prescribing potentially inappropriate medications (PIMs) in older patients remains high despite evidence of adverse outcomes from their use. Little is known about whether admission to hospital has any effect on appropriateness of prescribing.
This study aimed to identify the prevalence and nature of PIMs and explore the association of risk factors for receiving a PIM.
This was a prospective study of 206 patients discharged to residential aged care facilities (RACFs) from acute care. All patients were aged at least 70 years and were admitted between July 2005 and May 2010; their admission and discharge medications were evaluated.
Mean patient age was 84.8 ± 6.7 years; the majority (57%) were older than 85 years and mean (SD) Frailty Index was 0.42 (0.15). At least one PIM was identified in 112 (54.4%) patients on admission and 102 (49.5%) patients on discharge. Of all medications prescribed at admission (1728), 10.8% were PIMs and at discharge of 1759 medications, 9.6% were PIMs. Of total 187 PIMs on admission, 56 (30%) were stopped and 131 were continued; 32 new PIMs were introduced. Of the potential risk factors considered, in-hospital cognitive decline and frailty status were the only significant predictors of PIMs.
Although, admission to hospital is an opportunity to review the indications for specific medications, a high prevalence of inappropriate drug use was observed. The only associations with PIM use were the frailty status and in-hospital cognitive decline. Additional studies are needed to further evaluate this association.
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|Item Type:||Journal Article|
|Keywords:||Beers criteria, frailty, inappropriate prescribing, older patients, residential aged care facilities|
|Subjects:||Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PHARMACOLOGY AND PHARMACEUTICAL SCIENCES (111500)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PHARMACOLOGY AND PHARMACEUTICAL SCIENCES (111500) > Clinical Pharmacology and Therapeutics (111502)
Australian and New Zealand Standard Research Classification
|Divisions:||Current > Schools > School of Clinical Sciences
Current > QUT Faculties and Divisions > Faculty of Health
|Copyright Owner:||Copyright 2014 The Author(s)|
|Deposited On:||21 Jan 2015 05:01|
|Last Modified:||19 Jan 2016 01:08|
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