Cargando…

Potentially inappropriate medication use in nursing homes: an observational study using the NORGEP-NH criteria

BACKGROUND: Frail residents in the nursing home sector call for extra care in prescribing. The Norwegian General Practice Nursing Home (NORGEP-NH) list of 34 explicit criteria for potentially inappropriate medication use in nursing homes was developed explicitly for this population. The aim of this...

Descripción completa

Detalles Bibliográficos
Autores principales: Nyborg, Gunhild, Brekke, Mette, Straand, Jørund, Gjelstad, Svein, Romøren, Maria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5606129/
https://www.ncbi.nlm.nih.gov/pubmed/28927372
http://dx.doi.org/10.1186/s12877-017-0608-z
_version_ 1783265110701113344
author Nyborg, Gunhild
Brekke, Mette
Straand, Jørund
Gjelstad, Svein
Romøren, Maria
author_facet Nyborg, Gunhild
Brekke, Mette
Straand, Jørund
Gjelstad, Svein
Romøren, Maria
author_sort Nyborg, Gunhild
collection PubMed
description BACKGROUND: Frail residents in the nursing home sector call for extra care in prescribing. The Norwegian General Practice Nursing Home (NORGEP-NH) list of 34 explicit criteria for potentially inappropriate medication use in nursing homes was developed explicitly for this population. The aim of this study was to employ the NORGEP-NH Criteria to study the extent of potentially inappropriate medication use among nursing home residents and explore possible associated factors. METHODS: Cross-sectional observational pharmacoepidemiological study from residents in nursing homes in the county of Vestfold, Norway. Data collected 2009–11 included residents’ demographic and clinical status and all medications, regular and on demand. RESULTS: 881 patients from 30 institutions (mean 85.9 years, 68.6% female), were included. According to NORGEP-NH, 43.8% were prescribed at least one potentially inappropriate regular medication, and 9.9% regularly received three or more potentially inappropriate medications. When also including a) the NORGEP-NH Deprescribing Criteria and b) including drugs prescribed for use as needed, 92.7% of all residents received medication that needs particular surveillance according to the NORGEP-NH. 69.7% of the nursing home residents used at least one psychotropic drug regularly. Female residents received more often than males at least one potentially inappropriate regular medication (OR 1.60, p=0.007). Regarding the prescription of three or more concomitant psychotropic medications, odds ratio for females was 1.79 (p=0.03) compared to males. Residents with the best performance in activities of daily living, and residents residing in long-term wards, had higher risk of using three or more psychotropic drugs. Use of multiple psychoactive drugs increased the risk of falls in the course of an acute episode of infection or dehydration (odds ratio 1.70, p=0.009). CONCLUSIONS: Prevalence of potentially inappropriate medications in nursing homes according to the NORGEP-NH was extensive, and especially the use of multiple psychotropic drugs. The high prevalence found in this study shows that there is a need for higher awareness of medication use and side effects in the elderly population. TRIAL REGISTRATION: Retrospectively registered. Data obtained from clinical trial NCT01023763 registered with ClinicalTrials.gov 12/01/2009.
format Online
Article
Text
id pubmed-5606129
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-56061292017-09-20 Potentially inappropriate medication use in nursing homes: an observational study using the NORGEP-NH criteria Nyborg, Gunhild Brekke, Mette Straand, Jørund Gjelstad, Svein Romøren, Maria BMC Geriatr Research Article BACKGROUND: Frail residents in the nursing home sector call for extra care in prescribing. The Norwegian General Practice Nursing Home (NORGEP-NH) list of 34 explicit criteria for potentially inappropriate medication use in nursing homes was developed explicitly for this population. The aim of this study was to employ the NORGEP-NH Criteria to study the extent of potentially inappropriate medication use among nursing home residents and explore possible associated factors. METHODS: Cross-sectional observational pharmacoepidemiological study from residents in nursing homes in the county of Vestfold, Norway. Data collected 2009–11 included residents’ demographic and clinical status and all medications, regular and on demand. RESULTS: 881 patients from 30 institutions (mean 85.9 years, 68.6% female), were included. According to NORGEP-NH, 43.8% were prescribed at least one potentially inappropriate regular medication, and 9.9% regularly received three or more potentially inappropriate medications. When also including a) the NORGEP-NH Deprescribing Criteria and b) including drugs prescribed for use as needed, 92.7% of all residents received medication that needs particular surveillance according to the NORGEP-NH. 69.7% of the nursing home residents used at least one psychotropic drug regularly. Female residents received more often than males at least one potentially inappropriate regular medication (OR 1.60, p=0.007). Regarding the prescription of three or more concomitant psychotropic medications, odds ratio for females was 1.79 (p=0.03) compared to males. Residents with the best performance in activities of daily living, and residents residing in long-term wards, had higher risk of using three or more psychotropic drugs. Use of multiple psychoactive drugs increased the risk of falls in the course of an acute episode of infection or dehydration (odds ratio 1.70, p=0.009). CONCLUSIONS: Prevalence of potentially inappropriate medications in nursing homes according to the NORGEP-NH was extensive, and especially the use of multiple psychotropic drugs. The high prevalence found in this study shows that there is a need for higher awareness of medication use and side effects in the elderly population. TRIAL REGISTRATION: Retrospectively registered. Data obtained from clinical trial NCT01023763 registered with ClinicalTrials.gov 12/01/2009. BioMed Central 2017-09-19 /pmc/articles/PMC5606129/ /pubmed/28927372 http://dx.doi.org/10.1186/s12877-017-0608-z Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Nyborg, Gunhild
Brekke, Mette
Straand, Jørund
Gjelstad, Svein
Romøren, Maria
Potentially inappropriate medication use in nursing homes: an observational study using the NORGEP-NH criteria
title Potentially inappropriate medication use in nursing homes: an observational study using the NORGEP-NH criteria
title_full Potentially inappropriate medication use in nursing homes: an observational study using the NORGEP-NH criteria
title_fullStr Potentially inappropriate medication use in nursing homes: an observational study using the NORGEP-NH criteria
title_full_unstemmed Potentially inappropriate medication use in nursing homes: an observational study using the NORGEP-NH criteria
title_short Potentially inappropriate medication use in nursing homes: an observational study using the NORGEP-NH criteria
title_sort potentially inappropriate medication use in nursing homes: an observational study using the norgep-nh criteria
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5606129/
https://www.ncbi.nlm.nih.gov/pubmed/28927372
http://dx.doi.org/10.1186/s12877-017-0608-z
work_keys_str_mv AT nyborggunhild potentiallyinappropriatemedicationuseinnursinghomesanobservationalstudyusingthenorgepnhcriteria
AT brekkemette potentiallyinappropriatemedicationuseinnursinghomesanobservationalstudyusingthenorgepnhcriteria
AT straandjørund potentiallyinappropriatemedicationuseinnursinghomesanobservationalstudyusingthenorgepnhcriteria
AT gjelstadsvein potentiallyinappropriatemedicationuseinnursinghomesanobservationalstudyusingthenorgepnhcriteria
AT romørenmaria potentiallyinappropriatemedicationuseinnursinghomesanobservationalstudyusingthenorgepnhcriteria