Silvia Giovannini1,2, Henriëtte G van der Roest3, Angelo Carfì4, Harriet Finne-Soveri5, Vjenka Garms-Homolová6, Anja Declercq7, Pálmi V Jónsson8, Hein van Hout3, Davide L Vetrano4,9, Ester Manes Gravina4, Roberto Bernabei4, Graziano Onder4. 1. Department of Gerontology and Geriatrics, A. Gemelli Foundation, School of Medicine, Catholic University of the Sacred Heart, Rome, Italy. silvia_giovannini@yahoo.it. 2. Dipartimento di Scienze Gerontologiche, Geriatriche e Fisiatriche, Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168, Roma, Italy. silvia_giovannini@yahoo.it. 3. Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Institute, VU University Medical Center, Amsterdam, The Netherlands. 4. Department of Gerontology and Geriatrics, A. Gemelli Foundation, School of Medicine, Catholic University of the Sacred Heart, Rome, Italy. 5. National Institute for Health and Welfare, Helsinki, Finland. 6. Department of Economics and Law, HTW Berlin University of Applied Sciences, Berlin, Germany. 7. LUCAS & Center for Sociological Research, KU Leuven, Leuven, Belgium. 8. Department of Geriatrics, Faculty of Medicine, Landspitali University Hospital, University of Iceland, Reykjavík, Iceland. 9. Aging Research Center, Karolinska Institutet, Stockholm, Sweden.
Abstract
BACKGROUND: Home care (HC) patients are characterized by a high level of complexity, which is reflected by the prevalence of multimorbidity and the correlated high drug consumption. This study assesses prevalence and factors associated with polypharmacy in a sample of HC patients in Europe. METHODS: We conducted a cross-sectional analysis on 1873 HC patients from six European countries participating in the Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of community care (IBenC) project. Data were collected using the interResident Assessment Instrument (interRAI) instrument for HC. Polypharmacy status was categorized into three groups: non-polypharmacy (0-4 drugs), polypharmacy (5-9 drugs), and excessive polypharmacy (≥ 10 drugs). Multinomial logistic regressions were used to identify variables associated with polypharmacy and excessive polypharmacy. RESULTS: Polypharmacy was observed in 730 (39.0%) HC patients and excessive polypharmacy in 433 (23.1%). As compared with non-polypharmacy, excessive polypharmacy was directly associated with chronic disease but also with female sex (odds ratio [OR] 1.58; 95% confidence interval [CI] 1.17-2.13), pain (OR 1.51; 95% CI 1.15-1.98), dyspnea (OR 1.37; 95% CI 1.01-1.89), and falls (OR 1.55; 95% CI 1.01-2.40). An inverse association with excessive polypharmacy was shown for age (OR 0.69; 95% CI 0.56-0.83). CONCLUSIONS: Polypharmacy and excessive polypharmacy are common among HC patients in Europe. Factors associated with polypharmacy status include not only co-morbidity but also specific symptoms and age.
BACKGROUND: Home care (HC) patients are characterized by a high level of complexity, which is reflected by the prevalence of multimorbidity and the correlated high drug consumption. This study assesses prevalence and factors associated with polypharmacy in a sample of HC patients in Europe. METHODS: We conducted a cross-sectional analysis on 1873 HC patients from six European countries participating in the Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of community care (IBenC) project. Data were collected using the interResident Assessment Instrument (interRAI) instrument for HC. Polypharmacy status was categorized into three groups: non-polypharmacy (0-4 drugs), polypharmacy (5-9 drugs), and excessive polypharmacy (≥ 10 drugs). Multinomial logistic regressions were used to identify variables associated with polypharmacy and excessive polypharmacy. RESULTS: Polypharmacy was observed in 730 (39.0%) HC patients and excessive polypharmacy in 433 (23.1%). As compared with non-polypharmacy, excessive polypharmacy was directly associated with chronic disease but also with female sex (odds ratio [OR] 1.58; 95% confidence interval [CI] 1.17-2.13), pain (OR 1.51; 95% CI 1.15-1.98), dyspnea (OR 1.37; 95% CI 1.01-1.89), and falls (OR 1.55; 95% CI 1.01-2.40). An inverse association with excessive polypharmacy was shown for age (OR 0.69; 95% CI 0.56-0.83). CONCLUSIONS: Polypharmacy and excessive polypharmacy are common among HC patients in Europe. Factors associated with polypharmacy status include not only co-morbidity but also specific symptoms and age.
Authors: Kathleen M Akgün; Supriya Krishnan; Shelli L Feder; Janet Tate; Jean S Kutner; Kristina Crothers Journal: Am J Hosp Palliat Care Date: 2019-09-24 Impact factor: 2.500
Authors: Miguel Ángel Hernández-Rodríguez; Ermengol Sempere-Verdú; Caterina Vicens-Caldentey; Francisca González-Rubio; Félix Miguel-García; Vicente Palop-Larrea; Ramón Orueta-Sánchez; Óscar Esteban-Jiménez; Mara Sempere-Manuel; María Pilar Arroyo-Aniés; Buenaventura Fernández-San José; José Ignacio de Juan-Roldán; Ignatios Ioakeim-Skoufa Journal: Int J Environ Res Public Health Date: 2021-04-29 Impact factor: 3.390
Authors: Elisa Pelosin; Chiara Ponte; Martina Putzolu; Giovanna Lagravinese; Jeffrey M Hausdorff; Alice Nieuwboer; Pieter Ginis; Lynn Rochester; Lisa Alcock; Bastiaan R Bloem; Freek Nieuwhof; Andrea Cereatti; Ugo Della Croce; Anat Mirelman; Laura Avanzino Journal: Front Aging Neurosci Date: 2022-01-05 Impact factor: 5.750