María Victoria Vivanco1, Francesc Formiga2, Imma Mundet Riera3, Antonio San José Laporte4, David Curto Prieto5. 1. Equipos de Atención a Residencias Geriátricas, Grup Mutuam, Barcelona, España. Electronic address: mvviv3@outlook.com. 2. Unidad de Geriatría, Servicio Medicina Interna, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España. 3. Equipos de Atención a Residencias Geriátricas, Grup Mutuam, Barcelona, España. 4. Unidad de Geriatría, Servicio de Medicina Interna, Hospital Universitario Vall d'Hebron, Barcelona, España. 5. Sanitas Residencial, Sanitas Mayores, Barcelona, España.
Abstract
INTRODUCTION: As frailty and multiple drug therapy often coexists in institutionalised elderly patients, it is important to assess the level of frailty and therapeutic appropriateness in this population group. The aim of the study is to: assess the frailty level of institutionalised elderly patients and to analyse their prescriptions. MATERIAL AND METHODS: An observational and cross-sectional study of a geriatric population of 85 years or older, institutionalised in a nursing home in Barcelona. Frailty was assessed using the Frail-VIG index, and the adequacy of the prescription of each group was done according to the STOPP-Frail Criteria. RESULTS: The study included 79 patients, with a mean age of 90.9±4.2 years. Most of them (96.2%) had some degree of frailty. Slight frailty was observed in 21.5%, moderate in 37.7%, and advanced in 38%. The patients were prescribed a median of 7 drugs. No statistically significant differences were found in the majority of the prescriptions of the frailty groups. Differences were only found for those who had difficulty taking the medication, those who took medication for prostatic hypertrophy, and nutritional supplements. In all 3 groups, it was found that up to one third of the prescription was inappropriate, and some were even contraindicated in the most frail patients. CONCLUSION: The elderly study population has a high frailty index with a high prevalence of multiple drug therapy with inappropriate prescription. The poor individualisation of these prescriptions in relation to the level of frailty, especially in those with short life prognosis, is a situation that should be improved.
INTRODUCTION: As frailty and multiple drug therapy often coexists in institutionalised elderly patients, it is important to assess the level of frailty and therapeutic appropriateness in this population group. The aim of the study is to: assess the frailty level of institutionalised elderly patients and to analyse their prescriptions. MATERIAL AND METHODS: An observational and cross-sectional study of a geriatric population of 85 years or older, institutionalised in a nursing home in Barcelona. Frailty was assessed using the Frail-VIG index, and the adequacy of the prescription of each group was done according to the STOPP-Frail Criteria. RESULTS: The study included 79 patients, with a mean age of 90.9±4.2 years. Most of them (96.2%) had some degree of frailty. Slight frailty was observed in 21.5%, moderate in 37.7%, and advanced in 38%. The patients were prescribed a median of 7 drugs. No statistically significant differences were found in the majority of the prescriptions of the frailty groups. Differences were only found for those who had difficulty taking the medication, those who took medication for prostatic hypertrophy, and nutritional supplements. In all 3 groups, it was found that up to one third of the prescription was inappropriate, and some were even contraindicated in the most frail patients. CONCLUSION: The elderly study population has a high frailty index with a high prevalence of multiple drug therapy with inappropriate prescription. The poor individualisation of these prescriptions in relation to the level of frailty, especially in those with short life prognosis, is a situation that should be improved.
Authors: Ana A Esteban-Burgos; María José Lozano-Terrón; Daniel Puente-Fernandez; César Hueso-Montoro; Rafael Montoya-Juárez; María P García-Caro Journal: Int J Environ Res Public Health Date: 2021-03-19 Impact factor: 3.390