Rahel Schneider1, Daphne Reinau1, Nadine Schur2, Eva Blozik3, Mathias Früh3, Andri Signorell3, Christoph R Meier4, Matthias Schwenkglenks2. 1. Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Switzerland / Hospital Pharmacy, University Hospital Basel, Switzerland. 2. Institute of Pharmaceutical Medicine (ECPM), University of Basel, Switzerland. 3. Department of Health Sciences, Helsana Group, Zurich, Switzerland. 4. Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Switzerland / Hospital Pharmacy, University Hospital Basel, Switzerland / Boston Collaborative Drug Surveillance Program, Lexington, MA, USA.
Abstract
BACKGROUND: To date, comprehensive data on drug utilisation in Swiss nursing homes are lacking. OBJECTIVE: To describe drug prescription patterns, polypharmacy and potentially inappropriate medication (PIM) in Swiss nursing home residents (NHR). METHODS: Using administrative claims data provided by the Swiss health insurance company Helsana, we assessed drug claims and drug costs in 2016 in individuals aged ≥65 years and insured with Helsana, who were either NHR or living in the community (reference group, RG). In particular, we analysed the prevalence of polypharmacy (≥5 claims for different drugs during a 3-month period) and PIM use according to the 2015 Beers criteria and the PRISCUS list. We standardised the results to the Swiss population. RESULTS: In 2016, NHR had on average nearly twice as many drug claims per capita as individuals in the RG (NHR 58.8; RG 30.8). The average per capita drug costs per day for NHR were low, but higher than in the RG (NHR CHF 8.55; RG CHF 5.45). The same pattern applied to the prevalence of polypharmacy (NHR 85.5%; RG 50.4%). Standardisation by age and sex did not materially alter these observations. Overall, 79.1% of NHR received ≥1 PIM, and 56.2% were long-term users (≥3 claims) of at least one PIM (based on the combined PRISCUS list and Beers criteria). Among all PIMs in nursing homes, quetiapine (antipsychotic agent), lorazepam (anxiolytic agent) and zolpidem (hypnotic agent) were the most prevalent (22.4, 20.2 and 13.0%, respectively). CONCLUSIONS: The high prevalence of polypharmacy and PIM in Swiss nursing homes may indicate a need for interventions aiming at de-prescribing drugs with an unfavourable benefit-risk profile.
BACKGROUND: To date, comprehensive data on drug utilisation in Swiss nursing homes are lacking. OBJECTIVE: To describe drug prescription patterns, polypharmacy and potentially inappropriate medication (PIM) in Swiss nursing home residents (NHR). METHODS: Using administrative claims data provided by the Swiss health insurance company Helsana, we assessed drug claims and drug costs in 2016 in individuals aged ≥65 years and insured with Helsana, who were either NHR or living in the community (reference group, RG). In particular, we analysed the prevalence of polypharmacy (≥5 claims for different drugs during a 3-month period) and PIM use according to the 2015 Beers criteria and the PRISCUS list. We standardised the results to the Swiss population. RESULTS: In 2016, NHR had on average nearly twice as many drug claims per capita as individuals in the RG (NHR 58.8; RG 30.8). The average per capita drug costs per day for NHR were low, but higher than in the RG (NHR CHF 8.55; RG CHF 5.45). The same pattern applied to the prevalence of polypharmacy (NHR 85.5%; RG 50.4%). Standardisation by age and sex did not materially alter these observations. Overall, 79.1% of NHR received ≥1 PIM, and 56.2% were long-term users (≥3 claims) of at least one PIM (based on the combined PRISCUS list and Beers criteria). Among all PIMs in nursing homes, quetiapine (antipsychotic agent), lorazepam (anxiolytic agent) and zolpidem (hypnotic agent) were the most prevalent (22.4, 20.2 and 13.0%, respectively). CONCLUSIONS: The high prevalence of polypharmacy and PIM in Swiss nursing homes may indicate a need for interventions aiming at de-prescribing drugs with an unfavourable benefit-risk profile.
Authors: Sara Mucherino; Manuela Casula; Federica Galimberti; Ilaria Guarino; Elena Olmastroni; Elena Tragni; Valentina Orlando; Enrica Menditto Journal: Int J Environ Res Public Health Date: 2022-05-31 Impact factor: 4.614
Authors: Raquel Cadenas; María José Diez; Nélida Fernández; Juan José García; Ana M Sahagún; Matilde Sierra; Cristina López; Julen Susperregui; Raquel Díez Journal: Int J Environ Res Public Health Date: 2021-02-19 Impact factor: 3.390
Authors: Yael Rachamin; Levy Jäger; Rahel Meier; Thomas Grischott; Oliver Senn; Jakob M Burgstaller; Stefan Markun Journal: Front Pharmacol Date: 2022-02-14 Impact factor: 5.810
Authors: Kevin Migliazza; Caroline Bähler; Daniel Liedtke; Andri Signorell; Stefan Boes; Eva Blozik Journal: BMC Health Serv Res Date: 2021-05-28 Impact factor: 2.655