Tomoya Tachi1,2, Manami Otsubo3, Manabu Toyoshima4, Azusa Murayama3, Hayato Katsuno3, Anri Ueno3, Yoshihiro Noguchi3, Satoshi Aoyama5, Masahiro Yasuda5, Takashi Mizui5, Chitoshi Goto5, Hitomi Teramachi6,7. 1. Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, 1-25-4, Daigakunishi, Gifu, 501-1196, Japan. tachi@gifu-pu.ac.jp. 2. Department of Pharmacy, Gifu Municipal Hospital, 7-1, Kashima-cho, Gifu, 500-8513, Japan. tachi@gifu-pu.ac.jp. 3. Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, 1-25-4, Daigakunishi, Gifu, 501-1196, Japan. 4. Department of Pharmacy, Tomei Atsugi Hospital, Funako, 232, Atsugi, Kanagawa, 243-8571, Japan. 5. Department of Pharmacy, Gifu Municipal Hospital, 7-1, Kashima-cho, Gifu, 500-8513, Japan. 6. Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, 1-25-4, Daigakunishi, Gifu, 501-1196, Japan. teramachih@gifu-pu.ac.jp. 7. Laboratory of Community Health Pharmacy, Gifu Pharmaceutical University, 1-25-4, Daigakunishi, Gifu, 501-1196, Japan. teramachih@gifu-pu.ac.jp.
Abstract
BACKGROUND: The Functional Independence Measure (FIM) evaluates the activities of daily living (ADL), and FIM efficiency represents daily improvement in FIM. Polypharmacy affects both ADL and FIM; however, few studies have evaluated its relationship with FIM efficiency. AIM: This retrospective study investigated the effect of polypharmacy on FIM efficiency in patients undergoing rehabilitation at our acute care hospital in 2014. METHODS: We collected data on the patients' age, sex, diagnosis, length of hospital stay, type and duration of rehabilitation, indications for rehabilitation, FIM score before and after rehabilitation, and number of pharmaceuticals being used. Polypharmacy was defined as the administration of five or more pharmaceuticals. Using propensity score matching, we compared the FIM efficiency between the polypharmacy and non-polypharmacy groups (sub-scales and totals). RESULTS: A total of 2455 patients were included. The analytical population included 2168 patients. The analytical population used for propensity score matching included 727 patients in each group (total: 1454 patients). The following FIM sub-scale items were found to be associated with significantly low FIM efficiency in the polypharmacy group: self-care (polypharmacy group FIM efficiency: 0.43 points/day, non-polypharmacy group FIM efficiency: 0.54 points/day) and sphincter control (0.11 points/day and 0.18 points/day, respectively). No significant differences in the FIM efficiency were observed either for any other sub-scales or for totals. DISCUSSION: In the polypharmacy group, self-care and sphincter control, in particular, were associated with inhibited improvement in ADL and FIM. CONCLUSIONS: Reducing polypharmacy among acute-phase patients would allow an earlier return to their normal daily lives.
BACKGROUND: The Functional Independence Measure (FIM) evaluates the activities of daily living (ADL), and FIM efficiency represents daily improvement in FIM. Polypharmacy affects both ADL and FIM; however, few studies have evaluated its relationship with FIM efficiency. AIM: This retrospective study investigated the effect of polypharmacy on FIM efficiency in patients undergoing rehabilitation at our acute care hospital in 2014. METHODS: We collected data on the patients' age, sex, diagnosis, length of hospital stay, type and duration of rehabilitation, indications for rehabilitation, FIM score before and after rehabilitation, and number of pharmaceuticals being used. Polypharmacy was defined as the administration of five or more pharmaceuticals. Using propensity score matching, we compared the FIM efficiency between the polypharmacy and non-polypharmacy groups (sub-scales and totals). RESULTS: A total of 2455 patients were included. The analytical population included 2168 patients. The analytical population used for propensity score matching included 727 patients in each group (total: 1454 patients). The following FIM sub-scale items were found to be associated with significantly low FIM efficiency in the polypharmacy group: self-care (polypharmacy group FIM efficiency: 0.43 points/day, non-polypharmacy group FIM efficiency: 0.54 points/day) and sphincter control (0.11 points/day and 0.18 points/day, respectively). No significant differences in the FIM efficiency were observed either for any other sub-scales or for totals. DISCUSSION: In the polypharmacy group, self-care and sphincter control, in particular, were associated with inhibited improvement in ADL and FIM. CONCLUSIONS: Reducing polypharmacy among acute-phase patients would allow an earlier return to their normal daily lives.
Entities:
Keywords:
Activities of daily living; Functional independence measure; Polypharmacy; Rehabilitation
Authors: Danijela Gnjidic; Sarah N Hilmer; Fiona M Blyth; Vasi Naganathan; Louise Waite; Markus J Seibel; Andrew J McLachlan; Robert G Cumming; David J Handelsman; David G Le Couteur Journal: J Clin Epidemiol Date: 2012-06-27 Impact factor: 6.437
Authors: Danijela Gnjidic; Robert G Cumming; David G Le Couteur; David J Handelsman; Vasi Naganathan; Darrell R Abernethy; Sarah N Hilmer Journal: Br J Clin Pharmacol Date: 2009-07 Impact factor: 4.335