Emanuele Rocco Villani1, Davide Liborio Vetrano2, Rosa Liperoti3,4, Katie Palmer3, Michael Denkinger5, Henriëtte G van der Roest6, Roberto Bernabei3,4, Graziano Onder7. 1. Department of Geriatrics, Catholic University of the Sacred Heart, Rome, Italy. Emanuele.rocco.villani@gmail.com. 2. Karolinska Institutet, Stockholm, Sweden. 3. Department of Geriatrics, Catholic University of the Sacred Heart, Rome, Italy. 4. Department of Geriatrics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 5. AGAPLESION Bethesda Ulm, Geriatric Research Ulm University and Geriatric Center Ulm/Alb-Donau, Ulm, Germany. 6. Department on Aging, Netherlands Insititute of Mental Health and Addicition (Trimbos Insititute), Utrecht, The Netherlands. 7. Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy.
Abstract
BACKGROUND: 1.5-8% of older adults live in nursing homes (NHs), presenting a high prevalence of frailty and polypharmacy. AIMS: To investigate the association of frailty with polypharmacy and drug prescription patterns in a sample of European Nursing Home (NH) residents. METHODS: Cross-sectional study based on the data from the Services and Health for Elderly in Long TERm care (SHELTER) study. 4121 NH residents in Europe and Israel. Residents' clinical, cognitive, social, and physical status were evaluated with the InterRAI LTCF tool, which allows comprehensive, standardized evaluation of persons living in NH. Polypharmacy and hyperpolypharmacy were defined as the concurrent use of ≥ 5 and ≥ 10 medications. Frailty was defined according to the FRAIL-NH scale. RESULTS: Of 4121 participants, 46.6% were frail (mean age 84.6 ± 9.2 years; 76.4% female). Polypharmacy and hyperpolypharmacy were associated with a lower likelihood of frailty (Odds Ratio = 0.72; 95% CI = 0.59-0.87 and OR = 0.75; 95% CI = 0.60-0.94, respectively). Patterns of drug prescriptions were different between frail and non-frail residents. Symptomatic drugs (laxatives, paracetamol, and opioids) were more frequently prescribed among frail residents, while preventive drugs (bisphosphonates, vitamin D, and acetylsalicylic acid) were more frequently prescribed among non-frail residents. CONCLUSIONS: Frailty is associated with less polypharmacy and with higher prevalence of symptomatic drugs use among NH residents. Further studies are needed to define appropriateness of drug prescription in frail individuals.
BACKGROUND: 1.5-8% of older adults live in nursing homes (NHs), presenting a high prevalence of frailty and polypharmacy. AIMS: To investigate the association of frailty with polypharmacy and drug prescription patterns in a sample of European Nursing Home (NH) residents. METHODS: Cross-sectional study based on the data from the Services and Health for Elderly in Long TERm care (SHELTER) study. 4121 NH residents in Europe and Israel. Residents' clinical, cognitive, social, and physical status were evaluated with the InterRAI LTCF tool, which allows comprehensive, standardized evaluation of persons living in NH. Polypharmacy and hyperpolypharmacy were defined as the concurrent use of ≥ 5 and ≥ 10 medications. Frailty was defined according to the FRAIL-NH scale. RESULTS: Of 4121 participants, 46.6% were frail (mean age 84.6 ± 9.2 years; 76.4% female). Polypharmacy and hyperpolypharmacy were associated with a lower likelihood of frailty (Odds Ratio = 0.72; 95% CI = 0.59-0.87 and OR = 0.75; 95% CI = 0.60-0.94, respectively). Patterns of drug prescriptions were different between frail and non-frail residents. Symptomatic drugs (laxatives, paracetamol, and opioids) were more frequently prescribed among frail residents, while preventive drugs (bisphosphonates, vitamin D, and acetylsalicylic acid) were more frequently prescribed among non-frail residents. CONCLUSIONS: Frailty is associated with less polypharmacy and with higher prevalence of symptomatic drugs use among NH residents. Further studies are needed to define appropriateness of drug prescription in frail individuals.
Authors: Katie Palmer; Emanuele R Villani; Davide L Vetrano; Antonio Cherubini; Alfonso J Cruz-Jentoft; Denis Curtin; Michael Denkinger; Marta Gutiérrez-Valencia; Adalsteinn Guðmundsson; Wilma Knol; Diane V Mak; Denis O'Mahony; Farhad Pazan; Mirko Petrovic; Chakravarthi Rajkumar; Eva Topinkova; Catarina Trevisan; Tischa J M van der Cammen; Rob J van Marum; Martin Wehling; Gijsbertus Ziere; Roberto Bernabei; Graziano Onder Journal: Eur Geriatr Med Date: 2018-11-07 Impact factor: 1.710
Authors: Laura C Maclagan; Colleen J Maxwell; Sima Gandhi; Jun Guan; Chaim M Bell; David B Hogan; Nick Daneman; Sudeep S Gill; Andrew M Morris; Lianne Jeffs; Michael A Campitelli; Dallas P Seitz; Susan E Bronskill Journal: J Am Geriatr Soc Date: 2017-07-28 Impact factor: 5.562
Authors: Shahar Shmuel; Jennifer L Lund; Carolina Alvarez; Christine D Hsu; Priya Palta; Anna Kucharska-Newton; Joanne M Jordan; Amanda E Nelson; Yvonne M Golightly Journal: J Am Geriatr Soc Date: 2019-10-24 Impact factor: 5.562