Medication use in a cohort of newly admitted nursing home residents (Ageing@NH) in relation to evolving physical and mental health |
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| Affiliation: | 1. Ghent University, Heymans Institute of Pharmacology, Clinical Pharmacology Research Unit, De pintelaan 185 (1 Blok B), 9000, Gent, Belgium;2. Centre for Research and Innovation in Care, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, CDE R.3, 2610, Wilrijk, Antwerp, Belgium;1. Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, CO;2. Veterans Affairs Eastern Colorado Geriatric Research Education and Clinical Center, Denver, CO;3. Department of Preventive Medicine, University of Colorado School of Medicine, Aurora, CO;4. Colorado School of Public Health, Aurora, CO;5. University of Colorado College of Nursing, Aurora, CO;1. Punto de Atención Continuada de Urgencias, Centro de Atención Primaria de Azpeitia, Azpeitia, Gipuzkoa, España;2. Servicio Andaluz de Salud, España;3. Servicio Canario de Salud, España;4. Asesoría Unidad Docente de MFyC, Granada, España;5. Servicio de Medicina Interna, Hospital Universitario San Cecilio, Granada, España;1. Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France;2. Inserm UMR1027, Université de Toulouse III Paul Sabatier, Toulouse, France;3. APHP- Département de Gériatrie, Hôpital Bichat-Claude-Bernard, Paris, France;4. Centre Hospitalier Universitaire de Guadeloupe, Université des Antilles, France;1. Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden;2. Department of Geriatrics, Catholic University of Rome, Italy;1. Ghent University, Heymans Institute of Pharmacology, Clinical Pharmacology Research Unit, Ghent, Belgium;2. Université catholique de Louvain, Louvain Drug Research Institute, Cliniques universitaires Saint-luc, Brussels, Belgium;3. Catholic University of Leuven, Department of Public and Primary Health Care, Leuven, Belgium;1. Trinity Western University, Langley, BC, Canada;2. University of Victoria, Victoria, BC, Canada |
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| Abstract: | BackgroundMedication use is high among nursing home (NH) residents, but there is a lack of longitudinal studies, determining medication use at admission and its evolution over time.AimDescribing the evolution of the medication use two years after entering a NH, compared to the baseline observations and exploring the relation to the physical and mental health.MethodsData from the observational prospective Ageing@NH study, based on an inception cohort of newly admitted residents at NHs (65+) was used, selecting those consenting and with medication chart available. Information about socio-demographic, functional and mental characteristics, as well as medication use, was collected at baseline, year 1 and year 2.ResultsMedication chart was available for n = 741 at baseline (mean age 83.8, 66% female), and for n = 342 residents in year 2. The mean number of total medications increased from 8.9 to 10.1 (p-value < 0.001). Polypharmacy was high, with an increase in extreme polypharmacy from 23% to 32%. The biggest increase was noted in the respiratory (from 17% to 27%) and alimentary medications (from 80% to 87%). Cardiovascular medication use in year 2, was lower in those with stable high dependency (77%) and those evolving from low to high dependency (79%), than those with stable low dependency (89%) (p < 0.025). For residents with or evolving to dementia symptoms, decline in most medication groups was observed, especially in pain and sleeping medications, while antipsychotics use increased.ConclusionAlthough medication use was high, signs of deprescribing were noted when the physical and mental health of the residents declined. |
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| Keywords: | Drug utilization Nursing homes Dementia Functional dependency Longitudinal studies Deprescribing |
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