Medication-Related Acute Care Admission and Inappropriate Polypharmacy of Nursing Home Residents |
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| Institution: | 1. Department of Pharmacy, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea;2. College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea;3. College of Pharmacy, Yeungnam University, Gyeongsangbuk-do, Republic of Korea;4. Department of Internal Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea;5. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea;1. Center for Excellence in Assisted Living (CEAL), Workforce & Quality Innovations, LLC, Bear Creek, NC, USA;2. Center for Excellence in Assisted Living (CEAL), Pioneer Network, Orlando, FL, USA;3. Center for Excellence in Assisted Living (CEAL), AMDA, The Society for Post-Acute and Long-Term Care Medicine, Columbia, MD, USA;4. Center for Excellence in Assisted Living (CEAL), American Assisted Living Nurses Association (AALNA), NAPA, CA, USA;5. Center for Excellence in Assisted Living (CEAL), ADvancing States, Arlington, VA, USA;6. Center for Excellence in Assisted Living (CEAL), Alzheimer’s Association, Washington, DC, USA;7. CLP Consulting, Bloomington, IN, USA;1. Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan;2. Department of Geriatric Medicine, National Yang Ming Chiao Tung University, School of Medicine, Taipei, Taiwan;3. Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan;4. Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan;5. Office of the Deputy Superintendent, National Yang Ming Chiao Tung University Hospital, Yilan County, Taiwan;6. Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan;7. School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan;8. Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan;9. Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan;1. University of California Los Angeles, Center for Health Policy Research, Los Angeles, CA, USA;2. Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA;3. Senior Care Action Network (SCAN) Health Group, Long Beach, CA, USA;4. Division of Geriatric Medicine, University of California Los Angeles, Los Angeles, CA, USA;1. School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR;2. Center for Psycho-Oncological Research and Training, Division of Behavioral Sciences, School of Public Health, The University of Hong Kong, Hong Kong SAR;3. Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong SAR;4. Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands;1. Department of Anesthesiology, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Salt Lake City, UT, USA;2. Department of Anesthesiology, University of Utah School of Medicine, Salt Lake City, UT, USA;3. Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, UT, USA;4. Division of Vascular Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA;1. The Second School of Clinical Medicine, Xuzhou Medical University, Xuzhou, Jiangsu, China;2. Department of Rehabilitation, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China;3. Medical Technology School, Xuzhou Medical University, Xuzhou, Jiangsu, China;4. Department of Medical Imaging, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China |
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| Abstract: | ObjectivesTo evaluate the prevalence of medication-related admissions (MRAs) and their association with potentially inappropriate medications (PIMs) used by nursing home residents admitted to the geriatric center of a tertiary hospital.DesignCross-sectional study.Setting and ParticipantsOlder patients admitted from nursing homes to the geriatric center of the Seoul National University Bundang Hospital who had undergone comprehensive geriatric assessment from January 1, 2016, to December 31, 2020.MethodsMRAs were determined and verified using a previously described MRA adjudication guide. The PIMs in the preadmission medication lists were identified according to each of the following criteria (as well as the combined criteria), the Beers, NORGEP-NH, STOPP/START-NH, and STOPPFrail criteria. Medication use factors associated with MRAs were analyzed using multivariate logistic regression.ResultsAmong the 304 acute care admissions, 32.2% were MRAs. The main cause of MRAs was acute kidney injury related with use of renin-angiotensin system inhibitors. Approximately 81% of the patients used at least 1 PIM according to the combined criteria. The use of 1 or more PIMs, renin-angiotensin system inhibitors, diuretics, nonsteroidal anti-inflammatory drugs, and benzodiazepines was significantly associated with MRAs. The combined criteria were able to predict MRAs better than the individual criteria.Conclusions and ImplicationsApproximately one-third of acute admissions of nursing home residents may be MRAs. Interventions for the optimal use of medication among nursing home residents are needed. |
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| Keywords: | Potentially inappropriate medication nursing home medication-related admission Beers criteria STOPP/START-NH STOPPFrail |
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